Congestive heart failure after acute myocardial infarction in patients receiving antiarrhythmic agents for ventricular premature complexes (Cardiac Arrhythmia Pilot Study)

Am J Cardiol. 1989 Feb 15;63(7):393-8. doi: 10.1016/0002-9149(89)90306-8.


The Cardiac Arrhythmia Pilot Study (CAPS) was a randomized, double-blind trial of antiarrhythmic drugs (encainide, flecainide, moricizine, imipramine and placebo) in 502 patients with an ejection fraction greater than 0.20 and at least 10 ventricular premature complexes/hour, 6 to 60 days after acute myocardial infarction. Patients were followed for 1 year and the incidence of new or worsened congestive heart failure (CHF) was evaluated. Heart failure in the 1-year follow-up was gauged by the development (in order of increasing severity) of new symptoms (grade 1), the need for a change in therapy, including addition of digitalis, addition or increase of dose of diuretics or afterload reduction agents or discontinuation of beta-blocking agents (grade 2), or by hospitalization (grade 3). Sixty-one of 502 patients (12%) required hospitalization for CHF in the 1-year follow-up. One hundred five of 403 patients (26%) in the active treatment group and 18 of 99 patients (18%) in the placebo group (difference not significant) developed CHF requiring hospitalization or a change in therapy or both. Although patients with severely impaired ejection fraction were excluded, new or worsened CHF was common in follow-up during CAPS.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anilides / adverse effects
  • Anti-Arrhythmia Agents / adverse effects*
  • Cardiac Complexes, Premature / drug therapy
  • Cardiac Complexes, Premature / etiology
  • Double-Blind Method
  • Encainide
  • Female
  • Flecainide / adverse effects
  • Heart Failure / chemically induced
  • Heart Failure / etiology*
  • Heart Failure / mortality
  • Humans
  • Imipramine / adverse effects
  • Male
  • Middle Aged
  • Moricizine
  • Myocardial Infarction / complications*
  • Phenothiazines / adverse effects
  • Random Allocation
  • Stroke Volume / drug effects


  • Anilides
  • Anti-Arrhythmia Agents
  • Phenothiazines
  • Moricizine
  • Flecainide
  • Imipramine
  • Encainide