A 51-year-old man who yesterday underwent left - darkhorse

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A 51-year-old man who yesterday underwent left
anterior descending coronary artery stenting for an
acute anterior wall ST-elevation myocardial infarction
begins having frequent premature ventricular contractions
(PVCs). All of the following are correct, except:
a) Frequent PVCs and ventricular couplets signify
an increased mortality risk in the peri-infarct
time period.
b) Suppression of frequent PVCs in the peri-infarct
period with a Class I anti-arrhythmic reduces
mortality.
c) β blockers reduce the risk of postinfarction ventricular
fibrillation.
d) Amiodarone has been shown to reduce postinfarction
arrhythmias but it has not been shown to
reduce mortality.

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B
Isolated premature ventricular contractions (PVCs) are
common after a myocardial infarction (MI). Frequent or
complex PVCs in the post-MI period have been shown to
signify increased mortality, especially in patients with
reduced left ventricular function. The Cardiac Arrhythmia
Suppression Trial (CAST) tested the hypothesis that suppression
of asymptomatic or mildly symptomatic ventricular
arrhythmias after acute MI with the Class IC antiarrhythmics
encainide or flecainide would decrease
mortality during long-term follow-up. The results from
CAST showed that encainide and flecainide caused an
increased cardiovascular mortality with a relative risk of
2.5. As a result, antiarrhythmic suppression of frequent or
complex PVCs after an MI is no longer recommended.