Dr. Maria Araneta confirmed that arrhythmia caused Ernst's death. But what caused the arrhythmia?

A blood clot probably led to a heart attack which produced the arrhythmia, she said. Clots and heart attacks are exactly the sorts of cardiovascular events that studies found Vioxx could cause.
Clot Vanishes
So, why didn't she find evidence of a clot or heart attack while performing the autopsy? The clot could have been dislodged during attempts to revive Ernst, and the heart attack killed him so quickly that it left no telltale damage, Araneta testified.
After all, something must have caused the irregular beat. Ernst, a marathon runner, had no previous heart problems when he died in his sleep at age 59, Lanier argued.
On the other hand, a defense expert called Ernst a ``walking time bomb'' because his arteries were so heavily clogged.
Probably. Maybe. Could be. Might not.
What killed Ernst was the threshold question. Answer that it wasn't Vioxx, and the case is over. Answer that it was, and you get to say just how evil Merck was, punish it and send a message to drug companies to take patients' lives more seriously.