AIMS: Implantable cardioverter-defibrillators (ICDs) are now a first-line option for prevention of sudden death in Chagas disease (ChD). However, efficacy and safety of ICD treatment in ChD remains controversial. The aim of our study was to compare clinical outcome after ICD implantation in ChD and non-ChD patients. METHODS AND RESULTS: The study population consists of patients who received ICD implantation in a tertiary Reference Center for ChD in Brazil. The primary endpoint of the study was appropriate therapy (appropriate shocks or anti-tachycardia pacing); the secondary endpoint was the event-free survival defined as absence of death or appropriate therapy. One hundred and thirty-five [corrected] patients were followed for the median time of 266 days. Sixty-five patients had ChD. Appropriate ICD therapy occurred in 32 (49.2%) ChD and in 19 (27.1%) non-ChD patients (P=0.005). Ventricular tachycardia occurred in 27 (42%) ChD and in 16 (23%) non-ChD (P = 0.01) patients. There was a statistically significant difference in event-free survival between the group of patients with and without ChD (P=0.004). The median event-free survival was 230 days (95% confidence interval, CI: 113-347) in patients with ChD and 549 days (95% CI: 412-687) in non-ChD patients. Chagas disease double the risk of the patient to have appropriate therapy (hazard ratio, HR = 2.2, 95% CI = 1.2-4.3, P = 0.02) and appropriate therapy or death (HR = 2.2, 95% CI = 1.2-4.2, P = 0.01) in multivariate analysis. There were 16 deaths (11.8%) with 8 deaths in each group and five inappropriate shocks (3.7%) with one in ChD patients (1.6%). CONCLUSION: The higher frequency of appropriate ICD therapy and the shorter event-free survival in ChD patients are consistent with the presence of an arrhythmogenic substrate that characterizes this cardiomyopathy.
AIMS: Implantable cardioverter-defibrillators (ICDs) are now a first-line option for prevention of sudden death in Chagas disease (ChD). However, efficacy and safety of ICD treatment in ChD remains controversial. The aim of our study was to compare clinical outcome after ICD implantation in ChD and non-ChD patients. METHODS AND RESULTS: The study population consists of patients who received ICD implantation in a tertiary Reference Center for ChD in Brazil. The primary endpoint of the study was appropriate therapy (appropriate shocks or anti-tachycardia pacing); the secondary endpoint was the event-free survival defined as absence of death or appropriate therapy. One hundred and thirty-five [corrected] patients were followed for the median time of 266 days. Sixty-five patients had ChD. Appropriate ICD therapy occurred in 32 (49.2%) ChD and in 19 (27.1%) non-ChD patients (P=0.005). Ventricular tachycardia occurred in 27 (42%) ChD and in 16 (23%) non-ChD (P = 0.01) patients. There was a statistically significant difference in event-free survival between the group of patients with and without ChD (P=0.004). The median event-free survival was 230 days (95% confidence interval, CI: 113-347) in patients with ChD and 549 days (95% CI: 412-687) in non-ChD patients. Chagas disease double the risk of the patient to have appropriate therapy (hazard ratio, HR = 2.2, 95% CI = 1.2-4.3, P = 0.02) and appropriate therapy or death (HR = 2.2, 95% CI = 1.2-4.2, P = 0.01) in multivariate analysis. There were 16 deaths (11.8%) with 8 deaths in each group and five inappropriate shocks (3.7%) with one in ChD patients (1.6%). CONCLUSION: The higher frequency of appropriate ICD therapy and the shorter event-free survival in ChD patients are consistent with the presence of an arrhythmogenic substrate that characterizes this cardiomyopathy.
Authors: Fernando A Botoni; Antonio Luiz P Ribeiro; Carolina Coimbra Marinho; Marcia Maria Oliveira Lima; Maria do Carmo Pereira Nunes; Manoel Otávio C Rocha Journal: Biomed Res Int Date: 2013-11-24 Impact factor: 3.411
Authors: Arn Migowski; Antonio Luiz Ribeiro; Marilia Sá Carvalho; Vitor Manuel Pereira Azevedo; Rogério Brant Martins Chaves; Lucas de Aquino Hashimoto; Carolina de Aquino Xavier; Regina Maria de Aquino Xavier Journal: BMC Cardiovasc Disord Date: 2015-03-13 Impact factor: 2.298
Authors: Katia do Nascimento Couceiro; Jessica Vanina Ortiz; Mônica Regina Hosannah da Silva E Silva; Débora Raysa Teixeira de Sousa; Kenny Rodrigues de Souza; Gabriela Maciel Alencar; Laylah Kelre Costa Magalhães; Maria das Graças Vale Barbosa Guerra; João Marcos Bemfica Barbosa Ferreira; Jorge Augusto de Oliveira Guerra Journal: Rev Soc Bras Med Trop Date: 2021-03-22 Impact factor: 1.581
Authors: Tereza Augusta Grillo; Guilherme Rafael S Athayde; Ana Flávia L Belfort; Reynaldo C Miranda; Andrea Z Beaton; Bruno R Nascimento Journal: Case Rep Cardiol Date: 2015-11-08