Long-Term Follow-Up of Patients with Chronic Chagas Disease and Implantable Cardioverter-Defibrillator

Background/Objectives Chronic Chagas heart disease (ChHD) is associated with ventricular tachyarrhythmias and an increased risk of sudden cardiac death. Little is known about the effectiveness of implantable cardioverter‐defibrillator (ICD) therapy in this population. The objective of this study was...

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Published in:Pacing and clinical electrophysiology 2014-06, Vol.37 (6), p.751-756
Main Authors: PEREIRA, FRANCISCA TATIANA MOREIRA, ROCHA, EDUARDO ARRAIS, MONTEIRO, MARCELO DE PAULA MARTINS, NETO, ALMINO CAVALCANTE ROCHA, DAHER, ELISABETH DE FRANCESCO, SOBRINHO, CARLOS ROBERTO MARTINS RODRIGUES, NETO, ROBERTO DA JUSTA PIRES
Format: Article
Language:English
Subjects:
Brazil - epidemiology
Chagas Cardiomyopathy - mortality
Chagas Cardiomyopathy - therapy
Chronic Disease
Cohort Studies
Comorbidity
CRT
Death, Sudden, Cardiac - epidemiology
Death, Sudden, Cardiac - prevention & control
defibrillation-ICD
Defibrillators, Implantable - statistics & numerical data
Devices
Female
Follow-Up Studies
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Retrospective Studies
Risk Assessment
Survival Rate
Treatment Outcome
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Summary:Background/Objectives Chronic Chagas heart disease (ChHD) is associated with ventricular tachyarrhythmias and an increased risk of sudden cardiac death. Little is known about the effectiveness of implantable cardioverter‐defibrillator (ICD) therapy in this population. The objective of this study was to evaluate the efficacy of ICD in patients with ChHD and to identify predictors of mortality and appropriate ICD shocks. Methods The cohort study included 65 patients with ChHD and ICD for primary and secondary prevention of sudden death. The Cox model was applied to evaluate the predictors of mortality, and survival was assessed by Kaplan‐Meier analysis. Results The median age was 56 ± 11.9 years. The median follow‐up was 40 ± 26.8 months. Among the patients 23 (36.5%) had appropriate shocks. A total of 13 (20%) patients died (6.1% of annual mortality rate), and there was no sudden death. In univariate Cox model, functional class IV (hazard ratio [HR] = 1.99; 95% confidence interval [CI], 1.05–3.76; P = 0.034), primary prevention (HR = 0.29; 95% CI, 0.09–0.99; P = 0.048), lower education (HR = 2.51; 95% CI, 1.05–5.99; P = 0.038), and ejection fraction
ISSN:0147-8389
1540-8159
DOI:10.1111/pace.12342