Clinical Course After Cardioverter-Defibrillator Implantation: Chagasic Versus Ischemic Patients

Arq Bras Cardiol. 2016 Aug;107(2):99-100. doi: 10.5935/abc.20160101. Epub 2016 Jul 11.
[Article in English, Portuguese]

Abstract

Background: The outcome of Chagas disease patients after receiving implantable cardioverter defibrillator (ICD) is still controversial.

Objective: To compare clinical outcomes after ICD implantation in patients with chronic Chagas cardiomyopathy (CCC) and ischemic heart disease (IHD).

Methods: Prospective study of a population of 153 patients receiving ICD (65 with CCC and 88 with IHD). The devices were implanted between 2003 and 2011. Survival rates and event-free survival were compared.

Results: The groups were similar regarding sex, functional class and ejection fraction. Ischemic patients were, on average, 10 years older than CCC patients (p < 0.05). Patients with CCC had lower schooling and monthly income than IHD patients (p < 0.05). The number of appropriate therapies was 2.07 higher in CCC patients, who had a greater incidence of appropriate shock (p < 0.05). Annual mortality rate and electrical storm incidence were similar in both groups. There was no sudden death in CCC patients, and only one in IHD patients. Neither survival time (p = 0.720) nor event-free survival (p = 0.143) significantly differed between the groups.

Conclusion: CCC doubles the risk of receiving appropriate therapies as compared to IHD, showing the greater complexity of arrhythmias in Chagas patients.

MeSH terms

  • Adult
  • Aged
  • Chagas Cardiomyopathy / mortality
  • Chagas Cardiomyopathy / therapy*
  • Cohort Studies
  • Defibrillators, Implantable / statistics & numerical data*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / mortality
  • Myocardial Ischemia / therapy*
  • Prospective Studies
  • Survival Rate
  • Treatment Outcome