Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2013 Jul;15(7):957-62.
doi: 10.1093/europace/eut011. Epub 2013 Feb 1.

Efficacy and safety of implantable cardioverter-defibrillators in patients with Chagas disease

Marco Paulo Tomaz Barbosa  1 , Manoel Otávio da Costa Rocha, Alexandre Barbosa de Oliveira, Federico Lombardi, Antonio Luiz Pinho Ribeiro
Affiliations
Observational Study

Efficacy and safety of implantable cardioverter-defibrillators in patients with Chagas disease

Marco Paulo Tomaz Barbosa et al. Europace. 2013 Jul.

Erratum in

  • Europace. 2013 Nov;15(11):1684

Abstract

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.

Keywords: Chagas disease; Implantable cardioverter defibrillator; Sudden death; Ventricular arrhythmia.

PubMed Disclaimer

Comment in

Publication types

MeSH terms