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. 2023 Nov 24;69(12):e20230322.
doi: 10.1590/1806-9282.20230322. eCollection 2023.

Electrophysiological study in chagasics with syncope and conduction disorder

Alexia Hallack Dreicon  1 , Luciana Armaganijan  1 , Dalmo Antonio Ribeiro Moreira  1 , Renato Deláscio Lopes  2 , Bruno Pereira Valdigem  1
Affiliations

Electrophysiological study in chagasics with syncope and conduction disorder

Alexia Hallack Dreicon et al. Rev Assoc Med Bras (1992). .

Abstract

Background: Investigation of syncope involves the use of electrophysiological study, particularly in patients with cardiac conduction disorder. There is conflicting evidence about the role of electrophysiological study in patients with Chagas disease.

Objective: The objective of this study was to evaluate the electrophysiological study findings in patients with Chagas disease and bundle branch block and/or divisional block presenting with syncope.

Methods: This is a retrospective study of patients with Chagas disease and cardiac conduction disorder who underwent electrophysiological study from 2017 to 2021 for the investigation of syncope in a tertiary hospital in São Paulo, Brazil. Those with non-interpretable ECG, known coronary artery disease, and/or other cardiomyopathies were excluded. HV interval and electrophysiological study-induced malignant ventricular arrhythmias data were analyzed.

Results: A total of 45 patients (60.2±11.29 years, 57.8% males) were included. The mean HV interval was 58.37 ms±10.68; 22.2% of the studied population presented an HV interval of ≥70 ms; and malignant ventricular arrhythmias were induced in 57.8% patients. The use of beta-blockers and amiodarone (p=0.002 and 0.036, respectively), NYHA functional class≥II (p=0.013), wide QRS (p=0.047), increased HV interval (p=0.02), Rassi score >6.5 (p=0.003), and reduced left ventricular ejection fraction (p=0.031) were associated with increased risk of inducible malignant ventricular arrhythmias.

Conclusion: More than half of the patients with Chagas disease, syncope, and cardiac conduction disorder have inducible malignant ventricular arrhythmias. Prolonged HV interval was observed in only 20% of population. Wide QRS, prolonged HV, reduced ejection fraction, and higher Rassi score were associated with increased risk of malignant ventricular arrhythmias.

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Conflict of interest statement

Conflicts of interest: the authors declare there is no conflicts of interest.

Figures

Figure 1
Figure 1. Receiver operating characteristic curve for QRS, left ventricular ejection fraction, and Rassi score values in the prediction of VMA.
See this image and copyright information in PMC

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