Key result
Patients with chronic Chagas cardiomyopathy had a twofold higher risk of receiving appropriate ICD therapies compared to those with ischemic heart disease (HR 2.07), despite similar mortality rates.
Why the study?
Do clinical outcomes and appropriate ICD therapies differ between patients with chronic Chagas cardiomyopathy and ischemic heart disease after ICD implantation?
Cohort (n=153)
No
Do clinical outcomes and appropriate ICD therapies differ between patients with chronic Chagas cardiomyopathy and ischemic heart disease after ICD implantation?
Answers are grounded in this paper and cite their sources.
Patients with chronic Chagas cardiomyopathy receiving an ICD have double the risk of appropriate therapies compared to those with ischemic heart disease, despite similar overall survival.
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.
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Pereira et al. (2016) conducted a cohort in Chronic Chagas cardiomyopathy or ischemic heart disease requiring ICD (n=153). Chronic Chagas cardiomyopathy vs. Ischemic heart disease was evaluated on Appropriate therapies (antitachycardia pacing + appropriate shock) (HR 2.07, 95% CI 1.02-4.17, p=<0.05). Patients with chronic Chagas cardiomyopathy had a twofold higher risk of receiving appropriate ICD therapies compared to those with ischemic heart disease (HR 2.07), despite similar mortality rates.
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