Key result
LVEF <30% linked to ~12-fold higher odds of death or hospitalization in Chagas cardiomyopathy.
Why the study?
Despite the broad use of pacemakers, ICDs, and CRT in patients with chronic Chagas cardiomyopathy, evidence regarding patient characteristics and clinical outcomes with these implantable cardiac devices remains limited.
Does implantable cardiac device therapy improve functional status and clinical outcomes (death or hospitalization) in adults with chronic Chagas cardiomyopathy?
Cohort (n=50)
No
Does implantable cardiac device therapy improve functional status and clinical outcomes (death or hospitalization) in adults with chronic Chagas cardiomyopathy?
In patients with chronic Chagas cardiomyopathy and advanced cardiac disease, implantable cardiac devices—especially CRT-D—are associated with NYHA functional improvement and a potentially delayed CRT response at 12 months, while advanced age, LVEF <30%, severe mitral regurgitation, and sustained VT predict worse outcomes.
High-risk Chagas device patients warrant closer monitoring; extends sparse outcome data but remains hypothesis-generating.
Background Chronic Chagas cardiomyopathy (CCC) features conduction disease, ventricular arrhythmias and progressive heart failure. Despite broad use of pacemakers, implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy (CRT), evidence in CCC remains limited. Objective To describe characteristics and outcomes of CCC patients with implantable cardiac devices in a Colombian referral center. Methods Retrospective cohort of adults (≥18 years) with confirmed CCC and a cardiac device, followed at our Clinic from 2004–2025. We captured sociodemographic, ECG/echocardiographic and device variables. Outcomes included heart-failure/arrhythmia hospitalizations, NYHA class change and mortality. Predictors of a composite endpoint (death or hospitalization) were assessed by logistic regression. Results Fifty patients were included (mean age 64.2 years; 42% men; rural origin). Right bundle branch block (52%), atrial fibrillation (44%), chronic kidney disease (50%) and left-ventricular apical aneurysm (34%) were common. Devices were ICD 38.7%, CRT-D 38.7%, pacemaker 18.3% and CRT-P 4.0%; CRT was used in 21 patients (42%) with high biventricular pacing (mean 96.5%). NYHA class improved after implantation, mainly among baseline NYHA III patients, and CRT response was more often documented at 12 months than at 6 months. Event-free survival appeared higher in CRT-D recipients. Worse outcomes were associated with age >65 years (OR 9.2), LVEF <30% (OR 12.2), severe mitral regurgitation (OR 2.7) and sustained ventricular tachycardia (OR 11.1). Conclusions CCC patients receiving devices have advanced electrical and structural disease. Device therapy—particularly CRT-D—was associated with functional improvement and a potentially delayed CRT response, highlighting the importance of careful candidate selection and follow-up in endemic settings.Kaplan Meier curve
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Franco et al. (2026) conducted a cohort in Chronic Chagas cardiomyopathy (n=50). Implantable cardiac devices (ICD, CRT-D, pacemaker, CRT-P) was evaluated on Composite of death or heart-failure/arrhythmia hospitalization. Implantable cardiac devices in Chagas cardiomyopathy improved NYHA class, while LVEF <30% (OR 12.2), sustained VT (OR 11.1), and age >65 (OR 9.2) predicted death or hospitalization.
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