Probability of occurrence of life-threatening ventricular arrhythmias in Chagas' disease versus non-Chagas' disease.
The implantable cardioverter defibrillator (ICD) is highly effective in the treatment of ventricular arrhythmias (VA) responsible for sudden cardiac death. However, the probability of occurrence of these arrhythmic events in presence of cardiomyopathy remains uncertain. The aim of this study was to compare the probability of nonoccurrence of life-threatening VA in ICD recipients with Chagas' versus non-Chagas' heart disease. Over a mean follow-up of 10.5 months, 53 ICD recipients (mean age = 50.1 years, 48 male) were evaluated. Eleven patients had Chagas' heart disease, 19 had idiopathic dilated cardiomyopathy and 23 had ischemic cardiomyopathy. Ventricular tachyarrhythmias with a cycle length < 315 ms were considered life-threatening. The cumulative probability of nonoccurrence of life-threatening VA was examined by Kaplan-Meyer method and the outcomes were submitted to the log rank test. At 2 years, the cumulative probability of life-threatening VA nonoccurrence was 0 in the Chagas' heart disease group versus 40% up to 55 months of follow-up in the non-Chagas' disease group (P = 0.0097). Among patients with cardiomyopathies of different etiologies, those with Chagas' heart disease had the lowest cumulative probability of nonoccurrence of life-threatening VA, confirming its unfavorable prognosis and the importance of preventive measures against sudden death in this disease.
Martinelli Filho
M
M
InCor Heart Institute, University of São Paulo, São Paolo, Brazil. martino@incor.usp.br
De Siqueira
S F
SF
Moreira
H
H
Fagundes
A
A
Pedrosa
A
A
Nishioka
S D
SD
Costa
R
R
Scanavacca
M
M
D'Avila
A
A
Sosa
E
E
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology*; D002598:Chagas Cardiomyopathy / Q000453:epidemiology*; D015897:Comorbidity; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D018570:Risk Assessment; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000453:epidemiology