[Clinical predictors of ventricular arrhythmia storms in Chagas cardiomyopathy patients with implantable defibrillators].
OBJECTIVE
To define the predictive factors of electrical storm (ES) in patients with Chronic Chagas Heart Disease (CCh) with an implantable cardioverter defibrillator (ICD).


METHODS
We retrospectively studied 21 consecutive patients with CCh in whom an ICD was implanted between April 2005 and December 2008, with a mean follow up of 867 days. Patients were classified into two groups according to the presence of electrical storm episodes. We compared baseline characteristics, medical treatment and determinants of ventricular function. P values less than 0.05 were considered statistically significant.


RESULTS
Of the 21 patients with CCh there were eight women (37%), mean age 61 years and an EF of 30%. It was noted at least one episode of arrhythmic storm in 9 cases (incidence of 43%). The total number of episodes of arrhythmic storm was 13 and the number of ventricular arrhythmias in each episode of arrhythmic storm was 15.6 (range 3-61). A trigger was identified in only two cases (pulmonary infectious process and decompensation of chronic heart failure). After analyzing the possible predictors of arrhythmic storm was found that a greater percentage of subjects with this complication had an EF <35% (89% vs. 50%, p = 0.01) and NYHA functional class III (66% vs. 8.3%, p = 0.001). In contrast, a lower percentage of subjects with arrhythmic storm were under beta-blocker treatment (55% vs. 100%, p = 0.01).


CONCLUSIONS
In subjects with CCh with an ICD, the following variables are predictive of arrhythmic storm: EF <35%, NYHA functional class III-IV and absence of beta-blocker treatment.
Flores-Ocampo
Jorge
J
Departamento de Electrocardiología del Instituto Nacional de Cardiología Ignacio Chávez, México, DF.
Nava
Santiago
S
Márquez
Manlio F
MF
Gómez-Flores
Jorge
J
Colín
Luis
L
López
Atala
A
Celaya
Manuel
M
Treviño
Ernesto
E
González-Hermosillo
Jesús Antonio
JA
Iturralde
Pedro
P
D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002598:Chagas Cardiomyopathy / Q000150:complications* / Q000628:therapy*; D017147:Defibrillators, Implantable; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies