title: The Prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas' Disease: A Meta-Analysis.
abstract: OBJECTIVE
  Chagas' disease (CD) has been associated with atrial fibrillation (AF) and electrocardiographic (ECG) conduction defects. However, prior studies have shown conflicting results. We performed a meta-analysis comparing the prevalence of AF and conduction abnormalities between CD and non-CD patients.
  
  
  METHODS
  PubMed, EMBASE, Cochrane Central, and Latin American databases were searched for studies that directly compared the prevalence of AF and conduction defects in CD and non-CD patients. Odds ratios (OR) were computed using random-effects model due to anticipated heterogeneity. We further performed subanalyses limited to studies that included only patients with cardiomyopathy.
  
  
  RESULTS
  A total of 17,238 patients from 30 studies were included, of whom 6,840 (40%) had a positive serology for CD. In the pooled data, AF was significantly more prevalent in the CD group (OR 1.62; 95%CI 1.21-2.15; P = 0.001). However, no significant difference was observed between groups when the analysis included only patients with cardiomyopathy (OR 1.21; 95%CI 0.97-1.50; P = 0.08) or heart failure (OR 1.09; 95%CI 0.81-1.47; P = 0.55). The combination of right bundle branch block (RBBB) and left anterior fascicular block (LAFB) had the highest OR for increased prevalence in patients with Chagas' cardiomyopathy compared to non-CD etiologies (OR 5.31; 95%CI 1.23-22.86; P = 0.03).
  
  
  CONCLUSIONS
  Our meta-analysis suggests that the prevalence of AF in patients with Chagas' cardiomyopathy is not significantly different from non-CD cardiomyopathies. The pattern of RBBB and LAFB in patients with cardiomyopathy of unknown etiology and epidemiologic risk factors should raise the possibility of CD and prompt specific diagnostic testing.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA.
authors.forename: Rhanderson
authors.initials: R
authors.lastname: Cardoso
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Garcia
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA.
authors.forename: Gilson
authors.initials: G
authors.lastname: Fernandes
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA.
authors.forename: L I
authors.initials: LI
authors.lastname: He
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA.
authors.forename: Paola
authors.initials: P
authors.lastname: Lichtenberger
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Viles-Gonzalez
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA.
authors.forename: James O
authors.initials: JO
authors.lastname: Coffey
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA.
authors.forename: Raul D
authors.initials: RD
authors.lastname: Mitrani
mesh_terms: D000200:Action Potentials; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D002598:Chagas Cardiomyopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016009:Chi-Square Distribution; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors
keywords: Chagas’ disease; atrial fibrillation; electrocardiogram; left anterior fascicular block; left bundle branch block; right bundle branch block