Europace Advance Access published online on December 3, 2008
Europace, doi:10.1093/europace/eun325
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CLINICAL RESEARCH
Implantable cardioverter defibrillators and Chagas' disease: results of the ICD Registry Latin America
1 Hospital Fernandez, Cerviño 3356, Buenos Aires, Argentina; 2 Hospital Monte Sinai, Rua Paissandu 220, Goiana, Brazil; 3 Hospital Ramos Mejia e Insituto Sacre Coeur, Urquiza 609, Buenos Aires, Argentina; 4 Hospital Santa Izabel, Praca Almeida Couto 500, Salvador, Bahía, Brazil; 5 Hospital de Clínicas Caracas, Av. Panteón con Av. Alameda, Caracas, Venezuela; 6 Santa Casa de Goiania, Rua Campinas 1135, Goiana, Brazil; 7 Clínica Medellín, Calle 53 No. 46-38 Piso 2, Medellín, Colombia; 8 Medtronic Latin America, Paraguay 1345, Buenos Aires, Argentina; 9 Medtronic Latin America, 7000 Central Avenue NE, Minneapolis, MN, USA
Aims: Chagas' disease is an endemic parasitic affliction in Latin America. It is frequently associated with ventricular tachyarrhythmia and sudden death. The aim of this study is to assess the evolution of patients with Chagas' disease treated with an implantable cardioverter defibrillator (ICD).
Methods and results: Eighty-nine chagasic patients with ICD were included for analysis from the Medtronic ICD Registry Latin America. At implant, mean age was 59 ± 10 years, and 72% were male. Eighty-one patients (91%) had secondary prevention indications. Mean left ventricular ejection fraction was 40 ± 11%, and mean follow-up was 12 ± 7 months. During follow-up, six patients died (6.7%); three due to congestive heart failure, one due to sudden death, and two due to non-cardiac cause. Hospitalization occurred in seven patients. Thirty-eight patients (42%) received appropriate ICD therapies. A total of 737 episodes were detected by the ICD. The mean period between ICD implantation and the first appropriate therapy was 104 days. Electrical storms were observed in 14 of the 89 patients (15.7%). Inappropriate therapies were observed in seven patients.
Conclusion: This registry confirms that ICD therapy provides protection by effectively terminating life-threatening arrhythmias in patients with Chagas' disease. This is especially so when patients receive the device for secondary prevention.
Key Words: Defibrillators, Chagas' disease, Sudden death, Ventricular arrhythmias, ICD
* Corresponding author: Pedro Morán 3538, Buenos Aires 1419, Argentina. Tel: +54 1145043722, Email: cmuratore{at}intramed.net
Manuscript submitted 8 August 2008. Accepted after revision 7 November 2008.
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