Characteristics and identification of sites of chagasic ventricular tachycardia by endocardial mapping

Abstract

Objective -To study electrophysiological characteristics that enable the identification and ablation of sites of chagasic tachycardia. Methods -

Realce Tardio miocárdico por Ressonância Magnética Cardíaca pode identificar risco para Taquicardia Ventricular na Cardiopatia Chagásica Crônica

“…Fibrosis and reentry are the most important substrates and mechanisms for VT in that group, respectively 2,27 . The CMRI with the DE technique provides an excellent correlation with fibrosis 18,19 , including the identification of the inflammatory process due to CCM via endocardial biopsy 28 .…”

“…Ventricular tachycardia (VT) is a common complication of chagas' cardiomyopathy (CCM), resulting from ventricular fibrosis and dysfunction [1][2] . Up to 70% of the patients with CCM have sudden cardiac death (SCD) (annual mortality rate between 0.2% and 19.2%) 1,[3][4][5] .…”

“…Up to 70% of the patients with CCM have sudden cardiac death (SCD) (annual mortality rate between 0.2% and 19.2%) 1,[3][4][5] . In such patients, recurrence of VT is considered the cause of death [2][3] . Cardiac magnetic resonance imaging (CMRI) using the technique of delayed enhancement (DE) has proved to be an important marker of risk in both ischemic (IHD) and non-ischemic (NIHD) heart disease 6,7 .…”

The impact of syncope during clinical presentation of sustained ventricular tachycardia on total and cardiac mortality in patients with chronic Chagasic heart disease

“…The electrophysiological study with programmed ventricular stimulation was performed in all patients, according to stimulation techniques previously reported [10][11][12][13] , using up to 3 extrastimuli with a minimum coupling of 200ms, under 2 cycles of basal stimulation (600 and 450ms) [10][11][12][13] . The patients were classified according to the presence (group I) or absence (group II) of syncope during clinical presentation of sustained ventricular tachycardia.…”

I Diretriz Latino-Americana para o Diagnóstico e Tratamento da Cardiopatia Chagásica

“…Diabetes mellitus can lead to the impairment of the epicardial coronary arteries and of the microcirculation, which, in patients with CD, have already been previously affected. Recent studies have shown that T. cruzi-infected diabetic rats die at a higher rate, and have a change in the metabolism of adipose cells, suggesting that, although very initially, inflammation in that tissue could be related to the development of cardiopathy 192 .…”