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

Abstract

Objective -To assess the impact of syncope during sustained ventricular tachycardia on total and cardiac mortality in patients with chronic chagasic heart disease. Methods -

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

“…Syncope may be due to AV block, but many patients manifest V VS. 554,555 Chagas disease [556][557][558][559] Chagasic cardiomyopathy caused by trypanosomiasis. Syncope and sudden death associated with ventricular tachyarrhythmias.…”

Sudden cardiac death in Chagas' heart disease in the contemporary era

“…This life-threatening ventricular dysrhythmia is a marker of disease progression in Chagas' disease patients at the early stages of the disease [50], and has a recurrence rate of around 50% at a 3-year follow up in patients treated with amiodarone [51,52]. Survival probability at 3-year follow up ranges from 78% to 82% in patients treated with amiodarone [51,52] to 20% in patients with no treatment or treated with quinidine or procainamide [6].…”

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

“…Ventricular arrhythmias are the most frequent and can manifest as isolated ectopies or repetitive forms 206 . The SVT is the most common potentially fatal reentry arrhythmia in patients with CCC and segmentary contractile changes, even when the global systolic function is preserved 24,28,[198][199][200] .…”

“…The SVT is the most common potentially fatal reentry arrhythmia in patients with CCC and segmentary contractile changes, even when the global systolic function is preserved 24,28,[198][199][200] . The arrhythmogenic substrate of that disease is complex, with LV subendocardial, transmural and epicardial scars, which can also affect the right ventricle 200,[201][202][203][204][205][206][207] . Because of that anatomical complexity, the subendocardium or subepicardium (approximately 55% of ventricular tachycardias), or both (transmural circuits), can participate in the reentry circuits of CCC, explaining the presence of episodes of SVT with multiple morphologies 200,201,207 .…”

“…Although ventricular arrhythmias in CD are associated with a higher risk of SD and increased total mortality 70,205,206,208,216 , there is no conclusive evidence that antiarrhythmic drugs have clinically relevant benefits. The most frequent ventricular arrhythmias in chagasic patients are isolated or repetitive ventricular ectopies.…”