Estudo clínico e epidemiológico de pacientes submetidos a implante de marcapasso cardíaco artificial permanente: comparação dos portadores da doença de Chagas com os de doenças degenerativas do sistema de condução

Abstract

Objective: To study patients with permanent cardiac pacemakers, comparing the clinical and epidemiological characteristics of patients with Chagas' disease versus those with degenerative or ischemic diseases. Method: 57,632 procedures performed from 1995 to 2003, registered in the Brazilian Pacemaker Register were analyzed: 25,648 patients with Chagas' disease and 31,984 with degenerative or ischemic bradyarrhythmias. The comparison of the characteristics of these two populations included Chi-square and Student T tests, with a 5% level of significance. Results: There was a predominance of the Chagas' disease in the Central-west region, in the initial implants. In reoperations, the population with Chagas' disease represented the majority in the Southeast, too. Mean age was 59.3 ± 15.3 and 58.6 ± 14.8, respectively for initial implants and reoperations in Chagas' disease patients and 73.5 ± 12.6 and 73.7 ± 13.5, in non-Chagas' disease patients. There was no difference in respect to both genders and etiology. Syncope episodes and 3rd degree A-V blocks with wide QRS were more frequent in patients with Chagas' disease, and dizziness, heart failure and 3rd degree A-V blocks with in the other patients. Ventricular pacing systems were used in 60% and 63% in the initial implants and 77% and 76% of the reoperations, respectively for Chagas' and non-Chagas' disease patients. The need to change the batteries was the main reason for reoperations in 76.1% and 79.6% of these procedures, respectively for patients with Chagas' disease and the other causes of bradicardia. Conclusions: The analysis of data of these two populations demonstrated significant differences in the clinical and demographic characteristics.

Current and emerging therapeutic options for the treatment of chronic chagasic cardiomyopathy

“…Despite sick sinus syndrome being the most frequent reason for implantation, single-chamber ventricular pacing is frequently used to treat these patients 46,49. Some economical limitations may account for this medical decision but lack of official data makes this comment purely speculative.…”

Perfil clínico de pacientes chagásicos e não-chagásicos portadores de marca-passo cardíaco artificial

“…Achado semelhante ao estudo de Costa e cols no qual foram comparadas características clínicas e epidemiológicas de pacientes chagásicos e não-chagásicos submetidos a implante de marca-passo cardíaco. Considerou-se, neste estudo, que o fato do grupo chagásico ser mais jovem tinha implicações importantes, sendo o responsável pelo maior número de reoperações nestes pacientes 8 .…”

Efeitos da mudança de modo de estimulação ventricular para atrioventricular sobre a qualidade de vida em pacientes com cardiopatia chagásica e bloqueio atrioventricular na troca eletiva do gerador de pulsos

“…These patients presented essential differences when compared to patients with degenerative atrioventricular blocks: they are younger at the moment of the initial pacemaker implantation and as they have a greater survival rate, thus they are submitted to more pulse generator replacements [5].…”

“…Theoretically more physiological stimulation modes cause a greater impact in the quality of life of these patients [4,5].…”