Pacemaker Implants in Children and Adolescents with Chagas Disease in Brazil: 18-Year Incidence

Abstract

Background:Chagas disease continues to be a serious public health problem, and accounts for 25-30% of the indications for cardiac stimulation in Brazil.Objective:To assess clinical and epidemiological characteristics of patients with Chagas disease, younger than 18 years, who had undergone pacemaker implantation in Brazil between 1994 and 2011, and its temporal trend.Methods:This was a cross-sectional analysis of data from the Brazilian Pacemaker Registry database. The following variables were analyzed: year when pacemaker was implanted, location, age, sex, ethnic group, functional class and the main electrocardiographic findings at baseline.Results:In a total of 183,123 implants performed between 1994 and 2011, 214 implants of cardiac stimulation device in Chagas disease patients aged younger than 18 years were identified. Mean age at implantation was 5.6 ± 6.2 years. Second- and third-degree atrioventricular blocks corresponded to 71% of indications for pacemaker implantation. Fifty-six percent of the procedures were performed in the southeast region. Regarding the total number of pacemaker implants per year, there was a remarkable increase in the implants for all causes. However, time series analysis of the implants in Chagas disease patients younger than 18 years revealed a significant reduction in the annual number of implants.Conclusion:There has been an important reduction in the number of pacemaker implantations among children and adolescents with Chagas disease, suggesting a reduction in the vertical transmission of the parasite.

Systematic neonatal screening for congenital Chagas disease in Northeast Brazil: prevalence of Trypanosoma cruzi infection in the Southern region of Sergipe

“…A screening test revealed that the general risk of CD via congenital infection is 5% 12,13 , especially in Argentina, Bolivia, and Paraguay. However, in Brazil, this rate decreases to approximately 1% for reasons that are still not completely understood 14 . According to a systematic review, the prevalence of CD in pregnant women varies from 0.1% to 8.5%, and the congenital transmission rate is 0-5.2%.…”

“…The high rates of recovery in congenital cases, as well as the increase in quality of life and prognosis of patients 14 , justify the application of routine screening procedures for CD among pregnant women and newborns in risk areas. However, these measures are neglected in most endemic areas and non-endemic countries that receive Latin American emigrants.…”

“…Most infected children are asymptomatic, and treatment provides a high rate of cure 14 . Therefore, there is a need for strategies for early diagnosis and treatment.…”

Cardiac devices in the pediatric population: an overview of the indications and complications

“…Electron J Gen Med 2019;16(5):em162 http://www.ejgm.co.uk 3 / 5 BIVENTRICULAR PACEMAKERS In 1997 and 2000, no occurrences of biventricular device (BiV) implantation in children were recorded in the US Health Department Kids' Inpatient Database. In 2003 and 2006, there were a combined 82 instances of BiV implantation in children recorded…”