Another disappointing result with implantable cardioverter-defibrillator therapy in patients with Chagas disease

Rassi, Anis

doi:10.1093/europace/eut092

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…15,34 18 Furthermore, Carmo et al, in a meta-analysis of observational studies, did not find differences in mortality rates between ChD patients with ICDs and those treated with antiarrhythmic drugs. 17 Such findings raised debates in medical literature concerning ICD benefit in patients with Chagas cardiomyopathy, 36,37 once the high burden of ventricular arrhythmias can lead to an increased number of ICD therapies and higher mortality rates. [23][24][25] While our findings regarding the occurrence of VT/VF in the initial period align with previously reported data, the last period of our study showed that the difference in VT/VF rates between Chagas and non-Chagas cardiomyopathy patients became similar, suggesting that the adverse effects of ICD therapies can be mitigated with optimized care.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Carmo et al, in a meta‐analysis of observational studies, did not find differences in mortality rates between ChD patients with ICDs and those treated with antiarrhythmic drugs 17 . Such findings raised debates in medical literature concerning ICD benefit in patients with Chagas cardiomyopathy, 36,37 once the high burden of ventricular arrhythmias can lead to an increased number of ICD therapies and higher mortality rates 23–25 …”

Section: Discussionmentioning

confidence: 99%

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Evaluation of patients with implantable cardioverter‐defibrillator in a Latin American tertiary center

França,

Martins,

de Oliveira

et al. 2024

Cardiovasc electrophysiol

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IntroductionDespite advancements in implantable cardioverter‐defibrillator (ICD) technology, sudden cardiac death (SCD) remains a persistent public health concern. Chagas disease (ChD), prevalent in Brazil, is associated with increased ventricular tachycardia (VT) and ventricular fibrillation (VF) events and SCD compared to other cardiomyopathies.MethodsThis retrospective observational study included patients who received ICDs between October 2007 and December 2018. The study aims to assess whether mortality and VT/VF events decreased in patients who received ICDs during different time periods (2007–2010, 2011–2014, and 2015–2018). Additionally, it seeks to compare the prognosis of ChD patients with non‐ChD patients. Time periods were chosen based on the establishment of the Arrhythmia Service in 2011. The primary outcome was overall mortality, assessed across the entire sample and the three periods. Secondary outcomes included VT/VF events and the combined outcome of death or VT/VF.ResultsOf the 885 patients included, 31% had ChD. Among them, 28% died, 14% had VT/VF events, and 37% experienced death and/or VT/VF. Analysis revealed that period 3 (2015–2018) was associated with better death‐free survival (p = .007). ChD was the only variable associated with a higher rate of VT/VF events (p < .001) and the combined outcome (p = .009).ConclusionMortality and combined outcome rates decreased gradually for ICD patients during the periods 2011–2014 and 2015–2018 compared to the initial period (2007–2010). ChD was associated with higher VT/VF events in ICD patients, only in the first two periods.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of patients with implantable cardioverter‐defibrillator in a Latin American tertiary center

França,

Martins,

de Oliveira

et al. 2024

Cardiovasc electrophysiol

View full text Add to dashboard Cite

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“…68,69 However, the use of ICDs is hampered by the lack of controlled data to establish precise indications and efficacy. [70][71][72] In fact, the evidence on the use of amiodarone, β-blockers, enzyme inhibitors, aldosterone blockers, 73 and devices such as the ICD is not yet conclusive to support or reject their use, 71,72 which is recommended based on limited observational data and the extrapolation of results from other patient populations.…”

Section: Therapeutic Perspectivesmentioning

confidence: 99%

Dysautonomic Arrhythmogenesis: A Working Hypothesis in Chronic Chagas Cardiomyopathy

Pedrosa¹

2020

International Journal of Cardiovascular Sciences

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“…Its most severe clinical manifestations are attributed to the cardiac involvement leading to heart failure, thromboembolic events, arrhythmias and especially sudden death, with digestive tract manifestations occurring in isolation or in association with the cardiac manifestations ( 6 – 9 ). The pathological changes causing megaesophagus and/or megacolon are deemed to be mainly associated with the extensive destruction of the intramural autonomic system, especially of the Auerbach and Meisner myenteric plexuses of patients chronically infected with the T. cruzi ( 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Parasitic Load Correlates With Left Ventricular Dysfunction in Patients With Chronic Chagas Cardiomyopathy

Oliveira

Schmidt

Silva

et al. 2021

Front. Cardiovasc. Med.

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Background: Chronic Chagas disease (CChD), one of the infectious parasitic diseases with the greatest social and economic impact upon a large part of the American continent, has distinct clinical manifestations in humans (cardiac, digestive, or mixed clinical forms). The mechanisms underlying the development of the most common and ominous clinical form, the chronic Chagas cardiomyopathy (CCC) have not been completely elucidated, despite the fact that a high intensity of parasite persistence in the myocardium is deemed responsible for an untoward evolution of the disease. The present study aimed to assess the parasite load CCC and its relation to left ventricular ejection fraction (LVEF), a definite prognostic marker in patients with CCC.Methods: Patients with CCC were clinically evaluated using 12-lead-electrocardiogram, echocardiogram, chest X-ray. Peripheral blood sampling (5 ml of venous blood in guanidine/EDTA) was collected from each patient for subsequent DNA extraction and the quantification of the parasite load using real-time PCR.Results: One-hundred and eighty-one patients with CCC were evaluated. A total of 140 (77.3%) had preserved left ventricular ejection fraction (of ≥40%), and 41 individuals had LV dysfunction (LVEF of <40%). A wide variation in parasite load was observed with a, mean of 1.3460 ± 2.0593 (0.01 to 12.3830) par. Eq./mL. The mean ± SD of the parasite load was 0.6768 ± 0.9874 par. Eq./mL and 3.6312 ± 2.9414 par. Eq./mL in the patients with LVEF ≥ 40% and <40%, respectively.Conclusion: The blood parasite load is highly variable and seems to be directly related to the reduction of LVEF, an important prognostic factor in CCC patients.

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Another disappointing result with implantable cardioverter-defibrillator therapy in patients with Chagas disease

Cited by 7 publications

References 10 publications

Evaluation of patients with implantable cardioverter‐defibrillator in a Latin American tertiary center

Evaluation of patients with implantable cardioverter‐defibrillator in a Latin American tertiary center

Dysautonomic Arrhythmogenesis: A Working Hypothesis in Chronic Chagas Cardiomyopathy

Parasitic Load Correlates With Left Ventricular Dysfunction in Patients With Chronic Chagas Cardiomyopathy

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