Electrical Storm in Chagas Cardiomyopathy Clinical Predictors, Outcome, and Arrhythmic Characteristics in a Prospective Registry

Autor(es)

Ribeiro Cury Pavao, Maria Licia ^[1] ; Arfelli, Elerson ^[1] ; Scorzoni-Filho, Adilson ^[2] ; Pavao, Rafael Brolio ^[1] ; Pazin-Filho, Antonio ^[1] ; Marin-Neto, Jose Antonio ^[1] ; Schmidt, Andre ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Internal Med Dept, Cardiol Div, Ribeirao Preto - Brazil

^[2] Univ Sao Paulo, Ribeirao Preto Med Sch, Surg Dept, Ribeirao Preto - Brazil

• Tipo de documento: Artigo Científico
• Fonte: JACC-CLINICAL ELECTROPHYSIOLOGY; v. 6, n. 10, p. 1238-1245, OCT 2020.
• Citações Web of Science: 0

Resumo

OBJECTIVES This study of patients with Chagas heart disease (CHD) with an implantable cardioverter-defibrillator (ICD) for secondary prevention of sudden cardiac death sought to compare the characteristics of those with or without electrical storm (ES) during long-term follow-up. BACKGROUND ES is a common problem in patients with CHD harboring an ICD, but data on clinical predictors and outcomes are limited. METHODS The authors retrospectively evaluated 110 patients with CHD with a mean follow-up of 1,949 +/- 1,271 days. Demographic, clinical, arrhythmia characteristics, ICD treatment, and death data were collected. Descriptive statistics included mean +/- SD and Fisher exact tests used for comparisons. A p value <0.05 was considered significant. RESULTS The ES group (n = 57; 43 men; age 62 +/- 10 years) and the non-ES group (n = 53; 43 men; age 57 +/- 14 years) had similar baseline demographic and clinical parameters, but left ventricular ejection fraction was higher in the ES group (44 +/- 14% vs. 37 +/- 14%; p = 0.02) and QRS duration was shorter (109 +/- 35 ms vs. 134 +/- 36 ms; p = 0.0027). Mortality rates were comparable in the 2 groups (odds ratio: 1.2; 95% confidence interval: 0.79 to 1.85; p = 0.44). The ES group presented 116 ES (2.03 +/- 1.47, 1 to 6). A total of 2,953 (61%) arrhythmic events required ICD therapy. No deaths occurred directly caused by ES, but clinical triggers were reported in 20 patients. CONCLUSIONS ES is frequent in CHD but in itself does not carry a worse prognosis in this study population and was not associated with a more depressed left ventricular systolic function or a longer QRS. (C) 2020 by the American College of Cardiology Foundation. (AU)

• Processo FAPESP: 16/25403-9 - Investigações sobre etiopatogenia, fisiopatologia e terapêutica em humanos e em modelo experimental com a cardiomiopatia da Doença de Chagas
• Beneficiário: José Antonio Marin-Neto
• Modalidade de apoio: Auxílio à Pesquisa - Temático