Chagas disease is associated with a worse prognosis at 1‐year follow‐up after implantable cardioverter‐defibrillator for secondary prevention in heart failure patients

Chagas disease is associated with a worse prognosis at 1‐year follow‐up after implantable cardioverter‐defibrillator for secondary prevention in heart failure patients

Introduction There are conflicting data regarding the efficacy of implantable cardioverter‐defibrillator (ICD) in Chagas disease (CD) patients. This study aims to evaluate the short‐term outcome after ICD for secondary prevention, in a population where CD is a prevalent cause of heart failure (HF)....

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Published in:Journal of cardiovascular electrophysiology Vol. 30; no. 11; pp. 2448 - 2452
Main Authors: Vieira de Melo, Rodrigo M., Azevedo, Diogo F. C., Lira, Yasmin M., Cardoso de Oliveira, Natalia F., Passos, Luiz C. S.
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01-11-2019
Subjects:
Cardiomyopathy
Chagas cardiomyopathy
Chagas disease
Congestive heart failure
Defibrillators
Demographics
Heart failure
implantable cardioverter‐defibrillator
Implantation
Ischemia
Mortality
Multivariate analysis
Prevention
Prognosis
Vector-borne diseases
Ventricle
Chagas disease
heart failure
implantable cardioverter-defibrillator
Chagas cardiomyopathy
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Summary:Introduction There are conflicting data regarding the efficacy of implantable cardioverter‐defibrillator (ICD) in Chagas disease (CD) patients. This study aims to evaluate the short‐term outcome after ICD for secondary prevention, in a population where CD is a prevalent cause of heart failure (HF). Methods and Results Consecutive patients with HF and reduced left ventricular ejection fraction (LVEF), who underwent ICD implantation for secondary prevention of SCD. Clinical and demographic data were collected to investigate mortality predictors at 1 year. During the study period, 117 patients underwent ICD implantation, of which 108 were included. The most frequent causes of HF was CD: 52 (48.1%) and ischemic cardiomyopathy: 20 (18.5%). Chagas and non‐Chagas patients were well balanced—male: 32 (61.5%) vs 38 (67.9%), P = .548; age: 59.2 (±10.9) vs 56.8 (±13.4), P = .681; and LVEF: 34.1 (±0.2) vs 31.3 (±8.7), P = .064, respectively. At the mean follow‐up of 15.7 months, overall mortality occurred in 14 (12.9%) patients, with a higher incidence in patients with CD cardiomyopathy, 11 (21.2%) vs 3 (5.4%), P = .021 (log‐rank). In the multivariate analysis, CD remained as an independent predictor for death (hazard ratio: 4.62, confidence interval [95% CI]: 1.27‐16.81, P = .021). Conclusion CD was associated with a poor short‐term outcome in patients with HF submitted to ICD implantation for secondary prevention when compared with other HF etiologies. In this specific HF population, ICD indication should be individualized, considering the worst prognosis of these patients.
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ISSN:1045-3873
1540-8167
DOI:10.1111/jce.14164