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- Title
Automatic Implantable Cardioverter-Defibrillators in Chagas' Heart Disease Patients with Malignant Ventricular Arrhythmias.
- Authors
CARDINALLI‐NETO, AUGUSTO; GRECO, OSVALDO T.; BESTETTI, REINALDO B.
- Abstract
A total of 46 consecutive Chagas' disease patients had an automatic cardioverter defibrillator implanted at our institution from October 1998 to January 2004. A retrospective longitudinal study was carried out to identity type of life-threatening ventricular arrhythmias as well as type of therapy delivered. Of these, 41 (91%) had been recovered from cardiac arrest. Five (15%) of 33 patients in whom echocardiography was done had no left ventricular function. Antiarrhythmic therapy was delivered to 37 (80%) patients during postimplant follow-up. Thirty-one of 37 (84%) patients received both shock and antitachycardia pacing, five (13%) only antitachycardia pacing, and one (3%) patient only shock. Median time to first shock was 16 days, varying from 1 to 576 days. Ventricular fibrillation was the cause of first shock in 12 patients (32%), ventricular tachycardia in 11 (29%), and ventricular tachycardia not responding to antitachycardia pacing degenerating into ventricular fibrillation in nine (24%). Five patients with ventricular tachycardia were treated with antitachycardia pacing. Probability of freedom from device discharged was 47% at 90 days, 34% at 180 days, and 9% at 360 days in the postimplant follow-up. Thus, patients with chronic Chagas' heart disease recovered from cardiac arrest have a peculiar arrhythmogenic profile characterized by a high frequency of ventricular fibrillation and no left ventricular systolic dysfunction and a short period of time for first shock.
- Subjects
CHAGAS' disease; DEFIBRILLATORS; CARDIAC pacing; VENTRICULAR tachycardia; HEART diseases
- Publication
Pacing & Clinical Electrophysiology, 2006, Vol 29, Issue 5, p467
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.2006.00377.x