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Permanent pacing in patients with Chagas' disease
Mauricio Arce1, Jorge VAN Grieken, Francisco Femenía
1Unidad de Arritmias, Departamento de Cardiología, Hospital Español de Mendoza, Godoy Cruz, Argentina.
Pacing and Clinical Electrophysiology : PACE
|October 20, 2012
Summary
Patients with Chagas cardiomyopathy (ChCM) require pacemakers more often due to sinus node dysfunction. Chagas cardiomyopathy patients are younger, have longer implant times, higher pacing thresholds, and higher rates of new atrial fibrillation post-pacemaker implantation compared to ischemic cardiomyopathy patients.
Area of Science:
- Cardiology
- Electrophysiology
- Infectious Diseases
Background:
- Chagas' disease is a significant public health issue in Latin America, frequently leading to Chagas cardiomyopathy (ChCM).
- Bradycardia associated with ChCM often necessitates permanent pacemaker implantation.
- Comparing ChCM with ischemic cardiomyopathy (ICM) provides insights into pacemaker management for distinct etiologies.
Purpose of the Study:
- To compare pacemaker implantation indications, intraoperative parameters, and long-term outcomes in patients with ChCM versus ICM.
- To identify differences in patient demographics and underlying cardiac conditions between the two groups.
- To evaluate the safety and efficacy of pacemaker implantation in ChCM patients.
Main Methods:
- A retrospective study analyzed 360 patients undergoing pacemaker implantation.
- Patients were divided into two groups: Chagas' cardiomyopathy (ChCM) and ischemic cardiomyopathy (ICM).
- Data collected included patient demographics, indications for pacing, intraoperative measurements, and long-term follow-up outcomes.
Main Results:
- ChCM patients were younger (66 vs. 75 years) and more frequently male (72% vs. 60%).
- Sinus node dysfunction was more common in ChCM (70% vs. 52%), while atrioventricular block was less common (30% vs. 48%).
- Pacemaker implantation took longer in ChCM patients (39 vs. 29 minutes) with higher pacing thresholds; new atrial fibrillation occurred more frequently (34% vs. 25.5%) during follow-up.
Conclusions:
- Chagas' cardiomyopathy patients receiving pacemakers are younger and more often present with sinus node dysfunction compared to ICM patients.
- Pacemaker implantation in ChCM requires longer operative times and results in higher pacing thresholds.
- A significantly higher incidence of new atrial fibrillation is observed in ChCM patients post-pacemaker implantation.
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