Electrical Storm in Chagas Cardiomyopathy: Clinical Predictors, Outcome, and Arrhythmic Characteristics in a
Maria Lícia Ribeiro Cury Pavão1, Elerson Arfelli1, Adilson Scorzoni-Filho2
1Cardiology Division, Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Insights
Electrical storm (ES) is common in Chagas heart disease (CHD) patients with an implantable cardioverter-defibrillator (ICD). However, ES did not worsen prognosis or correlate with reduced heart function in this study.
Area of Science:
- Cardiology
- Electrophysiology
- Sudden Cardiac Death Prevention
Background:
- Electrical storm (ES) is a recognized complication in patients with Chagas heart disease (CHD) who have an implantable cardioverter-defibrillator (ICD).
- Limited data exists on clinical predictors and long-term outcomes associated with ES in this specific patient population.
Purpose of the Study:
- To compare the characteristics of patients with Chagas heart disease (CHD) and an implantable cardioverter-defibrillator (ICD) who experience electrical storm (ES) versus those who do not.
- To evaluate the long-term outcomes and clinical predictors of ES in patients with CHD undergoing secondary prevention for sudden cardiac death.
Main Methods:
- Retrospective analysis of 110 patients with CHD and an ICD, with a mean follow-up of 1,949 days.
- Collection and comparison of demographic, clinical, arrhythmia characteristics, ICD treatment data, and mortality.
- Statistical analysis included descriptive statistics and Fisher exact tests, with significance set at p < 0.05.
Main Results:
- The ES group (n=57) had a higher left ventricular ejection fraction (44% vs 37%) and shorter QRS duration (109 ms vs 134 ms) compared to the non-ES group (n=53).
- Mortality rates were similar between the ES and non-ES groups (p=0.44).
- No deaths were directly attributed to ES, although clinical triggers were identified in 20 patients.
Conclusions:
- Electrical storm (ES) is frequent in Chagas heart disease (CHD) patients with an ICD but does not appear to confer a worse prognosis in this cohort.
- ES was not associated with more depressed left ventricular systolic function or longer QRS duration in the studied population.
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.
More Related Videos
08:28Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus
Published on: April 5, 2011
10:17Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
Related Concept Videos
01:30Dysrhythmias V: Evaluating Dysrhythmias
01:28Dysrhythmias II: Classification of Tachyarrhythmias
01:28Mechanism of Cardiac Arrhythmias
01:25Cardiomyopathy I: Introduction and Classification
01:19Electrophysiology of Normal Cardiac Rhythm
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias