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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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First appropriate implantable defibrillator shocks in patients with Chagasic heart disease

Luis G García-Chamorro1, Ezequiel J Zaidel1, Lara Gheco1

  • 1Servicio de Cardiología, Servicio de Cardiología. Sanatorio Güemes, Buenos Aires, Argentina.

Archivos De Cardiologia De Mexico
|October 7, 2021
PubMed

Insights

Patients with Chagasic heart disease (CHD) experienced earlier effective implantable cardioverter defibrillator (ICD) shocks compared to those with ischemic heart disease (IHD). This highlights the need for ICDs in high-risk CHD populations.

Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Chagasic heart disease (CHD) is a significant cause of heart failure and sudden cardiac death.
  • Ischemic heart disease (IHD) is the most common cause of sudden cardiac death requiring defibrillator implantation.
  • The effectiveness of automatic implantable defibrillators (AID) in CHD patients compared to IHD patients is not well-established.

Purpose of the Study:

  • To compare the timing of the first effective AID shock in patients with CHD versus IHD.
  • To evaluate the efficacy of AID in managing arrhythmias in CHD patients.

Main Methods:

  • Retrospective cohort study of 64 patients (20 CHD, 44 IHD) who received an AID between 2009 and 2018.
  • Analysis of time from AID implantation to the first effective shock.
  • Comparison between CHD and IHD groups.

Main Results:

  • CHD patients received effective AID shocks significantly earlier than IHD patients (HR: 8.4, p=0.0027 at 1 year; HR: 4.61, p=0.0072 at 3 years).
  • 100% of CHD patients receiving AID for secondary prevention experienced a shock within 26 months.
  • This indicates a high burden of life-threatening arrhythmias in this population.

Conclusions:

  • Patients with CHD experience earlier effective AID shocks than those with IHD.
  • AID is effective in the short term for CHD patients receiving it for secondary prevention of sudden cardiac death.
  • These findings support AID use in high-risk CHD populations where clinical trial data are limited.
Abstract

Keywords:
Automatic implantable defibrillatorChagas cardiomyopathyChagas diseaseIschemic heart diseaseSuddendeath

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