Electrophysiological study in chagasics with syncope and conduction disorder

Area of Science:

• Cardiology
• Electrophysiology
• Infectious Diseases

Background:

• Syncope evaluation often utilizes electrophysiological study (EPS) for cardiac conduction disorders.
• Conflicting evidence exists regarding the utility of EPS in Chagas disease patients.

Purpose of the Study:

• To assess electrophysiological study findings in Chagas disease patients with syncope and conduction abnormalities.
• To identify predictors of malignant ventricular arrhythmias in this population.

Main Methods:

• Retrospective analysis of 45 Chagas disease patients undergoing EPS for syncope (2017-2021).
• Exclusion of patients with non-interpretable ECG, coronary artery disease, or other cardiomyopathies.
• Analysis of HV interval and EPS-induced ventricular arrhythmias.

Main Results:

• Over half (57.8%) of patients had inducible malignant ventricular arrhythmias.
• Mean HV interval was 58.37 ms, with 22.2% having prolonged intervals (≥70 ms).
• Beta-blockers, amiodarone, NYHA class ≥II, wide QRS, prolonged HV interval, high Rassi score, and reduced ejection fraction predicted inducible arrhythmias.

Conclusions:

• Inducible malignant ventricular arrhythmias are common in Chagas disease patients with syncope and conduction disorder.
• Prolonged HV interval is less common than anticipated but remains a risk factor.
• Wide QRS, prolonged HV, reduced ejection fraction, and higher Rassi score are associated with increased arrhythmia risk.