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Long term outcomes post-ICD in Chagas cardiomyopathy and non-ischemic cardiomyopathy: A comparative analysis

Francisca Tatiana Pereira Gondim1, Eduardo Arrais Rocha2, Neiberg de Alcantara Lima3

  • 1Division of Arrhythmia and Artificial Cardiac Stimulation, Department of Cardiology - Hospital Universitario Walter Cantideo, Universidade Federal do Ceara, Fortaleza, Brazil; Department of Public Health, Universidade Federal do Ceara, Fortaleza, Brazil.

International Journal of Cardiology
|January 24, 2025
PubMed

Insights

Patients with Chagas cardiomyopathy (CCM) face higher mortality and require more implantable cardiac defibrillator (ICD) interventions than those with non-ischemic cardiomyopathy (NICM). ICDs demonstrate effectiveness and safety for CCM management.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Public Health

Background:

  • Chagas cardiomyopathy (CCM) is a primary cause of ventricular arrhythmias and sudden cardiac death (SCD).
  • Limited studies exist on implantable cardiac defibrillator (ICD) efficacy in CCM, despite their use in non-ischemic cardiomyopathy (NICM).

Purpose of the Study:

  • To compare long-term outcomes, mortality rates, and tachycardia therapies in patients with CCM versus NICM after ICD implantation.
  • To evaluate the safety and effectiveness of ICDs in managing CCM.

Main Methods:

  • An 18-year retrospective study (2003-2021) comparing outcomes in CCM and NICM patients receiving ICDs.
  • Primary outcome: appropriate ICD therapies and mortality. Secondary outcomes: inappropriate shocks, incessant ventricular tachycardia/electrical storm, and SCD.

Main Results:

  • The study included 207 patients (117 CCM, 90 NICM).
  • CCM patients had significantly higher mortality (39.3% vs. 5.6%) and more frequent appropriate shocks, therapies, ATP, and electrical storms compared to NICM patients.
  • Inappropriate shocks were also more frequent in the CCM group.

Conclusions:

  • CCM patients experience substantially higher mortality and require more frequent ICD interventions than NICM patients.
  • ICDs are effective and safe for the long-term management of Chagas cardiomyopathy.
Abstract

Keywords:
Chagas heart diseaseImplantable cardiac defibrillatorSudden death

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