Abnormal atrioventricular nodal response patterns in patients with long-term Chagas' disease

Thirty-two volunteers with positive serologic tests for Chagas' disease were submitted to electrophysiologic studies. No one had documented tachyarrhythmias, heart failure, PR interval shorter than 0.12 or longer than 0.20 msec, pre-excitation or cardiac enlargement. The atrioventricular (AV) nodal function study under programmed atrial stimulation revealed abnormal AV nodal function in nine (28.1 percent) with long-term Chagas' disease. Due to the high incidence of the longitudinal dissociation in this disease, and based on previously reported histopathologic findings that demonstrate the involvement of the right side of the AV node and His bundle, this study suggests that the abnormal AV nodal responses may be secondary to the organic alterations produced by Chagas' disease.