Author + information
- Maziar Rahmania,b,
- Ivan Peñaa,b,
- Bianca Ummata,b,
- Pablo Toroa,b,
- Marcial Villedaa,b,
- Cynthia Tracya,b and
- Marco Mercadera,b
Background: Chagas heart disease is associated with the development of arrhythmias, heart failure with reduced ejection fraction, and sudden death. We aimed to compare the clinical characteristics and intraoperative measurements of patients with and without Chagas disease who underwent cardiac device implantation in Honduras.
Methods and Results: A total of 217 consecutive Honduran patients from a single center with indications for pacemaker implantation were included from September 2010 to September 2016. There were 47 patients with serologic positive Chagas disease [Male, 26(54.2%)] and 170 without Chagas disease [Male, 84(49.4%)], non-significant (NS). Mean age was not different between two groups (61.4±10.8 vs. 64.2±17.7, NS). The following variables were more frequent in the Chagas compared to non-Chagas group respectively: non-ischemic cardiomyopathy [24(50%) vs. 24(14.3%), p<0.00001], left ventricular ejection fraction ≤55% [21(46.7%) vs. 42(26.3%), p<0.009], right bundle branch block (RBBB) [19(39.6%) vs. 39 (23.2%), p<0.02]. The frequency of the left bundle branch block, sinus node disease, and pacemaker type (dual chamber, atrial only, or ventricular only) were not statistically different between two groups (data not shown). Among pacemaker parameters at the time of device implantation, the Chagas compared to non-Chagas group showed significantly lower R wave amplitude (7.94±4.33 vs. 10.14±5.28 mV, p<0.01). There was no difference between two groups for the rest of ventricular pacing parameters: right ventricular (RV) pacing threshold (0.79±0.33 vs. 0.82±0.72 Volts) NS, RV pulse width (0.49±0.02 vs. 0.48±0.03 milliseconds) NS, RV lead impedance (873.4±270.1 vs. 851.3±282.9 Ohms), NS, and RV current (1.23±0.71vs. 1.16±0.93), NS. Similarly, there was no difference between groups for atrial device measurements.
Conclusions: Our study shows higher frequency of left ventricular dysfunction, and RBBB in the Chagas compared to non-Chagas group. Among pacemaker parameters, a significantly lower R wave amplitude was noted in Chagas patients. The chronic myocarditis seen in Chagas cardiomyopathy affects the ventricular signal amplitude noted during implant.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias and Clinical EP: Devices 2
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1149-075
- 2017 American College of Cardiology Foundation