Acompanhamento de pacientes chagásicos portadores de arritmia ventricular submetidos a implante de cardioversor-desfibrilador.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

The natural history of Chagas disease has two important distinct phases: acute and chronic. The chronic phase usually occurs thirty to forty years after the initial infestation. Cardiac arrhythmia and electric conduction disturbances are manifestations of chronic phase of Chagas disease. Life threatening ventricular arrhythmias present on this phase, may be rarely responsible for sudden death even before the development of heart failure. However, with the implantable-cardioversor-defibrillator, many sudden death episodes have been aborted by the implantable-cardioversor-defibrillator therapy, changing the natural history and prognosis of chronic Chagas disease. The objective of this study is to show the clinical follow-up of patients with chronic Chagas heart disease and life threatening ventricular arrhythmias (sustained ventricular tachycardia and/or ventricular fibrillation) treated with implantable-cardioversor-defibrillator. Between October 1998 and December 2003, 46 patients received an implantable-cardioversor-defibrillator in the Base Hospital of São José do Rio Preto Medicine School. The mean age were 60,4 10,9 years old and thirty-three patients were male (71,7%). Unicameral ICD system was implanted in 31 out of 46 patients (67%) while 15 patients received bicameral implantable-cardioversor-defibrillator system (32,6%). After a follow-up of 587 439 days 37 patients (80,4%) received implantable-cardioversor-defibrillator therapy. A total of 1239 life-threatening arrhythmias were registered by the implantable-cardioversor-defibrillator (26 46 life-threatening arrhythmias per patients) and 2455 therapies were delivered (53 96 therapies per patients). Among the 37 patients that had implantable-cardioversor-defibrillator therapy, 1 patient (1,2%) received only shock therapy, 5 patients (13,5%) received only anti-tachycardia therapy and 31 patients (83%) received anti-tachycardia and shock therapy. In conclusion, the results shown that 80% of patients with chronic Chagas disease and life-threatening arrhythmias who received an implantable-cardioversor-defibrillator experienced at least 1 implantable-cardioversor-defibrillator therapy after a follow-up of 587 439 days. Implantable-cardioversor-defibrillator shock was the most frequently therapy used to interrupt life-threatening cardiac arrhythmias.

ASSUNTO(S)

defibrillators, implantables desfibriladores implantables cardiology chagas disease desfibriladores implantáveis doença de chagas cardioversores-desfibriladores implantáveis arritmia arrhythmia enfermedad de chagas cardiologia

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