Preditores de mortalidade geral em pacientes portadores de cardiopatia chagásica crônica tratados com cardioversor-desfibrilador implantável.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

In most Chagas disease patients, sudden cardiac death is caused by Sustained Ventricular Tachycardia or Ventricular Fibrillation. Implantable Cardioverter Defibrillators have sporadically been used as a treatment for such arrhythmias in Chagas disease patients. This study aimed at determining predictors of all-cause mortality for Chagas disease patients receiving Implantable Cardioverter Defibrillator therapy. A total of 90 consecutive patients were entered the study. Mean age was 59 11 years. Sixty-one patients (68%) were male. Mean Left Ventricular Ejection Fraction was 47 13%. Twenty-five (28%) patients had no left ventricular systolic dysfunction. All patients were treated with amiodarone and B-Blocker at conventional dose after device implantation. Shock electrograms were reviewed to determine type of arrhythmia as well as type of therapy delivered. A total of 4274 arrhythmias were observed in 64 (71%) out of 90 patients during the study period; Sustained Ventricular Tachycardia was observed in 45 (70%) patients and Ventricular Fibrillation in 19 (30%). Twenty-six (29%) out of 90 patients had no arrhythmia. Fifty-eight patients (64%) received appropriate shock, whereas Antitachycardia Pacing was delivered for 58 (54%) patients. No patient received inappropriate therapy. A multivariate stepwise regression analysis showed the number of apropriate shocks per 30 days as well as a left ventricular ejection fraction <35% to be independent predictors of mortality. Number of shocks per 30 days as well as ventricular function predict outcome in Chagas disease patients receiving Implantable Cardioverter Defibrillator therapy.

ASSUNTO(S)

doença de chagas arritmia choque shock shock defibriladores implantáveis muerte súbita death, sudden desfibriladores implantáveis enfermedad de chagas chagas disease cardiologia morte súbita cardioversor-desfibrilador implantável trypanosomiasis american implantable cardioverter defibrillators desfibriladores implantables tripanossomíase americana arrhythmia chagas disease arrhythmias sudden death

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