IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS IN PATIENTS WITH CHAGAS-DISEASE - ARE THEY DIFFERENT FROM PATIENTS WITH CORONARY-DISEASE

Chagas' disease is a parasitic affliction, endemic to certain regions of South America, which may lead to a chronic dilated nonischemic card iomyopathy. Ten Chagasic patients were compared to 18 coronary patient s undergoing transvenous ICD implantation for ventricular tachycardia (VT), ventricular fibrillation (VF), or aborted cardiac arrest. Indica tions for ICD implantation were either drug intolerance or refractorin ess, or no inducible tacharrhythmia at EPS. There was no statistically significant differences between the Chagas and coronary artery diseas e groups with respect to age (60.2 vs 62.6 yrs), NYHA Class II (50% vs 62%), ejection fraction (31.1% vs 29.7%), and incidence of cardiac ar rest (20% vs 33%), respectively. The following ICD implant and long-te rm follow-up variables were compared between the two groups: pacing th reshold (0.94 V vs 0.95V), defibrillation threshold (19.5 J vs 19.6 J) , number of VT episodes (414 vs 435), number of spontaneous VT termina tions (86 vs 187), percent efficacy of antitachycardia pacing (93.9% v s 92.1%), and total number of shocks (112 vs 145). These differences w ere not statistically significant. We conclude that patients with Chag as' disease, compared with coronary artery disease patients, have simi lar clinical characteristics leading to ICD implantation. Furthermore, no differences were found with respect to ICD and long-term follow-up characteristics between the two groups.