Long term outcomes post-ICD in Chagas cardiomyopathy and non-ischemic cardiomyopathy: A comparative analysis.

BACKGROUND

Chagas cardiomyopathy (CCM) is a significant cause of ventricular arrhythmias and sudden cardiac death (SCD). Although, implantable cardiac defibrillators (ICD) have been used for all forms of non-ischemic cardiomyopathy (NICM), studies on ICD efficacy in CCM are scarce.

OBJECTIVE

The present study aims to compare the long-term outcomes, mortality rates, and the occurrence of tachycardia therapies after ICD implantation in patients with CCM and NICM.

METHODS

The study was conducted over an 18-year period beginning in 2003. The primary outcome of this study was the difference in appropriate ICD therapies and mortality among patients in a single center receiving implant for CCM or NICM management. As a secondary outcome, we compared inappropriate shocks, presence of incessant ventricular tachycardia/electrical storm, and SCD.

RESULTS

The study included 207 patients (117 with CCM and 90 with NICM). The median follow-up time was 61 months [25-121] in the CCM group and 56.5 months [23-119] in the NICD group. During follow up, 39.3 % (46 patients) died in the CCM group and 5.6 % (5 patients) in the NICM group. Appropriate shocks, appropriate therapies, ATP, electrical storm and inappropriate shocks were all more frequent in patients with CCM.

CONCLUSION

CCM patients experienced higher mortality and more frequent appropriate ICD interventions compared to patients with NICM. ICDs appear effective and safe for long-term management in CCM.