Electrocardiographic abnormalities in chagasic patients compared to the general population: A systematic review with updated meta-analysis.

INTRODUCTION

Chagas disease (CD) remains a serious public health issue. It can progress from the acute phase to the chronic phase, manifesting as a cardiomyopathy with some typical electrocardiogram abnormality.

OBJECTIVES

This systematic review with meta-analysis aims to evaluate the overall prevalence of cardiac arrhythmias in patients with CD and discriminative values to clinical and epidemiological variables for specific arrhythmias.

METHODS

Articles that included the prevalence of electrocardiographic abnormalities in CD compared to other groups were searched in the following databases: MEDLINE/PubMed, Embase and Cochrane Library. The results obtained were pooled in meta-analyses

RESULTS

A total of 322.608 participants from 88 studies were included. The meta-analyses with single electrocardiographic changes showed a significant association with positive CD serology compared to non-chagasic individuals, (OR: 2.86 95 % CI 2.53; 3.23; I2 = 85 %). Significant associations were found to complete right bundle branch block [CRBBB], CRBBB + left anterior fascicular block [LAFB], first-degree atrioventricular block [AVB], incomplete right bundle branch block [IRBBB], second-degree AVB, LAFB, supraventricular ectopic beats, third-degree AVB, ventricular ectopic beats and atrial fibrillation or flutter. For the presence of a single electrocardiographic alterations, the discriminative capacity variables showed: sensitivity 0.511 (0.505, 0.517), specificity 0.622 (0.620, 0.624), Positive Predictive Value (PPV) 0.101 (0.099, 0.103), Negative Predictive Value (NPV) 0.939 (0.937, 0.940), Positive Likelihood Ratio (PLR) 1.352 (1.334, 1.370) and Negative Likelihood Ratio (NLR) 0.786 (0.776, 0.797).

CONCLUSION

Our findings show a significant association between CD and several electrocardiographic abnormalities, which highlights the need for ongoing surveillance and targeted therapeutic interventions to improve clinical outcomes for patients with chagasic cardiomyopathy.