Ventricular arrhythmias in the Chagas disease are not random phenomena: Long‐term monitoring in Chagas arrhythmias

• Published in: Journal of cardiovascular electrophysiology Vol. 30; no. 11; pp. 2370 - 2376
• Main Authors: Ferreira Silva, Nancy Christiane, Reis, Maria do Carmo M., Póvoa, Rui M. dos S., Paola, Angelo A. V., Luna Filho, Bráulio
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.11.2019
• Subjects: Arrhythmia; Cardiac arrhythmia; Cardiomyopathy; Chagas disease; Hurst exponent; Tachycardia; temporal analysis; Variance analysis; Ventricle; ventricular arrhythmias; Chagas disease; Hurst exponent; temporal analysis; ventricular arrhythmias
• ISSN: 1045-3873; 1540-8167; 1540-8167
• DOI: 10.1111/jce.14162

Background Variability of ventricular arrhythmias among days in patients with Chagas disease is not detected by 24 hours of Holter monitoring. Objective To analyze whether ventricular arrhythmias are a random phenomenon or have a reproducible behavior in patients with Chagas cardiomyopathy. Method Holter monitoring was recorded in 16 subjects with a mean age of 52 ± 8 years. They were clinically stable and had ventricular couplets, isolated premature ventricular contractions (PVCs), and nonsustained ventricular tachycardia (NSVT). The recordings occurred for 7 days. Hurst exponent (HE) evaluated randomness and predictability index (PI) and repeated analysis of variance (ANOVA) assessed reproducibility. Results The HE was significantly greater than 0.5 in all 16 patients, which confirms the nonrandomness of arrhythmias in this Chagas sample. The PI for ventricular couplets and isolated PVCs was, on average, 38% and 54%, respectively. ANOVA with repeated measurement showed significant differences in the daily frequency of ventricular couplets (n = 15, P ≤ .05), isolated PVC (n = 12, P ≤ .05), and NSVT (n = 7, P ≤ .05). Conclusion Ventricular arrhythmias in Chagas cardiomyopathy are not random. Dissimilarities in arrhythmias frequency make unlikely that 24 hours of Holter recording can capture this variability.