Predictors of All-Cause 1-Year Mortality in Implantable Cardioverter Defibrillator Patients with Chronic Chagas' Cardiomyopathy

• Published in: Pacing and clinical electrophysiology Vol. 34; no. 9; pp. 1063 - 1069
• Main Authors: TORO, DARÍO DI, MURATORE, CLAUDIO, AGUINAGA, LUIS, BATISTA, LUIZ, MALAN, ANTONIO, GRECO, OSWALDO, BENCHETRIT, CHAMIA, DUQUE, MAURICIO, BARANCHUK, ADRIAN, MALONEY, JENNIFER
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.09.2011; Wiley
• Subjects: Aged; Atrial Fibrillation - mortality; Atrial Fibrillation - physiopathology; Atrial Fibrillation - therapy; Biological and medical sciences; Cardiology. Vascular system; Chagas Cardiomyopathy - mortality; Chagas Cardiomyopathy - physiopathology; Chagas Cardiomyopathy - therapy; Chagas' cardiomyopathy; Chronic Disease; Cohort Studies; Death, Sudden, Cardiac - epidemiology; Defibrillators, Implantable - adverse effects; Diseases of the cardiovascular system; Female; Follow-Up Studies; Heart; Humans; implantable cardioverter defibrillator; Latin America - epidemiology; Male; Medical sciences; Middle Aged; mortality; Myocarditis. Cardiomyopathies; Prognosis; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Treatment Outcome; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - physiopathology; Latin America; Human; Instrumental stimulation; Chronic; Cardiomyopathy; Heart disease; Mortality; Implantable cardioverter defibrillator; Chagas' cardiomyopathy; Instrumentation therapy; Cardiovascular disease; Predictive factor; Myocardial disease
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/j.1540-8159.2011.03108.x

Background: Implantable cardioverter defibrillators (ICDs) have been used in the treatment of either sustained ventricular tachycardia or ventricular fibrillation in patients with Chagas’ cardiomyopathy. This study aimed at determining mortality rate and risk factors of all‐cause 1‐year mortality in primary and secondary ICD patients with Chagas’ cardiomyopathy. Methods: One hundred and forty‐eight Chagas’ patients with ICDs were included from the Medtronic ICD Registry Latin America. All patients were followed for 1 year. Results: At implant, mean age was 60.1 ± 9.4 years and 72.9% were male. Mean left ventricular ejection fraction (LVEF) was 40.1 ± 11%. Mean follow‐up was 12 ± 7 months. During the follow‐up, 15 patients died (10.2%). Patients who died were older (64 ±10.8 years vs 59 ± 9.1; P = 0.04), had more atrial fibrillation (13.3% vs 3.8%; P = 0.02), had lower LVEF (33.4%± 9.8 vs 40.9%± 11.3; P = 0.01), and worse functional class (III/IV 40% vs 21.8%; P = 0.03). The multivariate analysis showed that two independent predictors of all‐cause 1‐year mortality remained statistically significant: age more than 65 (hazard ratio [HR] = 2.85, 95% confidence interval [CI] 1.77–3.92; P = 0.03) and LVEF less than 30% (HR = 2.68, 95% CI 1.57–3.79; P = 0.04). Conclusion: This analysis showed that patients older than 65 years of age and with LVEF less than 30% were independent predictors of all‐cause 1‐year mortality in patients with chronic Chagas’ cardiomyopathy. (PACE 2011; 34:1063–1069)