• Rev Assoc Med Bras (1992) · Jan 2023

    Electrophysiological study in chagasics with syncope and conduction disorder.

    • Alexia Hallack Dreicon, Luciana Armaganijan, MoreiraDalmo Antonio RibeiroDAR0000-0003-3962-9992Dante Pazzanese Institute of Cardiology, Electrophysiology and Clinical Arrhythmias - São Paulo (SP), Brazil., Renato Deláscio Lopes, and Bruno Pereira Valdigem.
    • Dante Pazzanese Institute of Cardiology, Electrophysiology and Clinical Arrhythmias - São Paulo (SP), Brazil.
    • Rev Assoc Med Bras (1992). 2023 Jan 1; 69 (12): e20230322e20230322.

    BackgroundInvestigation of syncope involves the use of electrophysiological study, particularly in patients with cardiac conduction disorder. There is conflicting evidence about the role of electrophysiological study in patients with Chagas disease.ObjectiveThe objective of this study was to evaluate the electrophysiological study findings in patients with Chagas disease and bundle branch block and/or divisional block presenting with syncope.MethodsThis is a retrospective study of patients with Chagas disease and cardiac conduction disorder who underwent electrophysiological study from 2017 to 2021 for the investigation of syncope in a tertiary hospital in São Paulo, Brazil. Those with non-interpretable ECG, known coronary artery disease, and/or other cardiomyopathies were excluded. HV interval and electrophysiological study-induced malignant ventricular arrhythmias data were analyzed.ResultsA total of 45 patients (60.2±11.29 years, 57.8% males) were included. The mean HV interval was 58.37 ms±10.68; 22.2% of the studied population presented an HV interval of ≥70 ms; and malignant ventricular arrhythmias were induced in 57.8% patients. The use of beta-blockers and amiodarone (p=0.002 and 0.036, respectively), NYHA functional class≥II (p=0.013), wide QRS (p=0.047), increased HV interval (p=0.02), Rassi score >6.5 (p=0.003), and reduced left ventricular ejection fraction (p=0.031) were associated with increased risk of inducible malignant ventricular arrhythmias.ConclusionMore than half of the patients with Chagas disease, syncope, and cardiac conduction disorder have inducible malignant ventricular arrhythmias. Prolonged HV interval was observed in only 20% of population. Wide QRS, prolonged HV, reduced ejection fraction, and higher Rassi score were associated with increased risk of malignant ventricular arrhythmias.

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