Long-term follow up of asymptomatic chagasic individuals with intraventricular conduction disturbances, correlating with non-chagasic patients

摘要

This prospective study was designed to evaluate intraventricular conduction disturbances in asymptomatic patients with Chagas' disease, and patients with primary sclerosis of the conducting system of the heart (Lev-Len?¨gre's disease). Eighty-four asymptomatic individuals with right- or left-bundle branch block were submitted to electrophysiological evaluation and long-term follow-up. Fifty-five had positive serologic blood tests for Chagas' disease and 29 had Lev-Len?¨gre's disease. Mean-age of 45 years in chagasic and 63 in non-chagasic patients (p 0.001). There were 54 (98.2%) with right-bundle branch block in chagasic and 14 (48.3%) among non-chagasic patients (p 0.001). Sinus nodal and atrioventricular nodal functions presented no differences in either group. However, mean HV interval was greater in the NCH than in the CH group (p 0.01). After a mean follow-up of 121 ?± 63.75 months among chagasic and 94.97 ?± 67.55 months among non-chagasic patients, total mortality was 20 (36.6%) patients in chagasic and 9 (31%) among non-chagasic patients (NS). Cardiac death was recorded in 17 (85%) individuals among chagasic and 3 (33.3%) among non-chagasic patients(p 0.05). Sudden death occurred in 10 (50%) among chagasic and was not observed in non-chagasic patients (p 0.01). In conclusion: 1. Asymptomatic chagasic individuals with intraventricular conduction disturbances showed higher cardiac mortality, sudden or non-sudden death in relation to non-chagasic individuals. 2. The evaluated electrophysiological parameters were of no prognostic value in relation to mortality, although programmed ventricular stimulation was not performed.