Systematic Review and Meta-Analysis of Clinical Outcome After Implantable Cardioverter-Defibrillator Therapy in Patients With Chagas Heart Disease

摘要

OBJECTIVES The goal of this analysis was to pool data from published studies on outcomes after implantable cardioverter-defibrillator (ICD) therapy in patients with Chagas heart disease (CHD).BACKGROUND CHD is characterized by a high burden of ventricular arrhythmias and an increased risk of sudden cardiac death. The indications for ICD are not well established.METHODS An extensive literature search without language restrictions was performed to identify all studies on ICD therapy in patients with CHD. A random effects model was used to calculate percentages and 95% confidence intervals (CIs).RESULTS Of 397 articles screened, 13 studies (all observational) were included. There were 1,041 patients (mean age at implantation 57 +- 11 years; 64% men), most of whom (92%) received an ICD for secondary prevention. Antiarrhythmic medication consisted of amiodarone (79%) and beta-blockers (44%). Overall, the annual all-cause mortality rate was 9.0% (95% Cl: 6.9 to 11.7) in 2.8 +- 1.9 years of follow-up, and the annual sudden cardiac death rate was 2.0% (95% Cl: 1.3 to 3.3) in 2.6 +- 1.9 years. In addition, 24.8% (95% Cl: 15.7 to 37.0) of patients received 1 or more appropriate interventions (shocks or antitachycardia pacing), 4.7% (95% Cl: 3.2 to 6.9) received inappropriate shocks, and 9.1% (95% Cl: 5.5 to 14.7) had electric storms annually.