Abstract
ECG Findings in Chagas' Disease Background/Objectives Chagas' disease (CD) has been associated with atrial fibrillation (AF) and electrocardiographic (ECG) conduction defects. However, prior studies have shown conflicting results. We performed a meta-analysis comparing the prevalence of AF and conduction abnormalities between CD and non-CD patients. Methods PubMed, EMBASE, Cochrane Central, and Latin American databases were searched for studies that directly compared the prevalence of AF and conduction defects in CD and non-CD patients. Odds ratios (OR) were computed using random-effects model due to anticipated heterogeneity. We further performed subanalyses limited to studies that included only patients with cardiomyopathy. Results A total of 17,238 patients from 30 studies were included, of whom 6,840 (40%) had a positive serology for CD. In the pooled data, AF was significantly more prevalent in the CD group (OR 1.62; 95%CI 1.21-2.15; P = 0.001). However, no significant difference was observed between groups when the analysis included only patients with cardiomyopathy (OR 1.21; 95%CI 0.97-1.50; P = 0.08) or heart failure (OR 1.09; 95%CI 0.81-1.47; P = 0.55). The combination of right bundle branch block (RBBB) and left anterior fascicular block (LAFB) had the highest OR for increased prevalence in patients with Chagas' cardiomyopathy compared to non-CD etiologies (OR 5.31; 95%CI 1.23-22.86; P = 0.03). Conclusions Our meta-analysis suggests that the prevalence of AF in patients with Chagas' cardiomyopathy is not significantly different from non-CD cardiomyopathies. The pattern of RBBB and LAFB in patients with cardiomyopathy of unknown etiology and epidemiologic risk factors should raise the possibility of CD and prompt specific diagnostic testing.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 161-169 |
| Number of pages | 9 |
| Journal | Journal of Cardiovascular Electrophysiology |
| Volume | 27 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2016 |
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Keywords
- atrial fibrillation
- Chagas' disease
- electrocardiogram
- left anterior fascicular block
- left bundle branch block
- right bundle branch block
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
The Prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas' Disease : A Meta-Analysis. / Cardoso, Rhanderson; Garcia, Daniel; Fernandes, Gilson; He, Li; Lichtenberger, Paola; Viles Gonzalez, Juan; Coffey, James O.; Mitrani, Raul.
In: Journal of Cardiovascular Electrophysiology, Vol. 27, No. 2, 01.02.2016, p. 161-169.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The Prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas' Disease
T2 - A Meta-Analysis
AU - Cardoso, Rhanderson
AU - Garcia, Daniel
AU - Fernandes, Gilson
AU - He, Li
AU - Lichtenberger, Paola
AU - Viles Gonzalez, Juan
AU - Coffey, James O.
AU - Mitrani, Raul
PY - 2016/2/1
Y1 - 2016/2/1
N2 - ECG Findings in Chagas' Disease Background/Objectives Chagas' disease (CD) has been associated with atrial fibrillation (AF) and electrocardiographic (ECG) conduction defects. However, prior studies have shown conflicting results. We performed a meta-analysis comparing the prevalence of AF and conduction abnormalities between CD and non-CD patients. Methods PubMed, EMBASE, Cochrane Central, and Latin American databases were searched for studies that directly compared the prevalence of AF and conduction defects in CD and non-CD patients. Odds ratios (OR) were computed using random-effects model due to anticipated heterogeneity. We further performed subanalyses limited to studies that included only patients with cardiomyopathy. Results A total of 17,238 patients from 30 studies were included, of whom 6,840 (40%) had a positive serology for CD. In the pooled data, AF was significantly more prevalent in the CD group (OR 1.62; 95%CI 1.21-2.15; P = 0.001). However, no significant difference was observed between groups when the analysis included only patients with cardiomyopathy (OR 1.21; 95%CI 0.97-1.50; P = 0.08) or heart failure (OR 1.09; 95%CI 0.81-1.47; P = 0.55). The combination of right bundle branch block (RBBB) and left anterior fascicular block (LAFB) had the highest OR for increased prevalence in patients with Chagas' cardiomyopathy compared to non-CD etiologies (OR 5.31; 95%CI 1.23-22.86; P = 0.03). Conclusions Our meta-analysis suggests that the prevalence of AF in patients with Chagas' cardiomyopathy is not significantly different from non-CD cardiomyopathies. The pattern of RBBB and LAFB in patients with cardiomyopathy of unknown etiology and epidemiologic risk factors should raise the possibility of CD and prompt specific diagnostic testing.
AB - ECG Findings in Chagas' Disease Background/Objectives Chagas' disease (CD) has been associated with atrial fibrillation (AF) and electrocardiographic (ECG) conduction defects. However, prior studies have shown conflicting results. We performed a meta-analysis comparing the prevalence of AF and conduction abnormalities between CD and non-CD patients. Methods PubMed, EMBASE, Cochrane Central, and Latin American databases were searched for studies that directly compared the prevalence of AF and conduction defects in CD and non-CD patients. Odds ratios (OR) were computed using random-effects model due to anticipated heterogeneity. We further performed subanalyses limited to studies that included only patients with cardiomyopathy. Results A total of 17,238 patients from 30 studies were included, of whom 6,840 (40%) had a positive serology for CD. In the pooled data, AF was significantly more prevalent in the CD group (OR 1.62; 95%CI 1.21-2.15; P = 0.001). However, no significant difference was observed between groups when the analysis included only patients with cardiomyopathy (OR 1.21; 95%CI 0.97-1.50; P = 0.08) or heart failure (OR 1.09; 95%CI 0.81-1.47; P = 0.55). The combination of right bundle branch block (RBBB) and left anterior fascicular block (LAFB) had the highest OR for increased prevalence in patients with Chagas' cardiomyopathy compared to non-CD etiologies (OR 5.31; 95%CI 1.23-22.86; P = 0.03). Conclusions Our meta-analysis suggests that the prevalence of AF in patients with Chagas' cardiomyopathy is not significantly different from non-CD cardiomyopathies. The pattern of RBBB and LAFB in patients with cardiomyopathy of unknown etiology and epidemiologic risk factors should raise the possibility of CD and prompt specific diagnostic testing.
KW - atrial fibrillation
KW - Chagas' disease
KW - electrocardiogram
KW - left anterior fascicular block
KW - left bundle branch block
KW - right bundle branch block
UR - http://www.scopus.com/inward/record.url?scp=84956629551&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84956629551&partnerID=8YFLogxK
U2 - 10.1111/jce.12845
DO - 10.1111/jce.12845
M3 - Article
C2 - 26412204
AN - SCOPUS:84956629551
VL - 27
SP - 161
EP - 169
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
SN - 1045-3873
IS - 2
ER -