The Prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas' Disease: A Meta-Analysis

Rhanderson Cardoso, Daniel Garcia, Gilson Fernandes, Li He, Paola Lichtenberger, Juan Viles Gonzalez, James O. Coffey, Raul Mitrani

Research output: Contribution to journalArticle

7 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)161-169
Number of pages9
JournalJournal of Cardiovascular Electrophysiology
Volume27
Issue number2
DOIs
StatePublished - Feb 1 2016

Fingerprint

Chagas Disease
Atrial Fibrillation
Meta-Analysis
Bundle-Branch Block
Odds Ratio
Cardiomyopathies
Chagas Cardiomyopathy
Epidemiologic Factors
Serology
PubMed
Heart Failure
Databases

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 journalArticle

Cardoso, Rhanderson ; Garcia, Daniel ; Fernandes, Gilson ; He, Li ; Lichtenberger, Paola ; Viles Gonzalez, Juan ; Coffey, James O. ; Mitrani, Raul. / The Prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas' Disease : A Meta-Analysis. In: Journal of Cardiovascular Electrophysiology. 2016 ; Vol. 27, No. 2. pp. 161-169.
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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.",
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AU - Fernandes, Gilson

AU - He, Li

AU - Lichtenberger, Paola

AU - Viles Gonzalez, Juan

AU - Coffey, James O.

AU - Mitrani, Raul

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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

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