Start Submission Become a Reviewer

Reading: Electrocardiogram and Chagas Disease: A Large Population Database of Primary Care Patients

Download

A- A+
Alt. Display

Original Research

Electrocardiogram and Chagas Disease: A Large Population Database of Primary Care Patients

Authors:

Milena S. Marcolino ,

Medical School, Universidade Federal de Minas Gerais, Belo Horizonte; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Telehealth Network of Minas Gerais, Belo Horizonte, Minas Gerais, BR
X close

Daniel M. Palhares,

Medical School, Universidade Federal de Minas Gerais, Belo Horizonte; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Telehealth Network of Minas Gerais, Belo Horizonte, Minas Gerais, BR
X close

Lorena R. Ferreira,

Medical School, Universidade Federal de Minas Gerais, Belo Horizonte; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Telehealth Network of Minas Gerais, Belo Horizonte, Minas Gerais, BR
X close

Antonio L. Ribeiro

Medical School, Universidade Federal de Minas Gerais, Belo Horizonte; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Telehealth Network of Minas Gerais, Belo Horizonte, Minas Gerais, BR
X close

Abstract

Background: Chagas disease (ChD) used to be a disease restricted to Latin America, but has become a worldwide problem due to migration of infected individuals to developed countries. Electrocardiography has been considered an essential exam to evaluate ChD patients.

Objective: This study sought to identify prevalent electrocardiographic abnormalities in a large sample of ChD patients evaluated in the primary care setting.

Methods: This retrospective observational study assessed all consecutive digital 12-lead electrocardiograms (ECG) performed by the Telehealth Network of Minas Gerais, Brazil, from January 1 to December 31, 2011. In that time, the service attended primary care patients in 660 cities in the Minas Gerais province. ChD was self-reported, and the individuals who did not report having ChD were considered noninfected. The prevalence of electrocardiographic abnormalities was assessed.

Results: Self-reported ChD patients comprised 7,590 (2.9%) of 264,324 patients who underwent ECG during the study period. The mean age for ChD patients was 57.0 ± 13.7 years, and 64.1% of patients were women. The most common comorbidities were hypertension (61.3%), diabetes (9.1%), and dyslipidemia (6.9%), and 10.7% were smokers. The most frequent electrocardiographic abnormalities were nonspecific repolarization abnormalities (34.6%), right bundle branch block (RBBB) (22.7%), left anterior hemiblock (LAH) (22.5%), ventricular premature beats (5.4%), and atrial fibrillation (5.4%). Only 31.5% of the patients had no electrocardiographic abnormality versus 61.2% in noninfected individuals (p < 0.001). The prevalence of normal ECG decreased with aging and was significantly lower than for noninfected individuals in all age groups. Pacemaker rhythm (odds ratio [OR]: 13.3, 95% confidence intervals [CI]: 11.5 to 15.4), RBBB (OR: 10.7, 95% CI: 10.1 to 11.4), especially in association with LAH (OR: 12.1, 95% CI: 11.2 to 13.0), second atrioventricular block (OR: 4.1, 95% CI: 2.5 to 6.6), and third atrioventricular block (OR: 13.3, 95% CI: 11.5 to 15.4) were strongly related to ChD.

Conclusions: In this large sample of primary care patients with ChD, there was a high prevalence of electrocardiographic abnormalities. Pacemaker rhythm, RBBB, especially in association with LAH, and second and third atrioventricular block were strongly related to ChD.

Highlights

  • In this study, in a large sample of primary care patients, 2.9% of them had auto-referred Chagas disease.
  • Only 31.5% of the patients had no ECG abnormality versus 61.15% in noninfected individuals (p < 0.001).
  • Pacemaker rhythm (OR: 13.29, 95% CI: 11.47 to 15.40), RBBB (OR: 10.73, 95% CI: 10.10 to 11.41), especially in association with LAH (OR: 12.09, 95% CI: 11.20 to 13.04), second atrioventricular block (OR: 4.05, 95% CI: 2.47 to 6.63), and third atrioventricular block (OR: 13.29, 95% CI: 11.47 to 15.40) were strongly related to ChD.
How to Cite: Marcolino MS, Palhares DM, Ferreira LR, Ribeiro AL. Electrocardiogram and Chagas Disease: A Large Population Database of Primary Care Patients. Global Heart. 2015;10(3):167–72. DOI: http://doi.org/10.1016/j.gheart.2015.07.001
2
Views
Published on 01 Sep 2015.
Peer Reviewed

Downloads

  • PDF (EN)

    comments powered by Disqus