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Incidence and variables associated with arrhythmias during dobutamine–atropine stress echocardiography among patients with Chagas disease
Author(s) -
Carmo Rassi Daniela,
Hotta Viviane Tiemi,
Gomes Furtado Rogério,
Campos Vieira Marcelo Luiz,
Paula Turco Fabio,
Henrique Melato Luciano,
Godoy Nunes Colandy,
Rassi Luiz,
Rassi Salvador
Publication year - 2019
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14341
Subject(s) - medicine , cardiology , bigeminy , ventricular tachycardia , incidence (geometry) , coronary artery disease , atrial fibrillation , supraventricular tachycardia , population , ventricular fibrillation , dobutamine , tachycardia , hemodynamics , physics , environmental health , optics
Background Dobutamine stress echocardiography ( DSE ) is an important tool in the diagnosis of coronary artery disease. However, there is hesitation in clinical practice for using it in patients with Chagas disease ( CD ) due to the arrhythmogenic potential of this heart condition. This study aimed to evaluate the incidence and variables associated with arrhythmias during DSE in a population of patients with CD . Methods A population of 205 consecutive patients with CD and suspected coronary heart disease was assessed through a retrospective database analysis. CD was confirmed in all patients by serological testing. Results The mean age of the patients selected was 64 years, and 65.4% of the patients were female. Significant arrhythmias occurred as follows: nonsustained ventricular tachycardia in 7.3% of patients; supraventricular tachycardia and sustained ventricular tachycardia in 1%; and atrial fibrillation in 0.5%. Nonsignificant arrhythmias occurred as follows: premature ventricular contractions in 48% of patients and bigeminy in 4.4%. Values for the wall‐motion score index at rest greater than 1.12 and 1.18 were independently correlated with the occurrence of nonsignificant arrhythmias (odds ratio [ OR ] = 2.90, P < 0.001) and significant arrhythmias ( OR = 4.23, P = 0.044), respectively. Conclusion DSE should be considered a safe examination in patients with CD despite the known increased risk of arrhythmias in this group of patients. The occurrence of arrhythmias was low in this study. Abnormal wall‐motion score index values at rest were associated with the occurrence of significant and nonsignificant arrhythmias during the test.