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Ventricular arrhythmias in the Chagas disease are not random phenomena: Long‐term monitoring in Chagas arrhythmias
Author(s) -
Ferreira Silva Nancy Christiane,
Reis Maria do Carmo M.,
Póvoa Rui M. dos S.,
Paola Angelo A. V.,
Luna Filho Bráulio
Publication year - 2019
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14162
Subject(s) - medicine , ventricular tachycardia , cardiology , chagas disease , catecholaminergic polymorphic ventricular tachycardia , cardiomyopathy , heart disease , electrocardiography , analysis of variance , heart failure , ryanodine receptor 2 , pathology , ryanodine receptor , calcium
Abstract Background Variability of ventricular arrhythmias among days in patients with Chagas disease is not detected by 24 hours of Holter monitoring. Objective To analyze whether ventricular arrhythmias are a random phenomenon or have a reproducible behavior in patients with Chagas cardiomyopathy. Method Holter monitoring was recorded in 16 subjects with a mean age of 52 ± 8 years. They were clinically stable and had ventricular couplets, isolated premature ventricular contractions (PVCs), and nonsustained ventricular tachycardia (NSVT). The recordings occurred for 7 days. Hurst exponent (HE) evaluated randomness and predictability index (PI) and repeated analysis of variance (ANOVA) assessed reproducibility. Results The HE was significantly greater than 0.5 in all 16 patients, which confirms the nonrandomness of arrhythmias in this Chagas sample. The PI for ventricular couplets and isolated PVCs was, on average, 38% and 54%, respectively. ANOVA with repeated measurement showed significant differences in the daily frequency of ventricular couplets (n = 15, P ≤ .05), isolated PVC (n = 12, P ≤ .05), and NSVT (n = 7, P ≤ .05). Conclusion Ventricular arrhythmias in Chagas cardiomyopathy are not random. Dissimilarities in arrhythmias frequency make unlikely that 24 hours of Holter recording can capture this variability.