Abstract 11704: Conduction Abnormalities Among Chronic Chagas’ Disease Patients With Heart Involvement and Events of Cardiogenic Shock

Abstract

Introduction: Chronic Chagas Cardiomyopathy can disrupt various conduction pathways, triggering arrhythmias and cardiogenic shock (CS). The American Heart Association recently advocated for better global awareness in endemic regions. We aim to provide a perspective on cardiac arrhythmias seen in Chronic Chagas disease with heart involvement in the United States. Methods: Cases of “Chagas' disease (chronic) with heart involvement” were used via the 2016-2020 National Inpatient Sample. The presence of several cardiac arrhythmias was analyzed. Results: Between 1st January 2016 to 31st December 2020, around 1920 patients were hospitalized with Chronic Chagas’ disease with heart involvement in the United States. The cases were predominantly Males (61.2%) who were also younger compared to Females (mean age of Males: 55.83 years vs. mean age of Females 58.86 years, p<0.01). The mean age of all patients was estimated at 57.0 years. The patients were primarily covered by Medicaid (40.4%), followed by Medicare (26.0%), and Private insurance (21.9%). Moreover, 90.9% of hospitalizations took place in Urban-teaching centers. Several arrhythmias such as atrial fibrillation (37.2%, 715 cases), supraventricular tachycardia (4.7%, 90 cases), ventricular tachycardia (29.2%, 560 cases), ventricular fibrillation (4.2%, 80 cases), and atrial flutter (6.8%, 130 cases), as well as conduction defects such as first-degree Atrioventricular block (1.6%, 30 cases), complete atrioventricular block (3.9%, 75 cases), and sick sinus syndrome (2.9%, 55 cases), were observed. The mean Charlson Comorbidity Index (CCI) score among these patients was 2.66. Around 185 patients (9.6%) developed CS during their hospitalization. While no statistical significance was seen in the mean ages of patients with and without CS (58.57 vs. 56.84 years, p=0.062), those with CS had a higher mean CCI score (3.73 vs. 2.55, p<0.01; 14.6% of patients with CCI≥4 vs. 8.0% with CCI <4, p<0.01), with a longer hospitalization (22.97 days vs. 6.49 days, p<0.01). Conclusions: Patients with Chagas disease with heart involvement can experience various conduction abnormalities. CS was more common in patients with a higher CCI score, resulting in a longer stay.