Abstract 12496: A New Arrhythmic Threat to America. Chikungunya Myocarditis

Abstract

Background: The mosquito-borne Chikungunya virus infection is one of the most important emerging virus diseases globally. Local transmission has been found in the United States. There are very few published reports concerning the cardiac complications in general and less of arrhythmias in particular. Chikungunya can be fatal: there have been sudden deaths reports . Objective: To investigate arrhythmic complications of Chikungunya myocarditis. Methods: Prospective multicenter observational study of 280 patients with a Chikunguya infection from a Venezuelan Outbreak. Clinical evaluation, ECG, laboratory including virological evaluation and cardiac biomarkers, Echocardiogram, Holter and cardiac MRI procedures were carried out. Results: Of the 280 patients examined, 113 patients were male, with a mean age of 59 ± 9; 270 patients presented with fever and polyarthralgia and 85 developed palpitations. Arrhythmias occured in 45% of cases; they included bradyarrhythmias (33%), atrial and ventricular ectopic beats and tachyarrhythmias in which atrial fibrillation was observed in 19 cases. There were also ectopic atrial tachycardia and non sustained ventricular tachycardia, conduction disturbances and 3 cases of sudden death. Conclusion: Physicians should know that almost half of the Chikungunya patients will develop arrhythmias and manifest or silent myocarditis. In the proper epidemiological context, the triad of fever, polyarthralgia and new arrhythmia including bradiarrhythmias suggest Chikungunya Myocarditis.