Abstract 18264: Abnormalities in the Electrocardiogram: a Meta-Analysis Comparing Chagas Disease to Other Cardiomyopathies

Abstract

Introduction: Chagas Disease (CD) has been associated with a variety of abnormalities in the electrocardiogram (ECG). For epidemiologic purposes and differential diagnosis, we sought to perform a systematic review and meta-analysis of the relative frequencies of various ECG findings in patients with CD compared to a non-CD group. Hypothesis: ECG abnormalities differ significantly based on etiology of cardiomyopathy. Methods: PubMed, EMBASE, Cochrane Central and Latin American databases were searched for studies that directly compared the prevalence of ECG abnormalities in CD patients to a non-CD group. Odds-ratios were computed using a random-effects model due to anticipated heterogeneity. We further performed a subanalysis on studies that included only patients with known cardiomyopathy. Results: A total of 17 studies and 10,550 patients were included, of whom 4,192 (39.7%) had a positive serology for CD. Ten studies included only patients with known cardiomyopathy in both the control and CD groups. Table 1 reports the odds-ratios for the relative frequencies of various ECG abnormalities between groups. Conclusions: Our analysis suggests that amongst patients with cardiomyopathies, Chagas Disease etiology is significantly associated with an increased prevalence of right bundle branch block, premature ventricular complexes and permanent pacemaker implantation, whereas left bundle branch block is more prevalent among other cardiomyopathies. The combination of right bundle branch block with left anterior fascicular block had the highest odds ratio for prevalence among Chagas Disease patients.