Abstract
rate for the general population. In this context, the prevention of SCD in patients with Chagas heart disease represents a major challenge. Implantable cardioverter-defibrillators (ICDs) are effective in preventing SCD from ventricular arrhythmias. Compared with antiarrhythmic drugs in randomized primary and secondary preventions trials, ICD therapy reduced all-cause mortality in patients with ischemic and nonischemic cardiomyopathy at high risk for arrhythmic death, particularly those with severe left ventricular (LV) dysfunction. 5 Because of its frequent association with SCD, Chagas disease has become an emerging and attractive indication for ICDs in the setting of cardiomyopathies. However, none of the landmark randomized controlled trials of ICDs included patients with this condition. In addition, remarkably few observational data exist concerning the safety and efficacy of ICD therapy in Chagas heart disease. Only small series 6-10 and a Latin American registry 11 that involved ICDs from a single com
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