PO-04-223 ASSOCIATION BETWEEN ANTIPARASITIC TREATMENT AND VENTRICULAR ARRYTHMIAS IN PATIENTS WITH CHAGAS DISEASE

Abstract

Benznidazole and Nifurtimox are the two currently available antiparasitic treatments available for Chagas disease (CD), an important cause of cardiomyopathy and arrhythmias. There are limited data available describing impact of antiparasitic treatment on arrhythmia outcomes. Compare the incidence of ventricular arrhythmias in Chagas patients treated with anti-parasitic medication versus those who did not receive treatment. Patients treated at a Chagas disease center of excellence were retrospectively analyzed for ambulatory rhythm monitoring data (Holter and 14-day patch monitor). Patients with implantable cardiac devices were excluded. Significant ventricular arrhythmias were defined as either a PVC burden >/=1% or non-sustained ventricular tachycardia (NSVT) ≥4 beats. Patients were analyzed based on CD treatment: Benznidazole, Nifurtimox, or no treatment. Patients with incomplete treatment courses were excluded from analysis. A Fisher exact test was used to compare categorical variables. There were 191 patients with CD between 12/2014 and 8/2022 available for analysis, of whom 66 patients underwent ambulatory rhythm monitoring. Of these, 20 were male and 46 were female with an average age of 55.3 ± 12.6 years, and ejection fraction of 56.7 ± 10.5%. Of the 66 patients, 42 (63.6%) received treatment, 22 (33.3%) had no treatment, and 2 (3.0%) received incomplete treatment for CD. Among patients that received treatment for CD, 11/42 (26.2%) had significant ventricular arrhythmias on ambulatory rhythm monitoring. In comparison, among patients who did not receive CD treatment, 12/22 (54.5%) had significant ventricular arrhythmias (p = 0.031). No significant difference in the number of ventricular arrhythmias was observed between the Benznidazole (7/29, 24.1%) and Nifurtimox (4/12, 33.3%) treatment groups. These data demonstrate that treatment of CD is associated with a reduction in ventricular arrhythmias on ambulatory rhythm monitoring. Further studies are needed to determine if CD treatment can lead to reduced incidence of sudden death.