First-time implantation of pacemakers and prevalence of Chagas disease at an Argentinian public hospital

Abstract

Objectives: To describe the demographics of patients submitted to a first-time implantation of a pacemaker at an Argentinian public hospital and their reasons for implantation, pacing mechanisms, and prevalence of Chagas disease. Methods: Descriptive, analytical, cross-sectional, and single-center study, in which data were collected from 624 consecutive pts from 1998 to 2013.
Results: First implantations totaled 624, 57.3% were male patients. The average age was 63.8 years. Further, 81% had new generators implanted and 19% were re-sterilized. Reasons for implantation: 70% due to atrioventricular blocks (AVBs) and 30% due to sinus node dysfunction/tachycardia-bradycardia syndrome (SND/TBS). A total of 81.6% had a VVI/VVIR PM implanted. Serology for Chagas disease was positive in 58.9%. Chagasic and non-Chagasic pts had similar average ages and male prevalence. In both subgroups, AVB predominated. Non-Chagasic patients had a higher prevalence of AVB: 75.7% vs. 62.3% (p<0.002). Chagasic female patients had a higher incidence of SND / TBS compared with non-Chagasic women: 46% vs. 27% (p<0.007). Non-Chagasic male patients had the highest incidence of AVB (78%). Conclusions: The average age was 63.8 years, 57.3% of whom were male patients. The most common cause for implantation was AVB. There was a notable predominant indication for single-chamber PMs (81.6%). Nineteen percent received re-sterilized pacemakers. A high prevalence of Chagas disease was observed. Chagasic female patients had a higher incidence of SND / TBS, and more non-Chagasic male patients tended to have AVB.