The Prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas' Disease: A Meta-Analysis.
BACKGROUND/OBJECTIVES
Chagas' disease (CD) has been associated with atrial fibrillation (AF) and electrocardiographic (ECG) conduction defects. However, prior studies have shown conflicting results. We performed a meta-analysis comparing the prevalence of AF and conduction abnormalities between CD and non-CD patients.


METHODS
PubMed, EMBASE, Cochrane Central, and Latin American databases were searched for studies that directly compared the prevalence of AF and conduction defects in CD and non-CD patients. Odds ratios (OR) were computed using random-effects model due to anticipated heterogeneity. We further performed subanalyses limited to studies that included only patients with cardiomyopathy.


RESULTS
A total of 17,238 patients from 30 studies were included, of whom 6,840 (40%) had a positive serology for CD. In the pooled data, AF was significantly more prevalent in the CD group (OR 1.62; 95%CI 1.21-2.15; P = 0.001). However, no significant difference was observed between groups when the analysis included only patients with cardiomyopathy (OR 1.21; 95%CI 0.97-1.50; P = 0.08) or heart failure (OR 1.09; 95%CI 0.81-1.47; P = 0.55). The combination of right bundle branch block (RBBB) and left anterior fascicular block (LAFB) had the highest OR for increased prevalence in patients with Chagas' cardiomyopathy compared to non-CD etiologies (OR 5.31; 95%CI 1.23-22.86; P = 0.03).


CONCLUSIONS
Our meta-analysis suggests that the prevalence of AF in patients with Chagas' cardiomyopathy is not significantly different from non-CD cardiomyopathies. The pattern of RBBB and LAFB in patients with cardiomyopathy of unknown etiology and epidemiologic risk factors should raise the possibility of CD and prompt specific diagnostic testing.
['Cardoso|Rhanderson|R|', 'Garcia|Daniel|D|', 'Fernandes|Gilson|G|', 'He|L I|LI|', 'Lichtenberger|Paola|P|', 'Viles-Gonzalez|Juan|J|', 'Coffey|James O|JO|', 'Mitrani|Raul D|RD|']
D000200:Action Potentials D001281:Atrial Fibrillation D002598:Chagas Cardiomyopathy D016009:Chi-Square Distribution D004562:Electrocardiography D006329:Heart Conduction System D006339:Heart Rate D006801:Humans D016017:Odds Ratio D015995:Prevalence D011379:Prognosis D012307:Risk Factors
atrial fibrillation right bundle branch block left anterior fascicular block Chagas’ disease electrocardiogram left bundle branch block