Arrhythmias & electrophysiologyRandomised controlled trial
Amiodarone or Implantable Cardioverter-Defibrillator in Chagas Cardiomyopathy
- Randomised controlled trial
- open-label
- multicentre (13 centres in Brazil)
- stopped prematurely for administrative reasons
Authors' conclusion
In patients with chronic Chagas cardiomyopathy at moderate to high risk of mortality, ICD did not reduce the risk of all-cause mortality. However, ICD significantly reduced the risk of SCD, pacing need, and heart failure hospitalization compared with amiodarone therapy.
Study context
- Population
- Chronic Chagas cardiomyopathy, Rassi score ≥10 (moderate to high risk) and ≥1 episode of nonsustained VTintended 1100
- Participants
- 323 participants
- Comparison
- Implantable cardioverter-defibrillator (ICD) vs amiodarone
- ICDn = 157
- Amiodaronen = 166reference
- Primary endpoint
- All-cause mortality
- Follow-up
- Median 3.6 (IQR, 1.8-4.4) years
Primary result
As reported in the abstract
Hazard ratio
0.86
95% CI 0.60–1.22
P = 0.40
Events by treatment group
ICD vs Amiodarone
HR 0.86 (95% CI 0.60–1.22); P = 0.40
Secondary outcomes
| Outcome | ICD | Amiodarone | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| SCD | 3.8% | 13.9% | 0.25 (0.10–0.61) | P = 0.001 | |
| Bradycardia requiring pacing | 1.9% | 16.3% | 0.10 (0.03–0.34) | P < 0.001 | |
| HF hospitalization | 8.9% | 16.9% | 0.46 (0.24–0.87) | P = 0.01 | |
| 0.050.21520Hazard ratio (log scale) |
Original publication
Amiodarone or Implantable Cardioverter-Defibrillator in Chagas Cardiomyopathy. JAMA Cardiol. Published 1 December 2024. doi:10.1001/jamacardio.2024.3169
Summarised from the published abstract; every number is checked against it