Ventricular tachycardia refractory to medical treatment in chronic chagasic cardiomyopathy. Case Review

Abstract

The Ventricular Tachycardia in patients with chagasic cardiomyopathy arises as a consequence of the arrhythmogenic base that the illness develops over time, and as imminent cause of sudden death, proper antiarrhythmic management is essential. It is found in almost 90% of patients with chronic chagasic cardiomyopathy who come with data of heart failure and in 40% without data of heart failure. Clinical Case: A 53-year-old male patient with chagas disease, mixed heart disease, ischemic and hypertensive, and ventricular tachycardia, the latter undergoing a long-term daily mixed treatment with lecainide 100mg po, amiodarone 200mg po and propafenone 150mg po; He presented dyspnea at rest and acute chest pain from one day of evolution, physical exploration with inaudible blood pressure, heart rate of 185 beats per minute, arrhythmic heart. The electrocardiogram showed sustained monomorphic ventricular tachycardia with a wide QRS complex. Conclusion: The desired control has not been achieved by combined antiarrhythmic therapy in this case of patients with Ventricular Tachycardia. Therefore it is recommended to install therapeutic devices such as implantable cardioverter deibrillator, cardiac resynchronization therapy or catheter ablation to improve their survival and life quality.