Medical treatment of cardiac arrhythmias in Chagas' heart disease

ABSTRACT

There are no controlled clinical trials evaluating drug therapy in patients with ventricular arrhythmias and chronic chagasic cardiomyopathy. Empirical treatment with disopyramide (400-1,000 mg/d), phenytoin (4-6 mg/d), mexiletine (600-1,200 mg/d), propafenone (900 mg/d), amiodarone (loading 1,000 mg/d, 10-14 days; maintenance 200-600 mg/d), and sotalol (320 mg/d) had efficacy and tolerance ranging from 18 percent to 90 percent with heterogeneous criteria for efficacy definition. Further studies with homogenous criteria are required to determine which is the most appropriate drug therapy for patients with chronic chagasic cardiomyopathy and ventricular arrhythmias.