Abstract / Summary
Abstract Purpose Residual symptoms, particularly dizziness, persist in many recipients of cardiac implantable electronic devices (CIED). We compared dizziness and quality of life in CIED patients with and without chronic Chagas cardiomyopathy (CCC). Methods Cross-sectional study of consecutive CIED outpatients. The primary outcome was the presence of dizziness on systematic clinical assessment; the Dizziness Handicap Inventory measured burden. Quality of life was assessed with the Short Form-36 Health Survey (SF-36). Analyses used Firth penalized logistic and multiple linear regression, plus mediation analysis. Results Of 100 patients (mean age 68.2 years, 59% women), 36 had CCC. The CCC group had lower ejection fraction (p = 0.039), worse functional class (p = 0.024), and more non-sustained ventricular tachycardia (50.0% vs 4.7%; p < 0.001). Dizziness was more frequent in CCC (83.3% vs 51.6%; p = 0.002) and remained independent after adjustment (odds ratio 3.96; 95% confidence interval 1.46–10.78; p = 0.007). Global SF-36 and its components were similar between groups, but dizziness was associated with lower global (45.6 vs 50.1; p = 0.026) and physical component (42.7 vs 50.0; p = 0.002) scores; mediation analysis showed a significant indirect effect of CCC on quality of life through dizziness. No drug class or comorbidity was associated with dizziness. Conclusion CIED recipients with CCC report dizziness more often than other etiologies, independently of structural and arrhythmic burden and of medication, and dizziness is associated with worse physical quality of life. The variables evaluated did not identify the mechanism, supporting systematic assessment of dizziness in follow-up.