“Prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas Disease: A Systematic Review and an Updated Meta-Analysis”

Background: Chagas disease (CD) remains a major public health issue, characterized by a unique arrhythmogenic cardiomyopathy with atrial fibrillation (AF) and conduction abnormalities. Updated evidence on the prevalence of these disturbances is essential to inform clinical guidelines. Objective: This updated meta-analysis aimed to evaluate the prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas Disease. Methods: We conducted a comprehensive meta-analysis including 33 studies published through February 2025 (n=17,100; 6,644 with CD). Prevalence of AF and conduction disorders was assessed in CD compared with controls (healthy or non-Chagas cardiomyopathies). Subgroup analyses included ischemic, dilated, and idiopathic cardiomyopathies. Random-effects models were applied, with heterogeneity and publication bias formally evaluated. This systematic review and meta-analysis was registered in PROSPERO (CRD420251005184). Results: AF was significantly more prevalent in CD (9.9%) than in controls (6.6%; OR=1.88, 95% CI: 1.46–2.42). Among cardiomyopathy patients, AF remained more frequent in CD (12.1% vs. 9.5%; OR=1.31, 95% CI: 1.07–1.60). Compared with ICM, CD carried a higher AF risk (OR=1.55, 95% CI: 1.13–2.12), whereas no difference was observed versus DCM. Conduction abnormalities were markedly more common in CD: first-degree atrioventricular block (OR=2.71, 95% CI: 1.66–4.44), right bundle branch block (isolated or with left anterior fascicular block), and second-degree atrioventricular block. Conclusions: This updated meta-analysis confirms that Chagas cardiomyopathy confers a significantly higher burden of AF and conduction disturbances compared with other cardiomyopathies. These findings underscore the need for systematic electrocardiographic screening, early anticoagulation, and tailored therapeutic strategies in CD. Developing disease-specific management protocols could substantially reduce morbidity and mortality among millions affected across the Americas. Information & Authors Information Version history Peer review timeline Published Journal of Interventional Cardiac Electrophysiology Version of Record10 Feb 2026Published Copyright This work is licensed under a Non Exclusive No Reuse License.

Authors Metrics & Citations Metrics Article Usage 185views 113downloads Citations Download citation Francisco Rafael Gomes Lima, MBBS3 Muhammad Sharjeel Abbas, M.S.1 Kênnio Alves Aguiar, et al. “Prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas Disease: A Systematic Review and an Updated Meta-Analysis”. Authorea. 14 October 2025. DOI: https://doi.org/10.22541/au.176041093.35866379/v1 DOI: https://doi.org/10.22541/au.176041093.35866379/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu.