Autonomic dysfunction and Chagas Disease: what we know and what we need to integrate into clinical practice

Objective: To provide a general, comprehensive and up-to-date overview of the action of the autonomic nervous system in Chagas' disease and the validation of Heart Rate Variability (HRV) as a tool for assessing the autonomic nervous system in Chagas' disease. Methods: This review was based on a search of the databases of the Scientific Electronic Library Online (SCIELO) and PUBMED between May and December 2023, using the terms Chagas disease and heart rate variability between 2011 and 2023. Results: The Autonomic Nervous System (ANS) has been extensively analyzed in relation to Chagas Disease. These findings characterize a parasympathetic-deprived cardiopathy with sympathetic predominance. Heart rate variability (HRV) investigates the oscillations in the intervals between consecutive heartbeats (RR intervals) that are confidently related to the influence of the ANS on the sinus node over a certain period of time. Final Considerations: Autonomic nervous system dysfunction is one of the main mechanisms of injury in Chagas disease, and heart rate variability is one of the ways to detect this condition. However, the use of heart rate variability should be incorporated into clinical practice for the assessment of patients diagnosed with Chagas' disease.