Considering that in chronic Chagas cardiomyopathy, the blockade of the ventricular conduction system by the high and persistent parasitism in the cardiac tissue leads to ventricular dysfunction, which can result in heart failure [34, 74, 75], it is tempting to speculate that somehow, the dysfunction in the ventricular conduction system frequently seen in chronic chagasic cardiomyopathy may result partly from manipulation of the polysialylation machinery that compromises PSA-NCAM and/or SCN5A expression. The gene discussed is NCAM1; the disease is heart failure.