Ventricular Arrhythmias in Cardiac Sarcoidosis

Circulation. 2018 Sep 18;138(12):1253-1264. doi: 10.1161/CIRCULATIONAHA.118.034687.

Abstract

The diagnosis of cardiac sarcoidosis (CS), especially in cases where there is limited or no extracardiac involvement, is challenging. Patients with CS are at increased risk of ventricular arrhythmias and sudden cardiac death. Several techniques for risk stratification for sudden cardiac death have been proposed in this population, including advanced cardiac imaging and electrophysiology study. Clinical ventricular arrhythmias in patients with CS may be treated with immunosuppressant therapy, antiarrhythmic drugs, catheter ablation, or implantable cardioverter-defibrillator placement. This article will provide an update on techniques for diagnosing CS, risk stratifying patients with CS for sudden cardiac death, and treating patients with CS with ventricular arrhythmias, focusing on evidence that has become available since publication of the 2014 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Management of Arrhythmias Associated With Cardiac Sarcoidosis.

Keywords: cardiac sarcoidosis; electrophysiology study; risk stratification; ventricular arrhythmias.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Arrhythmia Agents / therapeutic use
  • Cardiomyopathies / complications*
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / drug therapy
  • Cardiomyopathies / mortality
  • Catheter Ablation
  • Death, Sudden, Cardiac / etiology*
  • Death, Sudden, Cardiac / prevention & control
  • Defibrillators, Implantable
  • Electric Countershock / instrumentation
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Sarcoidosis / complications*
  • Sarcoidosis / diagnosis
  • Sarcoidosis / drug therapy
  • Sarcoidosis / mortality
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / etiology*
  • Tachycardia, Ventricular / mortality
  • Tachycardia, Ventricular / therapy
  • Treatment Outcome

Substances

  • Anti-Arrhythmia Agents
  • Immunosuppressive Agents