Cardiac sarcoidosis: Electrophysiological outcomes on long-term follow-up and the role of the implantable cardioverter-defibrillator

Amr Mohsen, Alejandro Jimenez, Robert E. Hood, Timm Dickfeld, Anastasios Saliaris, Stephen Shorofsky, Magdi M. Saba

Research output: Contribution to journalArticle

Abstract

Cardiac Sarcoidosis Objectives The objectives of this study were to identify the predictors of life-threatening ventricular arrhythmias in patients with cardiac sarcoidosis (CS) and to evaluate the role of the implantable cardioverter-defibrillator (ICD) in this patient population. Background ICD implantation is a class IIA recommendation for patients with CS. However, some indications for ICD implantation in CS patients are still unclear and not enough data are available to establish predictors of malignant ventricular tachyarrhythmias in this group of patients. Methods We retrospectively identified all consecutive patients who were diagnosed with CS, during the period from March 2002 to April 2010. Cardiac rhythm devices were regularly interrogated and clinical data recorded during follow-up visits. Results Thirty-three patients (17 male) with CS were identified. The mean age was 53 ± 11. The mean left ventricular ejection fraction (LVEF) was 41 ± 18%. Thirty patients received an ICD. Twelve patients (36.3%) had sustained ventricular arrhythmias. Eleven patients received appropriate therapies and 9 patients received inappropriate shocks, representing 36.7% and 30.0% of the ICD population, respectively. Patients who received appropriate ICD therapies were younger with mean age 47.4 ± 7.8, and had a lower mean LVEF 33.0 ± 12.0 compared to those who did not receive ICD therapies (P = 0.0301 and 0.0341, respectively). There were no other demographic, clinical, electrocardiographic, electrophysiological, or imaging markers that predicted the future occurrence of appropriate ICD therapies in our cohort of patients. Conclusions CS is strongly associated with malignant ventricular arrhythmias. No specific predictors of such tachyarrhythmias emerged, other than young age and low LVEF.

Original languageEnglish (US)
Pages (from-to)171-176
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume25
Issue number2
DOIs
StatePublished - Feb 2014
Externally publishedYes

Fingerprint

Implantable Defibrillators
Sarcoidosis
Stroke Volume
Cardiac Arrhythmias
Tachycardia
Therapeutics
Population
Shock

Keywords

  • cardiac sarcoid
  • implantable cardioverter-defibrillator
  • sarcoidosis
  • sudden cardiac death
  • ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Cardiac sarcoidosis : Electrophysiological outcomes on long-term follow-up and the role of the implantable cardioverter-defibrillator. / Mohsen, Amr; Jimenez, Alejandro; Hood, Robert E.; Dickfeld, Timm; Saliaris, Anastasios; Shorofsky, Stephen; Saba, Magdi M.

In: Journal of Cardiovascular Electrophysiology, Vol. 25, No. 2, 02.2014, p. 171-176.

Research output: Contribution to journalArticle

Mohsen, Amr ; Jimenez, Alejandro ; Hood, Robert E. ; Dickfeld, Timm ; Saliaris, Anastasios ; Shorofsky, Stephen ; Saba, Magdi M. / Cardiac sarcoidosis : Electrophysiological outcomes on long-term follow-up and the role of the implantable cardioverter-defibrillator. In: Journal of Cardiovascular Electrophysiology. 2014 ; Vol. 25, No. 2. pp. 171-176.
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abstract = "Cardiac Sarcoidosis Objectives The objectives of this study were to identify the predictors of life-threatening ventricular arrhythmias in patients with cardiac sarcoidosis (CS) and to evaluate the role of the implantable cardioverter-defibrillator (ICD) in this patient population. Background ICD implantation is a class IIA recommendation for patients with CS. However, some indications for ICD implantation in CS patients are still unclear and not enough data are available to establish predictors of malignant ventricular tachyarrhythmias in this group of patients. Methods We retrospectively identified all consecutive patients who were diagnosed with CS, during the period from March 2002 to April 2010. Cardiac rhythm devices were regularly interrogated and clinical data recorded during follow-up visits. Results Thirty-three patients (17 male) with CS were identified. The mean age was 53 ± 11. The mean left ventricular ejection fraction (LVEF) was 41 ± 18{\%}. Thirty patients received an ICD. Twelve patients (36.3{\%}) had sustained ventricular arrhythmias. Eleven patients received appropriate therapies and 9 patients received inappropriate shocks, representing 36.7{\%} and 30.0{\%} of the ICD population, respectively. Patients who received appropriate ICD therapies were younger with mean age 47.4 ± 7.8, and had a lower mean LVEF 33.0 ± 12.0 compared to those who did not receive ICD therapies (P = 0.0301 and 0.0341, respectively). There were no other demographic, clinical, electrocardiographic, electrophysiological, or imaging markers that predicted the future occurrence of appropriate ICD therapies in our cohort of patients. Conclusions CS is strongly associated with malignant ventricular arrhythmias. No specific predictors of such tachyarrhythmias emerged, other than young age and low LVEF.",
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AU - Saliaris, Anastasios

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N2 - Cardiac Sarcoidosis Objectives The objectives of this study were to identify the predictors of life-threatening ventricular arrhythmias in patients with cardiac sarcoidosis (CS) and to evaluate the role of the implantable cardioverter-defibrillator (ICD) in this patient population. Background ICD implantation is a class IIA recommendation for patients with CS. However, some indications for ICD implantation in CS patients are still unclear and not enough data are available to establish predictors of malignant ventricular tachyarrhythmias in this group of patients. Methods We retrospectively identified all consecutive patients who were diagnosed with CS, during the period from March 2002 to April 2010. Cardiac rhythm devices were regularly interrogated and clinical data recorded during follow-up visits. Results Thirty-three patients (17 male) with CS were identified. The mean age was 53 ± 11. The mean left ventricular ejection fraction (LVEF) was 41 ± 18%. Thirty patients received an ICD. Twelve patients (36.3%) had sustained ventricular arrhythmias. Eleven patients received appropriate therapies and 9 patients received inappropriate shocks, representing 36.7% and 30.0% of the ICD population, respectively. Patients who received appropriate ICD therapies were younger with mean age 47.4 ± 7.8, and had a lower mean LVEF 33.0 ± 12.0 compared to those who did not receive ICD therapies (P = 0.0301 and 0.0341, respectively). There were no other demographic, clinical, electrocardiographic, electrophysiological, or imaging markers that predicted the future occurrence of appropriate ICD therapies in our cohort of patients. Conclusions CS is strongly associated with malignant ventricular arrhythmias. No specific predictors of such tachyarrhythmias emerged, other than young age and low LVEF.

AB - Cardiac Sarcoidosis Objectives The objectives of this study were to identify the predictors of life-threatening ventricular arrhythmias in patients with cardiac sarcoidosis (CS) and to evaluate the role of the implantable cardioverter-defibrillator (ICD) in this patient population. Background ICD implantation is a class IIA recommendation for patients with CS. However, some indications for ICD implantation in CS patients are still unclear and not enough data are available to establish predictors of malignant ventricular tachyarrhythmias in this group of patients. Methods We retrospectively identified all consecutive patients who were diagnosed with CS, during the period from March 2002 to April 2010. Cardiac rhythm devices were regularly interrogated and clinical data recorded during follow-up visits. Results Thirty-three patients (17 male) with CS were identified. The mean age was 53 ± 11. The mean left ventricular ejection fraction (LVEF) was 41 ± 18%. Thirty patients received an ICD. Twelve patients (36.3%) had sustained ventricular arrhythmias. Eleven patients received appropriate therapies and 9 patients received inappropriate shocks, representing 36.7% and 30.0% of the ICD population, respectively. Patients who received appropriate ICD therapies were younger with mean age 47.4 ± 7.8, and had a lower mean LVEF 33.0 ± 12.0 compared to those who did not receive ICD therapies (P = 0.0301 and 0.0341, respectively). There were no other demographic, clinical, electrocardiographic, electrophysiological, or imaging markers that predicted the future occurrence of appropriate ICD therapies in our cohort of patients. Conclusions CS is strongly associated with malignant ventricular arrhythmias. No specific predictors of such tachyarrhythmias emerged, other than young age and low LVEF.

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KW - sudden cardiac death

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