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Arrhythmic manifestations and outcomes of definite and probable cardiac sarcoidosis.
Sykora, Daniel; Rosenbaum, Andrew N; Churchill, Robert A; Kim, B Michelle; Elwazir, Mohamed Y; Bois, John P; Giudicessi, John R; Bratcher, Melanie; Young, Kathleen A; Ryan, Sami M; Sugrue, Alan M; Killu, Ammar M; Chareonthaitawee, Panithaya; Kapa, Suraj; Deshmukh, Abhishek J; Abou Ezzeddine, Omar F; Cooper, Leslie T; Siontis, Konstantinos C.
Afiliación
  • Sykora D; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Rosenbaum AN; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Churchill RA; Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota.
  • Kim BM; Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota.
  • Elwazir MY; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Bois JP; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Giudicessi JR; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Bratcher M; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Young KA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Ryan SM; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Sugrue AM; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Killu AM; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Chareonthaitawee P; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Kapa S; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Deshmukh AJ; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Abou Ezzeddine OF; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
  • Cooper LT; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida.
  • Siontis KC; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: Siontis.Konstantinos@mayo.edu.
Heart Rhythm ; 2024 Apr 06.
Article en En | MEDLINE | ID: mdl-38588996
ABSTRACT

BACKGROUND:

The 2014 Heart Rhythm Society consensus statement defines histological (definite) and clinical (probable) diagnostic categories of cardiac sarcoidosis (CS), but few studies have compared their arrhythmic phenotypes and outcomes.

OBJECTIVE:

The purpose of this study was to evaluate the electrophysiological/arrhythmic phenotype and outcomes of patients with definite and probable CS.

METHODS:

We analyzed the arrhythmic/electrophysiological phenotype in a single-center North American cohort of 388 patients (median age 56 years; 39% female, n = 151) diagnosed with definite (n = 58) or probable (n = 330) CS (2000-2022). The primary composite outcome was survival to first ventricular tachycardia/fibrillation (VT/VF) event or sudden cardiac death. Key secondary outcomes were also assessed.

RESULTS:

At index evaluation, in situ cardiac implantable electronic devices and antiarrhythmic drug use were more common in definite CS. At a median follow-up of 3.1 years, the primary outcome occurred in 22 patients with definite CS (38%) and 127 patients with probable CS (38%) (log-rank, P = .55). In multivariable analysis, only a higher ratio of the 18F-fluorodeoxyglucose maximum standardized uptake value of the myocardium to the maximum standardized uptake value of the blood pool (hazard ratio 1.09; 95% confidence interval 1.03-1.15; P = .003, per 1 unit increase) was associated with the primary outcome. During follow-up, patients with definite CS had a higher burden of device-treated VT/VF events (mean 2.86 events per patient-year vs 1.56 events per patient-year) and a higher rate of progression to heart transplant/left ventricular assist device implantation but no difference in all-cause mortality compared with patients with probable CS.

CONCLUSION:

Patients with definite and probable CS had similarly high risks of first sustained VT/VF/sudden cardiac death and all-cause mortality, though patients with definite CS had a higher overall arrhythmia burden. Both CS diagnostic groups as defined by the 2014 Heart Rhythm Society criteria require an aggressive approach to prevent arrhythmic complications.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Heart Rhythm Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Heart Rhythm Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos