title: Cardiac sarcoidosis: electrophysiological outcomes on long-term follow-up and the role of the implantable cardioverter-defibrillator.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Cardiology, Department of Medicine, University of Louisville, Kentucky, USA.
authors.forename: Amr
authors.initials: A
authors.lastname: Mohsen
authors.forename: Alejandro
authors.initials: A
authors.lastname: Jimenez
authors.forename: Robert E
authors.initials: RE
authors.lastname: Hood
authors.forename: Timm
authors.initials: T
authors.lastname: Dickfeld
authors.forename: Anastasios
authors.initials: A
authors.lastname: Saliaris
authors.forename: Stephen
authors.initials: S
authors.lastname: Shorofsky
authors.forename: Magdi M
authors.initials: MM
authors.lastname: Saba
mesh_terms: D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D017147:Defibrillators, Implantable; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
keywords: cardiac sarcoid; implantable cardioverter-defibrillator; sarcoidosis; sudden cardiac death; ventricular tachycardia