title: Long-Term Outcomes of Catheter Ablation of Ventricular Tachycardia in Patients With Cardiac Sarcoidosis.
abstract: Catheter ablation (CA) of ventricular tachycardia (VT) in patients with cardiac sarcoidosis can be challenging because of the complex underlying substrate. We sought to determine the long-term outcome of CA of VT in patients with cardiac sarcoidosis.
  
  
  
  We enrolled 31 patients (age, 55±10 years) with diagnosis of cardiac sarcoidosis based on Heart Rhythm Society criteria and VT who underwent CA. In 23 (74%) patients, preprocedure cardiac magnetic resonance imaging and positron emission tomographic (PET) evaluation were performed. Preprocedure magnetic resonance imaging was positive for late gadolinium enhancement in 21 of 23 (91%) patients, whereas abnormal 18-fluorodeoxyglucose uptake was found in 15 of 23 (65%) cases. In 14 of 15 patients with positive PET at baseline, PET was repeated after 6.1±3.7-month follow-up. After a median follow-up of 2.5 (range, 0-10.5) years, 1 (3%) patient died and 4 (13%) underwent heart transplant. Overall VT-free survival was 55% at 2-year follow-up. Among the 16 (52%) patients with VT recurrences, CA resulted in a significant reduction of VT burden, with 8 (50%) having only isolated (1-3) VT episodes and only 1 patient with recurrent VT storm. The presence of late gadolinium enhancement at magnetic resonance imaging, a positive PET at baseline, and lack of PET improvement over follow-up were associated with increased risk of recurrent VT.
  
  
  
  In patients with cardiac sarcoidosis and VT, CA is effective in achieving long-term freedom from VT or improvement in VT burden in the majority of patients. The presence of late gadolinium enhancement at magnetic resonance imaging, a positive PET scan at baseline, or lack of improvement at repeat PET over follow-up predict worse arrhythmia-free survival.
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Daniele
authors: D
authors: Muser
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Pasquale
authors: P
authors: Santangeli
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Rajeev K
authors: RK
authors: Pathak
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Simon A
authors: SA
authors: Castro
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Jackson J
authors: JJ
authors: Liang
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Silvia
authors: S
authors: Magnani
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Tatsuya
authors: T
authors: Hayashi
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Fermin C
authors: FC
authors: Garcia
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Mathew D
authors: MD
authors: Hutchinson
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Gregory E
authors: GE
authors: Supple
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: David S
authors: DS
authors: Frankel
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Michael P
authors: MP
authors: Riley
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: David
authors: D
authors: Lin
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Robert D
authors: RD
authors: Schaller
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Benoit
authors: B
authors: Desjardins
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Sanjay
authors: S
authors: Dixit
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: David J
authors: DJ
authors: Callans
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia.
authors: Erica S
authors: ES
authors: Zado
authors: From the Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia. francis.marchlinski@uphs.upenn.edu.
authors: Francis E
authors: FE
authors: Marchlinski
mesh_terms: D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D003952:Diagnostic Imaging; D056149:Epicardial Mapping; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: catheter ablation; fluorodeoxyglucose F18; positron-emission tomography; sarcoidosis, cardiac; tachycardia, ventricular