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Long-term monitoring of arrhythmias with cardiovascular implantable electronic devices in patients with cardiac sarcoidosis

Heart rhythm(2022)

Cited 6|Views4
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Abstract
BACKGROUND Risk stratification for sudden cardiac death (SCD) in cardiac sarcoidosis (CS) is challenging in patients without overt car-diac symptoms.
& nbsp;OBJECTIVE The purpose of this study was to determine the inci-dence of ventricular arrhythmias (VAs) and mortality after long-term monitoring with a cardiovascular implantable electronic device (CIED) in CS patients identified after systematic screening of pa-tients with extracardiac sarcoidosis (ECS).& nbsp;METHODS A retrospective study was performed in 547 predomi-nantly Caucasian patients with ECS screened for cardiac involve-ment. If CS was diagnosed, risk stratification (high vs low risk) for SCD was performed by a multidisciplinary team. The primary endpoint was defined as sustained VA, appropriate implantable cardioverter-defibrillator (ICD) therapy, or cardiac death.
& nbsp;RESULTS In total, 105 patients were included (mean follow-up 33 6 16 months). An ICD was implanted in 17 high-risk patients (16.2%), whereas 80 low-risk patients (76.1%) received an implant-able loop recorder (ILR). Eight low-risk patients (7.6%) did not receive a device. The primary endpoint occurred in 4.8% (n 5 5), with an overall annualized event rate of 1.7%. The annualized event rate was 9.8% in high-risk patients and 0.4% in low-risk patients. Nine low-risk patients received an ICD during follow-up, in 7 pa-tients as a result of the ILR recordings. None of these patients required ICD therapy.CONCLUSION In CS patients without overt cardiac symptoms at initial presentation the annualized overall event rate was 1.7%; 10% in high-risk patients, but only 0.4% in low-risk patients. In low-risk patients long-term arrhythmia monitoring with an ILR enabled early detection of clinically important arrhythmias without showing impact on prognosis. (C) 2021 Heart Rhythm Society.All rights reserved.
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Key words
Cardiovascular implantable electronic device,Cardiac sarcoidosis,Implantable cardioverter-defibrillator,Implantable loop recorder,Risk stratification,Sudden cardiac death,Ventricular arrhythmia
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