For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
3
views
37
references
 Top references
cited by
25
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      2,752
      similar
       All similar
      • Record: found
      • Abstract: not found
      • Article: not found

      Ventricular Arrhythmias in Cardiac Sarcoidosis

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The diagnosis of cardiac sarcoidosis (CS), especially in cases where there is limited or no extracardiac involvement, is challenging. Patients with CS are at increased risk of ventricular arrhythmias and sudden cardiac death. Several techniques for risk stratification for sudden cardiac death have been proposed in this population, including advanced cardiac imaging and electrophysiology study. Clinical ventricular arrhythmias in patients with CS may be treated with immunosuppressant therapy, antiarrhythmic drugs, catheter ablation, or implantable cardioverter-defibrillator placement. This article will provide an update on techniques for diagnosing CS, risk stratifying patients with CS for sudden cardiac death, and treating patients with CS with ventricular arrhythmias, focusing on evidence that has become available since publication of the 2014 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Management of Arrhythmias Associated With Cardiac Sarcoidosis.

          Related collections

          Most cited references37

          • Record: found
          • Abstract: found
          • Article: not found

          Cardiac sarcoidosis: epidemiology, characteristics, and outcome over 25 years in a nationwide study.

          Kari Kaikkonen, Markus Pelkonen, Jorma O. Kokkonen … (2015)
          This study was designed to assess the epidemiology, characteristics, and outcome of cardiac sarcoidosis (CS) in Finland.
          Article 0 comments Cited 152 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone.

            Yoshikazu Yazaki, Mitsuaki Isobe, Michiaki Hiroe … (2001)
            Cardiac involvement is an important prognostic factor in sarcoidosis, but reliable indicators of mortality risk in cardiac sarcoidosis are unstudied in a large number of patients. To determine the significant predictors of mortality and to assess the efficacy of corticosteroids, we analyzed clinical findings, treatment, and prognosis in 95 Japanese patients with cardiac sarcoidosis. Twenty of these 95 patients had cardiac sarcoidosis proven by autopsy; none of these patients had received corticosteroids. We assessed 12 clinical variables as possible predictors of mortality by Cox proportional hazards model in 75 steroid-treated patients. During the mean follow-up of 68 months, 29 patients (73%) died of congestive heart failure and 11 (27%) experienced sudden death. Kaplan-Meier survival curves showed 5-year survival rates of 75% in the steroid-treated patients and of 89% in patients with a left ventricular ejection fraction > or = 50%, whereas there was only 10% 5-year survival rate in autopsy subjects. There was no significant difference in survival curves of patients treated with a high initial dose (> 30 mg) and a low initial dose (> or = 30 mg) of prednisone. Multivariate analysis identified New York Heart Association functional class (hazard ratio 7.72 per class I increase, p = 0.0008), left ventricular end-diastolic diameter (hazard ratio 2.60/10 mm increase, p = 0.02), and sustained ventricular tachycardia (hazard ratio 7.20, p = 0.03) as independent predictors of mortality. In conclusion, the severity of heart failure was one of the most significant independent predictors of mortality for cardiac sarcoidosis. Starting corticosteroids before the occurrence of systolic dysfunction resulted in an excellent clinical outcome. A high initial dose of prednisone may not be essential for treatment of cardiac sarcoidosis.
            Article 0 comments Cited 139 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Cardiac positron emission tomography enhances prognostic assessments of patients with suspected cardiac sarcoidosis.

              Ho Kim, Hicham Skali, Pedram Kazemian … (2014)
              This study sought to relate imaging findings on positron emission tomography (PET) to adverse cardiac events in patients referred for evaluation of known or suspected cardiac sarcoidosis. Although cardiac PET is commonly used to evaluate patients with suspected cardiac sarcoidosis, the relationship between PET findings and clinical outcomes has not been reported. We studied 118 consecutive patients with no history of coronary artery disease, who were referred for PET, using [(18)F]fluorodeoxyglucose (FDG) to assess for inflammation and rubidium-82 to evaluate for perfusion defects (PD), following a high-fat/low-carbohydrate diet to suppress normal myocardial glucose uptake. Blind readings of PET data categorized cardiac findings as normal, positive PD or FDG, positive PD and FDG. Images were also used to identify whether findings of extra-cardiac sarcoidosis were present. Adverse events (AE)-death or sustained ventricular tachycardia (VT)-were ascertained by electronic medical records, defibrillator interrogation, patient questionnaires, and telephone interviews. Among the 118 patients (age 52 ± 11 years; 57% males; mean ejection fraction: 47 ± 16%), 47 (40%) had normal and 71 (60%) had abnormal cardiac PET findings. Over a median follow-up of 1.5 years, there were 31 (26%) adverse events (27 VT and 8 deaths). Cardiac PET findings were predictive of AE, and the presence of both a PD and abnormal FDG (29% of patients) was associated with hazard ratio of 3.9 (p < 0.01) and remained significant after adjusting for left ventricular ejection fraction (LVEF) and clinical criteria. Extra-cardiac FDG uptake (26% of patients) was not associated with AE. The presence of focal PD and FDG uptake on cardiac PET identifies patients at higher risk of death or VT. These findings offer prognostic value beyond Japanese Ministry of Health and Welfare clinical criteria, the presence of extra-cardiac sarcoidosis and LVEF. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
              Article 0 comments Cited 134 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Title: Circulation
                Abbreviated Title: Circulation
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Print): 0009-7322
                ISSN (Electronic): 1524-4539
                Publication date Created: September 18 2018
                Publication date (Print): September 18 2018
                Volume: 138
                Issue: 12
                Pages: 1253-1264
                Affiliations
                [1 ]Center of Excellence for Complex Arrhythmias, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD.
                Article
                DOI: 10.1161/CIRCULATIONAHA.118.034687
                PubMed ID: 30354431
                SO-VID: e2d703ab-1a4c-4c5a-9a8e-287b965200f3
                Copyright © © 2018
                History

                Data availability:

                Comments

                Comment on this article

                scite_

                Similar content2,752

                See all similar

                Cited by27

                See all cited by

                Most referenced authors736

                See all reference authors