Abstract 14420: Supraventricular Arrhythmias in Patients with Cardiac Sarcoidosis: Prevalence, Predictors and Clinical Implications
Background: Cardiac sarcoidosis is known to be associated with congestive heart failure, conduction disorders, and tachyarrhythmias. Ventricular arrhythmias are the most feared cardiac manifestation of sarcoidosis, they are often unpredictable and may be the first manifestation of the disease. The propensity to develop supraventricular arrhythmias (SVA) in patients with cardiac sarcoidosis has not been described. The aim of this study was to assess the prevalence and predictors of SVA, and their clinical impact.
Methods: We investigated retrospectively 101 patients that had biopsy-proven systemic sarcoidosis and evidence of cardiac involvement (defined by cardiac biopsy, positron emission tomography or cardiac MRI). The mean follow-up was 5.8 years. ECG, Holter, ICD interrogations or electrophysiology studies were used to document SVA. Several echocardiographic parameters, demographics, extracardiac involvement were recorded and studied with univariate and multivariate analysis. Groups were defined as patients with and without SVA.
Results: The prevalence of SVA was 32%. Atrial fibrillation was the most common arrhythmia comprising 18% of the total, followed by atrial tachycardias 7%, atrial flutter 5%, and 2% other SVTs. 96% of the patients with SVA were symptomatic. Left atrial enlargement (LAE) was more prevalent in the group of patients with SVA (78.6% vs. 21.4% in those without SVA, p<0.05), and it increased significantly the likelihood of SVA (Odds Ratio = 22.4, 95%CI 4.6-107.9 p<0.05). Concomitantly, diastolic dysfunction and systemic hypertension were also univariate predictors of SVA, [(53.5% vs 46.5%, p<0.05) and (52.2% vs. 47.8%, p<0.05), respectively]. LV hypertrophy, RV dysfunction, tricuspid valve disease, pulmonary hypertension and pulmonary sarcoidosis were not associated with SVA in univariate analysis
Conclusion: This is the first large study reporting the prevalence of SVA in patients with cardiac sarcoidosis. SVA appears to be fairly frequent and often symptomatic. Systemic hypertension, diastolic dysfunction and LAE seem to be associated with the development of SVA in this patient population. Their predictive value for the development of SVA in patients with cardiac sarcoidosis should be studied prospectively.
- © 2011 by American Heart Association, Inc.