Abstract 16190: Clinical Factors and Management of Ventricular Arrhythmias in Patients With Cardiac Sarcoidosis
(Background) Sarcoidosis is a systemic inflammatory syndrome of unknown etiology and cardiac involvement (heart failure, AV block and ventricular arrhythmias) has been reported to be an important prognostic factor in this disease. Corticosteroid has been widely used in this disease but anti-tachyarrhythmic effect was limited. Several pharmacologic and antiarrhythmic devices (ICD/CRTD) were widely used for the treatment of this disease but little is known about the factors associated with the development of ventricular tachycardia/ventricular fibrillation (VT/VF).
(Method) Total one-hundred eighty four Japanese patients with cardiac sarcoidosis (clinical diagnosis in 79, and biopsy proven in 105 cases, M/F=54/130, age 62.4±12.0 years and mean follow-up period of 5.1 years) were collected from 43 hospitals. Mean left ventricular ejection fraction (EF) at diagnosis was 42.0±17.8% and corticosteroids was administered in 136 cases (74%). Sustained VT/VF was documented in 30 cases (16%), ICD/CRTD was implanted in 56 (41/15) cases and antiarrhythmic drugs were used in 72 (amiodaron in 39, sotalol in 14 and Na blocker in 27). Catheter ablation was performed in 20 cases.
(Results) Sustained VT/VF was more observed in low EF patients (25% in EF0.35, P<0.05) but not associated with positive gallium uptake. Corticosteroid did not reduce the number of episodes of VT/VF but significantly improves AV block in 26 cases (19%). Efficacy of antiarrhythmic drugs was amiodarone in 73%, sotalol in 57% and Na blockers in 50%.
(Conclusion) Sustained VT/VF is commonly observed in cardiac sarcoidosis. Defibrillation device with amiodarone should be considered in patients with decreased cardiac function.
- © 2011 by American Heart Association, Inc.