Abstract 17076: Prognostic Implications of 12-Lead Surface ECG Characteristics in Patients With Cardiac Sarcoidosis and Preserved Ejection Fraction
Introduction: Among patients with cardiac sarcoidosis (CS) and preserved left ventricular ejection fraction (LVEF), there is little evidence for risk stratification to guide device therapy, and the prognosis of these patients is not well defined. We sought to determine if 12-lead surface ECG characteristics predict adverse events (AE) in patients with biopsy proven extra-cardiac sarcoidosis, preserved LVEF, and late-gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR), demonstrating CS.
Methods: Forty-eight patients (age 54 +/- 11 years, 63% female), referred for CMR to evaluate for CS between April 2008 and December 2012, were found to have LGE and preserved LVEF (>50%). Medical records, including ICD interrogations, were reviewed and patients contacted to determine AE (death, ventricular fibrillation, or sustained ventricular tachycardia). ECG characteristics assessed include ventricular rate, PR interval, QRS duration, QT interval, corrected QT interval (QTc), axis deviation, ventricular hypertrophy, and the presence of a bundle branch block, among others. In the setting of a bundle branch block, 40ms was subtracted from the QTc interval, in-line with previous studies. AE-free survival analysis was performed, comparing patients with and without a prolonged QTc (>440ms). Patients with CS and AE were compared to those with no AE using a student’s t-test.
Results: Ten of forty-eight patients with CS had an AE during follow-up (average of 2.6 years). AE-free survival was significantly less for those patients with QTc >440ms (p=0.002). Patients with CS and AE have longer QTc intervals compared to those without AE (462 vs. 435ms, p=0.003). Other ECG characteristics were not significantly different.
Conclusions: In patients with CS and preserved LVEF, a QTc greater than 440ms is a negative prognostic marker and may play a role in risk stratification to guide device therapy.
Author Disclosures: L.J. Laffin: None. A.R. Patel: None. G. Murtagh: None. Z. Yu: None. A.V. Patel: None. C. Bonham: None. K. Addetia: None. J.D. Moss: None. D.K. Hogarth: None. N. Sweiss: None. R.M. Lang: None. J.F. Beshai: None.
- © 2014 by American Heart Association, Inc.