What does this research mean for the field?

Patients with cardiac sarcoidosis can experience progressive left ventricular dilatation and persistent ventricular tachycardia despite immunosuppressive and antiarrhythmic therapies, highlighting the complementary role of CMR and PET in guiding management. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To analyze the imaging features and treatment approaches for arrhythmias in a patient with cardiac sarcoidosis.

March 12, 2026European Heart Journal - Case ReportsOpen Access

Cardiac sarcoidosis imaging features and latest advances in the management of arrhythmias: a case report

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Key result

Immunosuppression and antiarrhythmics fail to prevent progressive LV dilatation and persistent VT in cardiac sarcoidosis.

Key Points

To analyze the imaging features and treatment approaches for arrhythmias in a patient with cardiac sarcoidosis.
Presented a case of a 53-year-old male with out-of-hospital ventricular fibrillation arrest.
Utilized multimodality imaging including transthoracic echocardiography, cardiac magnetic resonance, and PET scans.
Employed advanced therapies including cardiac resynchronisation therapy defibrillator and immunosuppressive medications.
Established a definitive diagnosis of cardiac sarcoidosis with 90% likelihood based on imaging findings.
Progressive left ventricular dilatation and worsening systolic function noted over 18 months despite treatment.
Recurrent ventricular tachycardia persisted, leading to referral for ablation and transplant assessment.

Structured PICO

Population

53-year-old male presenting with out-of-hospital ventricular fibrillation arrest, subsequently diagnosed with cardiac sarcoidosis.

Intervention

Multimodality imaging (CMR and 18F-FDG PET) and multidisciplinary management including CRT-D, immunosuppression (methylprednisolone, prednisolone, methotrexate), and referral for VT ablation and heart transplant.

This case highlights the complementary role of CMR and PET in monitoring cardiac sarcoidosis, differentiating inflammatory from scar-mediated arrhythmias, and informing the timing of advanced interventions.

Discussion

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Implication

Warrants integrated CMR-PET monitoring to differentiate inflammation from scar in cardiac sarcoidosis; extends evidence for imaging-guided timing of advanced therapies.

Cite This Study

Sharma et al. (2026) studied this question. The patient with cardiac sarcoidosis experienced progressive LV dilatation and persistent ventricular tachycardia despite immunosuppressive therapy and antiarrhythmic treatment.

synapsesocial.com/papers/69b2580996eeacc4fcec74e6 https://doi.org/10.1093/ehjcr/ytag147

Topics

Cardiomyopathy Ventricular arrhythmias Cardiac amyloidosis

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Implication

Warrants integrated CMR-PET monitoring to differentiate inflammation from scar in cardiac sarcoidosis; extends evidence for imaging-guided timing of advanced therapies.