Among patients with cardiac sarcoidosis and an ICD, 32.1% received appropriate therapies for ventricular tachyarrhythmias over a mean 29.2 months, with LVEF <55% as a strong predictor (OR 6.52).
Cohort (n=112)
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What is the incidence and what are the predictors of appropriate ICD therapies in patients with cardiac sarcoidosis?
Almost one-third of patients with cardiac sarcoidosis and an ICD receive appropriate therapies, highlighting the high arrhythmic risk in this population, particularly those with ventricular dysfunction.
UNLABELLED: ICD Shocks in Cardiac Sarcoidosis. BACKGROUND: An implantable cardioverter defibrillator (ICD) is indicated for some patients with cardiac sarcoidosis (CS) for prevention of sudden death. However, there are little data regarding the event rates of ICD therapies in these patients. We sought to identify the incidence and characteristics of ICD therapies in this patient population. METHODS: We performed a cohort study of patients with ICDs at 3 institutions. Cases were those patients with CS and an ICD implanted for primary or secondary prevention of sudden death. Additionally, we included a comparison with historical controls of ICD therapy rates reported in clinical trials evaluating the ICD for primary and secondary prevention of sudden death. RESULTS: Of the 112 CS subjects identified, 36 (32.1%) received appropriate therapies for ventricular tachyarrhythmias (VT) over a mean follow-up period of 29.2 months. VT storm (>3 episodes in 24 hours) occurred in 16 (14.2%) CS subjects. Inappropriate therapies occurred in 13 CS subjects (11.6%). Covariates associated with appropriate ICD therapies included left ventricular ejection fraction (LVEF) <55% (OR 6.52 95% CI 2.43-17.5), right ventricular dysfunction (OR 6.73 95% CI 2.69-16.8), and symptomatic heart failure (OR 4.33 95% CI 1.86-10.1). CONCLUSIONS: In our cohort of patients with CS and ICDs, almost one-third receive appropriate therapies. This may be due to a myocardial inflammatory process leading to increased triggered activity and subsequent scarring leading to reentrant tachyarrhythmias. Adjusted predictors of ICD therapies in this population include left or right ventricular dysfunction. (J Cardiovasc Electrophysiol, Vol. 23, pp. 925-929, September 2012).
Schuller et al. (Thu,) conducted a cohort in Cardiac Sarcoidosis (n=112). Implantable cardioverter defibrillator (ICD) vs. Historical controls was evaluated on Appropriate therapies for ventricular tachyarrhythmias (VT). Among patients with cardiac sarcoidosis and an ICD, 32.1% received appropriate therapies for ventricular tachyarrhythmias over a mean 29.2 months, with LVEF <55% as a strong predictor (OR 6.52).