Why the study?
Patients with cardiac sarcoidosis are at increased risk of atrioventricular blocks, ventricular arrhythmias, and sudden cardiac death, but characteristics associated with appropriate ICD therapy remained to be clarified.
What factors are associated with appropriate ICD therapy in patients with cardiac sarcoidosis?
What factors are associated with appropriate ICD therapy in patients with cardiac sarcoidosis?
In patients with cardiac sarcoidosis and an ICD, appropriate therapy is common (39% over 3.5 years) and is significantly associated with younger age, male sex, lower LVEF, complete heart block, and ventricular pacing.
May guide risk stratification and monitoring in cardiac sarcoidosis patients with ICDs; leaves open prospective validation of these associations.
BACKGROUND: Patients with cardiac sarcoidosis (CS) are at increased risk of atrioventricular blocks, ventricular arrhythmias, and sudden cardiac death. Objectives We aimed to investigate the characteristics associated with appropriate therapy in implantable cardiac defibrillator (ICD) -implanted CS patients. METHODS: We performed a PubMed and Web of Science search for studies reporting patients with CS who underwent an ICD implantation. The primary criterion was an appropriate therapy. RESULTS: We screened 705 studies, of which 5 were included in the final analysis. We conducted a meta-analysis including 464 patients (mean age 55 years, 282 males (60%)). The mean follow-up was 3.5 years. Among the 464 patients, 180 received an appropriate therapy (39%). Patients who received an appropriate therapy were younger (-3.33, 95% confidence interval (CI) -6.42 to -0.23, p=0.004), were more likely to be male (OR 2.06, 95% CI 1.37-3.09, p=0.0005), had a lower left ventricular ejection fraction (LVEF) (-10.5, 95% CI -18.23 to -2.78, p=0.008), had a higher rate of complete heart block (OR 2.19, 95% CI 1.20 to 3.99, p=0.01), and more frequently had ventricular pacing (OR 6.44 95% CI 2.57 to 16.16, p<0.0001). CONCLUSIONS: .
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Azoulay et al. (2020) studied this question.
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