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November 17, 2021JAMA CardiologyOpen Access

Catheter ablation for VT in cardiac sarcoidosis eliminates storm in ~82% despite frequent major events.

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Why the study?

Medical management of VT in cardiac sarcoidosis has high failure rates, and the role of catheter ablation had only been studied in small, single-center cohorts.

Does catheter ablation improve outcomes in patients with cardiac sarcoidosis and ventricular tachycardia?

Population

158 consecutive patients with cardiac sarcoidosis and VT across 16 centers

Comparison

Catheter ablation of CS-associated VT and, as appropriate, medical treatment

Design

Multicenter international registry-based cohort study

Follow-up

Median 2.5 years

Key result

Catheter ablation for VT in cardiac sarcoidosis eliminated VT storm in 82% of patients, though 51% experienced VT recurrence, heart transplant, or death over a median 2.5 years.

Authors

KSKonstantinos C. SiontisPSPasquale SantangeliDMDaniele Muser

Discussion

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Member takes

Overview

Ablation may acutely resolve VT storm in cardiac sarcoidosis; leaves open durable benefit versus medical therapy.

Study Design

Type

Cohort (n=158)

Multicenter

Yes

Structured PICO

Does catheter ablation improve outcomes in patients with cardiac sarcoidosis and ventricular tachycardia?

P
Population
158 consecutive patients with cardiac sarcoidosis and ventricular tachycardia (mean age 52 years, 33% female) followed for a median of 2.5 years.
E
Exposure
Catheter ablation of CS-associated VT in conjunction with medical treatment
O
Outcome
Composite of VT recurrence, heart transplant (HT), or deathcomposite

Catheter ablation for ventricular tachycardia in cardiac sarcoidosis is associated with significant reductions in defibrillator shocks and VT storm, though long-term recurrence remains common, particularly in patients with baseline LV dysfunction or myocardial inflammation.

Limitations

  • Observational study design
  • Selected patients
  • Observational design
  • Selected patient population

Cite This Study

Siontis et al. (2021) conducted a cohort in Cardiac sarcoidosis with ventricular tachycardia (n=158). Catheter ablation was evaluated on composite of VT recurrence, heart transplant (HT), or death. Catheter ablation for VT in cardiac sarcoidosis eliminated VT storm in 82% of patients, though 51% experienced VT recurrence, heart transplant, or death over a median 2.5 years.

synapsesocial.com/papers/6aa28aece7df1a0e26240823https://doi.org/10.1001/jamacardio.2021.4738
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