Corticosteroid therapy did not reduce arrhythmias overall, but significantly reduced PVCs (from 1820 to 742, P=0.048) and NSVT (41% to 6%, P=0.039) in patients with EF ≥35%.
Observational (n=31)
Does prednisone reduce the number of premature ventricular contractions and prevalence of nonsustained ventricular tachycardia in patients with cardiac sarcoidosis?
Corticosteroid therapy reduces ventricular arrhythmia burden in cardiac sarcoidosis patients with preserved or mildly reduced ejection fraction (EF ≥ 35%), but appears ineffective for arrhythmias in those with advanced LV dysfunction.
BACKGROUND: Ventricular arrhythmias are one of the main causes of sudden death in cardiac sarcoidosis (CS). Little is known about the efficacy of corticosteroid therapy for ventricular arrhythmias in CS. METHODS: Thirty-one CS patients presenting premature ventricular contractions (PVCs, ≥300/day) were investigated. Fourteen patients had nonsustained ventricular tachycardia (NSVT). All of patients were treated with corticosteroid, and the initial dosage is 30 mg/day of prednisone, which was tapered over a period of 6 months to a maintenance dosage of 10 mg/day. Twenty-four hour Holter monitoring, signal averaged electrocardiography (SAECG), echocardiography, gallium-67 scintigraphy, serum angiotensin converting enzyme (ACE) and plasma B-type natriuretic peptide (BNP) concentrations were assessed before and after corticosteroid therapy. RESULTS: As a whole, there were no significant differences in the number of PVCs and in the prevalence of NSVT before and after steroid therapy. However, the less advanced LV dysfunction patients (EF ≥ 35%, n = 17) showed significant reduction in the number of PVCs (from 1820 ± 2969 to 742 ± 1425, P = 0.048) and in the prevalence of NSVT (from 41 to 6%, p = 0.039). Late potentials on SAECG were abolished in 3 patients. The less advanced LV dysfunction group showed a significantly higher prevalence of gallium-67 uptake compared with the advanced LV dysfunction group (EF < 35 %, n = 14). In the advanced LV dysfunction patients, there were no significant differences in these parameters. CONCLUSIONS: Corticosteroid therapy may be effective for ventricular arrhythmias in the early stage, but less effective in the late stage.
Yodogawa et al. (Fri,) conducted a observational in Cardiac sarcoidosis with ventricular arrhythmias (n=31). Corticosteroid therapy (prednisone) vs. Baseline (before therapy) was evaluated on Number of premature ventricular contractions (PVCs) and prevalence of nonsustained ventricular tachycardia (NSVT). Corticosteroid therapy did not reduce arrhythmias overall, but significantly reduced PVCs (from 1820 to 742, P=0.048) and NSVT (41% to 6%, P=0.039) in patients with EF ≥35%.