Incidence and predictors of new-onset sustained ventricular tachycardia in patients with cardiac sarcoidosis and high-grade AV block as first cardiac symptom

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiac sarcoidosis (CS) is infrequently affecting the heart and may cause failure dangerous arrhythmias. If left untreated, it usually progresses to end-stage or can sudden cardiac death. A frequent initial presentation AV block, but malignant ventricular arrhythmias occur in course disease, as well. Ventricular tachycardia fibrillation (VT/VF) even patients with normal nearly ejection fraction. Therefore, current guidelines recommend implantation ICD devices whenever a pacemaker needed, such case although there are little data supporting this opinion. Purpose The purpose study was establish risk for occurrence VT/VF CS, initially presenting block. Furthermore, we sought possible predictors VT/VF. Methods We analyzed 128 diagnosed CS according latest JCS criteria. Patients block were selected followed differences between baseline characteristics imaging those without Results Out 30 (23%) (13 female, age 50 ± 10 y; EF 48 12%) high-grade Block symptom identified. In 7 them, permanent had already been implanted. 15 (50%) diagnosis confirmed histologically. MRI showed presence LGE mean volume 14±8%, RV involvement 5 cases. 18FDG-PET abnormal tracer enhancement 12 (40%) SUVmax 9 5. new sustained occurred during follow up (30%) patients; non-sustained VT other 4. Death suddenly 2 patients, both an device. univariate analysis, following not associated VT: age, LVEF, amount LGE, SUVmax, ACE sIL2-R. FU more frequently ( 50% vs. 0 %); CMR (100% vs 50%) positive PET 100% 57%). Conclusions have very high developing only ICD. implantation, instead pacemaker, should be considered all especially CMR, 18FDG involvement.