Electrophysiologic testing for diagnostic evaluation and risk stratification in patients with suspected cardiac sarcoidosis with preserved left and right ventricular systolic function.
Introduction: While cardiac sarcoidosis (CS) carries a risk of ventricular arrhythmias (VAs) and sudden cardiac death (SCD), risk stratification of patients with CS and preserved left ventricular/right ventricular (LV/RV) systolic function remains challenging. We sought to evaluate the role of elect...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 30; no. 10; pp. 1939 - 1949 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139054091&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139054091 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Oct2019 vid: 30 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 139054091 139054091 139054091 10.1111/jce.14058 139054091 ppf: 1939 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Electrophysiologic testing for diagnostic evaluation and risk stratification in patients with suspected cardiac sarcoidosis with preserved left and right ventricular systolic function. aug: au: Zipse, Matthew M. Tzou, Wendy S. Schuller, Joseph L. Aleong, Ryan G. Varosy, Paul D. Tompkins, Christine Borne, Ryan T. Tumolo, Alexis Z. Sandhu, Amneet Kim, Darlene Freeman, Andrew M. Weinberger, Howard D. Maier, Lisa A. Sung, Raphael K. Nguyen, Duy T. Sauer, William H. affil: Division of Cardiology, Section of Cardiac Electrophysiology, University of Colorado, Aurora Colorado sug: subj: Myocardial Diseases Complications Sarcoidosis Complications Ventricular Dysfunction, Left Complications Ventricular Dysfunction, Right Complications Systole Evaluation Arrhythmia, Ventricular Risk Factors Arrhythmia, Ventricular Diagnosis Electric Stimulation Methods Electrophysiology Risk Assessment Human Biopsy Methods Myocardial Diseases Diagnosis Sarcoidosis Diagnosis Ventricular Dysfunction, Right Diagnosis Ventricular Dysfunction, Left Diagnosis Tomography, Emission-Computed Methods Magnetic Resonance Imaging Methods Echocardiography Methods Tachycardia, Ventricular Risk Factors Death, Sudden, Cardiac Risk Factors Tachycardia, Ventricular Surgery Arrhythmia, Ventricular Surgery Defibrillators, Implantable Kaplan-Meier Estimator Disease Progression Autopsy Myocardial Diseases Mortality Sarcoidosis Mortality ab: Introduction: While cardiac sarcoidosis (CS) carries a risk of ventricular arrhythmias (VAs) and sudden cardiac death (SCD), risk stratification of patients with CS and preserved left ventricular/right ventricular (LV/RV) systolic function remains challenging. We sought to evaluate the role of electrophysiologic testing and programmed electrical stimulation of the ventricle (EPS) in patients with suspected CS with preserved ventricular function. Methods: One hundred twenty consecutive patients with biopsy‐proven extracardiac sarcoidosis and preserved LV/RV systolic function underwent EPS. All patients had either probable CS defined by an abnormal cardiac positron emission tomography or cardiac magnetic resonance imaging, or possible CS with normal advanced imaging but abnormal echocardiogram (ECG), SAECG, Holter, or clinical factors. Patients were followed for 4.5 ± 2.6 years for SCD and VAs. Results: Seven of 120 patients (6%) had inducible ventricular tachycardia (VT) with EPS and received an implantable cardioverter defibrillator (ICD). Three patients (43%) with positive EPS later had ICD therapies for VAs. Kaplan‐Meier analysis stratified by EPS demonstrated a significant difference in freedom from VAs and SCD (P = 0.009), though this finding was driven entirely by patients within the cohort with probable CS (P = 0.018, n = 69). One patient with possible CS and negative EPS had unrecognized progression of the disease and unexplained death with evidence of CS at autopsy. Conclusions: EPS is useful in the risk stratification of patients with probable CS with preserved LV and RV function. A positive EPS was associated with VAs. While a negative EPS appeared to confer low risk, close follow‐up is needed as EPS cannot predict fatal VAs related to new cardiac involvement or disease progression. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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