Cardiac electrophysiological evaluation in patients with sarcoidosis

Abstract

Background: Sarcoidosis is a multisystem granulomatous disease of unknown origin that can cause sudden death. Objective: Electrophysiological evaluation of patients with suspected sarcoidosis with cardiac involvement. Methods: We studied 22 patients with mean age of 55.32 ± 13.13 years, diagnosed with sarcoidosis and suspected cardiac involvement. These patients underwent clinical evaluation, laboratory tests, electrocardiogram, echocardiogram, 24-hour Holter, technetium or gallium scintigraphy and electrophysiological study. In selected cases, we performed positron emission tomography or magnetic resonance imaging. Patients were followed up in the outpatient care service with quarterly visits. Results: Cardiac involvement was confirmed in four (18.2%) patients. Ventricular extrasystoles with density > 100/24 h were documented in 24-Holter monitoring in 12 (54.5%) patients. Electrophysiological studies revealed an increased HV interval in seven patients (31.8%) and increased Wenckebach point in four (18.2%) patients. There was induction of atrial fibrillation in seven patients (31.8%) and sustained ventricular tachycardia in one patient (4.5%). Four patients with confirmed cardiac sarcoidosis had documented ventricular extrasystoles with density > 100/24 h. Out of these, two had prolonged HV interval and atrial fibrillation was induced in two of them. Sustained ventricular tachycardia was not induced in any of these patients. After mean follow-up period of 20.9 ± 15.7 months, one patient with cardiac sarcoidosis had sudden death. Conclusion: Patients with sarcoidosis and suspected cardiac involvement have a high prevalence of ventricular extrasystoles (VEs) and conduction system disorders.