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Brain & Heart Cardiac sarcoidosis with AVB and VA

management of CS. Improvements in implantable devices Availability of data
are evident from the significant reduction in inappropriate
shock deliveries reported in studies conducted 9 years apart. Not applicable.

CS is a challenging diagnosis due to its varied References
presentation, genetic diversity, gradual onset, and the 1. Sarcoidosis UK. Sarcoidosis and the Heart; 2022. Available
highly invasive and low-sensitivity procedure required from: https://www.sarcoidosisuk.org/information-hub/
for a histological confirmation. Early detection and sarcoidosis-heart [Last accessed on 2022 Sep 11].
treatment are crucial for improving long-term prognosis 2. Cardiac Sarcoidosis-American College of Cardiology; 2022.
and reducing morbidity. This review has discussed current Available from: https://www.acc.org/latest-in-cardiology/
imaging and management strategies for VAs and AVB articles/2021/05/20/13/01/cardiac-sarcoidosis [Last
along with their outcomes. Due to the rarity of CS, most accessed on 2022 Sep 11].
studies included in this review are retrospective and 3. Markatis E, Afthinos A, Antonakis E, Papanikolaou IC.
single-center, which introduces inherent biases. Although Cardiac sarcoidosis: Diagnosis and management. Rev
there is substantial evidence supporting the use of cardiac Cardiovasc Med. 2020;21:321-338.
devices, there is limited research on medical therapy for doi: 10.31083/j.rcm.2020.03.102
CS. More studies are needed to evaluate the long-term
effects of corticosteroids and steroid-sparing agents on 4. Ahmed, R, Shahbaz, H, Ramphul, K, et al. Racial disparities
mortality and outcomes. In addition, biologic agents among patients with cardiac sarcoidosis and arrhythmias in
the United States: A propensity matched-analysis from the
such as infliximab, which are currently used as third- or National Inpatient Sample Database 2016-2020. Curr Probl
fourth-line treatments for resistant cases, could serve as Cardiol. 2024;49(4):102450.
a significant advancement in medical therapy. However,
their use warrants further investigation, especially in early doi: 10.1016/j.cpcardiol.2024.102450
disease stages, to assess their efficacy. 5. Perry A, Vuitch F. Causes of death in patients with sarcoidosis.
A morphologic study of 38 autopsies with clinicopathologic
At present, immunosuppression is recommended correlations. Arch Pathol Lab Med. 1995;119:167-172.
for active disease, whereas pharmacological treatment
is recommended for heart failure. ICD implantation and 6. Ekström K, Lehtonen J, Nordenswan HK, et al. Sudden death
in cardiac sarcoidosis: An analysis of nationwide clinical and
catheter ablation for VT may be necessary for certain cause-of-death registries. Eur Heart J. 2019;40:3121-3128.
patients. A multidisciplinary team approach is essential to
achieve optimal outcomes. doi: 10.1093/eurheartj/ehz428
7. Patel MR, Cawley PJ, Heitner JF, et al. Detection of
Acknowledgments myocardial damage in patients with sarcoidosis. Circulation.
2009;120:1969-1977.
None.
doi: 10.1161/CIRCULATIONAHA.109.851352
Funding 8. Ahmed, R, Sawatari, H, Amanullah, K, et al. Characteristics
None. and outcomes of hospitalized patients with heart failure
and sarcoidosis: A propensity-matched analysis of the
Conflict of interest Nationwide Readmissions Database 2010-2019. Am J Med.
2024;137:751-760.e8.
The authors declare that they have no competing interests.
doi: 10.1016/j.amjmed.2024.03.039
Author contributions 9. Rosenthal DG, Fang CD, Groh CA, et al. Heart failure,
Conceptualization: Raheel Ahmed atrioventricular block, and ventricular tachycardia in
Writing–original draft: Caleb Carver sarcoidosis. J Am Heart Assoc. 2021;10:e017692.
Writing–review & editing: All authors doi: 10.1161/JAHA.120.017692
10. Hoogendoorn JC, Ninaber MK, Piers SRD, et al. The harm
Ethics approval and consent to participate of delayed diagnosis of arrhythmogenic cardiac sarcoidosis:
Not applicable. A case series. Eurospace. 2020;22:1376-1383.
doi: 10.1093/europace/euaa115
Consent for publication
11. Nery PB, Beanlands RS, Nair GM, et al. Atrioventricular block
Not applicable. as the initial manifestation of cardiac sarcoidosis in middle-

Volume 2 Issue 4 (2024) 10 doi: 10.36922/bh.3515