Arrhythmias in cardiac sarcoidosis: diagnosis and treatment

Area of Science:

• Cardiology
• Immunology
• Granulomatous Diseases

Background:

• Sarcoidosis is a multisystem granulomatous disease with variable clinical presentations.
• Cardiac involvement in sarcoidosis can lead to severe outcomes like heart block, ventricular tachycardia, and sudden cardiac death.
• Current diagnostic and management strategies for cardiac sarcoidosis lack consensus, necessitating updated clinical guidance.

Purpose of the Study:

• To provide a practical update on the diagnosis and management of cardiac sarcoidosis.
• To highlight recent findings and clinical considerations for healthcare providers.
• To identify areas requiring further research and collaborative studies.

Main Methods:

• Review of recent studies on cardiac sarcoidosis presentations.
• Analysis of diagnostic challenges and emerging imaging techniques.
• Synthesis of current understanding regarding treatment modalities.

Main Results:

• Cardiac sarcoidosis is increasingly recognized as the initial manifestation of sarcoidosis, particularly in adults under 55 with unexplained atrioventricular block.
• Isolated cardiac sarcoidosis, without involvement of other organs, is being reported more frequently.
• Advances in cardiac imaging are improving the detection of myocardial involvement and monitoring treatment response.

Conclusions:

• Cardiac sarcoidosis should be suspected in patients under 55 with unexplained atrioventricular block and in those with idiopathic cardiomyopathy and ventricular tachycardia.
• Further research is needed to clarify the roles of corticosteroids, implantable devices, and advanced imaging in managing cardiac sarcoidosis.
• Multicenter collaborative studies are essential to address outstanding clinical questions and improve patient outcomes.