Cardiac resynchronization therapy response in cardiac sarcoidosis
Samuel A Shabtaie1, Ojasav Sehrawat1, Justin Z Lee1
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Journal of Cardiovascular Electrophysiology
|July 23, 2022
Summary
Cardiac resynchronization therapy (CRT) showed no significant improvement in heart function for cardiac sarcoidosis (CS) patients within six months. Many patients still required advanced heart failure therapies, indicating a variable response to CRT in this population.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiomyopathy Research
Background:
- Cardiac sarcoidosis (CS) is a form of nonischemic cardiomyopathy (NICM) characterized by granuloma infiltration of the heart.
- Clinical manifestations of CS are highly variable, including conduction abnormalities and systolic heart failure.
- Cardiac resynchronization therapy (CRT) is effective in NICM, but its role in CS is not well-defined.
Purpose of the Study:
- To evaluate the efficacy of cardiac resynchronization therapy (CRT) in improving cardiac remodeling in patients diagnosed with cardiac sarcoidosis (CS).
Main Methods:
- Retrospective review of patients with CS who underwent CRT implantation between 2000 and 2021.
- Assessment of baseline characteristics, imaging parameters, heart failure hospitalizations, need for advanced therapies, and major adverse cardiac events (MACE).
Main Results:
- No significant improvement in ejection fraction or left ventricular end-diastolic diameter was observed at 6 months post-CRT.
- A mild improvement in left ventricular end-systolic diameter was noted.
- Within 6 months, 9.1% of patients were hospitalized for heart failure; over a mean follow-up of 4.1 years, 25.5% experienced heart failure hospitalizations, and 20% underwent cardiac transplantation.
Conclusions:
- Cardiac resynchronization therapy (CRT) demonstrates a variable response in patients with cardiac sarcoidosis (CS).
- No significant improvement in ventricular function was observed within the initial 6 months post-CRT.
- A substantial proportion of CS patients treated with CRT progressed to advanced heart failure therapies.
Keywords:
cardiac resynchronization therapycardiac sarcoidosisimplantable cardioverter defibrillatorsarcoidosisventricular tachycardiaMore Related Videos
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