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Atrial Arrhythmias in Cardiac Sarcoidosis-Case Presentation and Systematic Review
Emily C Hodkinson1, Luis Quininir2, Edward Hsiao3
1Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
Pacing and Clinical Electrophysiology : PACE
|September 26, 2025
Summary
Atrial arrhythmias (AA) are a frequent and under-recognized complication of cardiac sarcoidosis (CS), affecting up to 40% of patients. Early recognition and tailored management strategies are crucial for improving patient outcomes in this rare disease.
Area of Science:
- Cardiology
- Immunology
- Pulmonology
Background:
- Cardiac sarcoidosis (CS) is a rare multisystem disease affecting approximately 5% of sarcoidosis patients.
- Current CS diagnosis and management primarily target left ventricular dysfunction, ventricular arrhythmias, and AV conduction disease.
- Atrial arrhythmias (AA) are an under-recognized manifestation of CS.
Purpose of the Study:
- To systematically review the literature on the prevalence and management of AA in CS.
- To highlight AA as a potentially predominant cardiac manifestation in CS.
- To inform future diagnostic criteria for CS.
Main Methods:
- Systematic literature review.
- Emphasis on prevalence and management of AA in CS.
- Discussion of diagnostic modalities like Positron Emission Tomography (PET).
Main Results:
- AA occur in up to 40% of CS patients.
- AA can result from direct granulomatous infiltration or secondary atrial myopathy.
- AA are associated with increased hospitalizations and reduced quality of life.
- AA may be the primary cardiac presentation in CS.
Conclusions:
- AA are a frequent and significant manifestation of CS.
- Current treatments (immunosuppression, anti-arrhythmics, ablation) have high recurrence rates in CS.
- Further multi-center studies are needed to guide AA management in CS.
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