Propensity-Matched Five-Year Cardiac Resynchronization Therapy Outcomes in Sarcoidosis With Heart Failure
Yong Hao Yeo1, Tze Ern Ong2, Aravinthan Vignarajah3
1Department of Internal Medicine/Pediatrics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA.
Journal of Cardiovascular Electrophysiology
|November 25, 2025
Summary
Cardiac resynchronization therapy (CRT) showed similar long-term outcomes to ICD-only implantation in heart failure with reduced ejection fraction (HFrEF) patients with sarcoidosis. This includes mortality, hospitalization, and heart failure exacerbation rates.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Cardiac resynchronization therapy (CRT) is established for heart failure with reduced ejection fraction (HFrEF).
- Limited data exist on CRT efficacy in HFrEF patients with sarcoidosis.
Purpose of the Study:
- To compare long-term outcomes of CRT versus ICD-only implantation in sarcoidosis patients with HFrEF.
- To evaluate the impact on mortality, hospitalization, heart failure exacerbation, and LVEF improvement.
Main Methods:
- Retrospective cohort study using the TriNetX network (2014-2019).
- Identified HFrEF patients with sarcoidosis, LVEF < 35%, and LBBB or QRS > 150ms.
- Compared 5-year outcomes between CRT and ICD-only groups.
Main Results:
- 87 patients received CRT, 87 received ICD-only (similar propensity scores).
- No significant differences in 5-year all-cause mortality (14.9% vs. 20.7%), hospitalization (83.9% vs. 77.0%), or heart failure exacerbation (28.7% vs. 28.7%).
- Similar LVEF improvement rates were observed in both groups.
Conclusions:
- CRT implantation yielded comparable long-term outcomes to ICD-only implantation in sarcoidosis patients with HFrEF.
- No significant benefit of CRT was observed for mortality, hospitalization, or heart failure exacerbation in this specific population.
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