Treatment of heart block due to sarcoid heart disease

The role of glucocorticosteroid therapy for myocardial sarcoidosis is not well defined. This report shows the effect of prednisone therapy on atrioventricular (AV) conduction in a patient with myocardial sarcoidosis and AV block. On three separate occasions AV block was documented prior to prednisone therapy. On the first two occasions the patient had first and second degree AV block which by His bundle electrogram initially was shown to be in the AV node. On the third occasion the patient developed complete heart block. On each occasion treatment with prednisone resulted in improved AV conduction. The results indicate that prednisone therapy can be beneficial in the treatment of AV block due to myocardial sarcoidosis.