Center of Excellence for Complex Arrhythmias, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD.
Circulation. 2018 Sep 18;138(12):1253-1264. doi: 10.1161/CIRCULATIONAHA.118.034687.
The diagnosis of cardiac sarcoidosis (CS), especially in cases where there is limited or no extracardiac involvement, is challenging. Patients with CS are at increased risk of ventricular arrhythmias and sudden cardiac death. Several techniques for risk stratification for sudden cardiac death have been proposed in this population, including advanced cardiac imaging and electrophysiology study. Clinical ventricular arrhythmias in patients with CS may be treated with immunosuppressant therapy, antiarrhythmic drugs, catheter ablation, or implantable cardioverter-defibrillator placement. This article will provide an update on techniques for diagnosing CS, risk stratifying patients with CS for sudden cardiac death, and treating patients with CS with ventricular arrhythmias, focusing on evidence that has become available since publication of the 2014 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Management of Arrhythmias Associated With Cardiac Sarcoidosis.
心脏结节病（CS）的诊断，尤其是在无或仅有有限的心脏外表现的情况下，具有挑战性。CS 患者发生室性心律失常和心源性猝死的风险增加。该人群中已经提出了几种用于心源性猝死风险分层的技术，包括先进的心脏影像学和电生理学研究。CS 患者的临床室性心律失常可采用免疫抑制剂治疗、抗心律失常药物、导管消融或植入式心脏复律除颤器治疗。本文将提供关于 CS 诊断技术、CS 患者心源性猝死风险分层以及 CS 合并室性心律失常患者治疗的最新信息，重点介绍自 2014 年心律学会专家共识声明发布以来有关心脏结节病相关心律失常的诊断和管理的最新证据。
