Northumbria Healthcare NHS Foundation Trust, Newcastle, United Kingdom.
Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College London, United Kingdom.
Curr Probl Cardiol. 2024 May;49(5):102483. doi: 10.1016/j.cpcardiol.2024.102483. Epub 2024 Feb 23.
Implantable cardioverter defibrillator (ICD) use in cardiac sarcoidosis (CS) to prevent sudden cardiac death (SCD) is a potentially life-saving intervention. However, the factors that determine outcome in this cohort remains largely unknown. This review analyses CS patients with an ICD and highlights determinants of poor outcome.
Analysis of studies which used the 2014 HRS Consensus, 2017 AHA/ACC/HRS Guideline and 2022 ESC Guidelines showed that those with class I recommendations have higher incidences of ventricular arrhythmia (VA) than those with class II recommendations. Additionally, even those with normal left ventricular ejection fraction (LVEF) and CS are at high risk of VA and SCD.
Compounding research emphasises the importance of cardiac imaging in those with sarcoidosis, with evidence to suggest a possible need for revision of the guidelines. Other variables such as demographics and ventricular characteristics may prove useful in predicting those to benefit most from ICD insertion.
植入式心脏复律除颤器（ICD）用于预防心源性猝死（SCD）的心脏结节病（CS）的使用是一种潜在的救生干预措施。然而，在这一队列中决定结局的因素在很大程度上尚不清楚。本综述分析了 CS 合并 ICD 的患者，并强调了预后不良的决定因素。
对使用 2014 年 HRS 共识、2017 年 AHA/ACC/HRS 指南和 2022 年 ESC 指南的研究进行分析表明，具有 I 类推荐的患者比具有 II 类推荐的患者发生室性心律失常（VA）的发生率更高。此外，即使左心室射血分数（LVEF）正常且 CS 患者也有发生 VA 和 SCD 的高风险。
越来越多的研究强调了心脏成像在结节病患者中的重要性，有证据表明可能需要修订指南。其他变量，如人口统计学和心室特征，可能有助于预测最受益于 ICD 植入的患者。
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