Cardiac Sarcoidosis and Arrhythmias
Sághy László1, Besenyi Zsuzsanna2, Benák Attila1
1SZTE ÁOK, II. sz. Belgyógyászati Klinika és Kardiológiai Központ, Szeged
2SZTE ÁOK, Nukleáris Medicina Intézet, Szeged
Cardiac sarcoidosis is a rare and underdiagnosed disease. The first clinical manifestation can be high degree atrioventricular (AV) block or malignant ventricular arrhythmias (VAs), when further diagnostics are recommended. The key of the diagnosis is the extracardiac or cardiac biopsy, which can be targeted based on advanced cardiovascular imaging (cardiac MRI or FDG PET/CT scan). The conduction abnormalities can be reversible, but in case of high degree AV block, an implantable pulse generator is recommended. The pathophysiology of VAs can be due to inflammation or ventricular remodeling. Treatment is based on immunosuppressants, but catheter ablation can be necessary in drug-refractory cases. Primary prophylactic ICD implantation is a complex decision, which is based on anamnestic, imaging and electrophysiological study findings.