PMID- 24731652
OWN - NLM
STAT- MEDLINE
DCOM- 20140604
LR  - 20220321
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 113
IP  - 9
DP  - 2014 May 1
TI  - Cardiac sarcoidosis detected by late gadolinium enhancement and prevalence of 
      atrial arrhythmias.
PG  - 1556-60
LID - S0002-9149(14)00636-5 [pii]
LID - 10.1016/j.amjcard.2014.01.434 [doi]
AB  - Cardiovascular magnetic resonance (CMR) imaging is being increasingly used to 
      help identify patients with cardiac sarcoidosis (CS). Whereas ventricular 
      arrhythmias have been well studied in this population, atrial arrhythmias have 
      not been thoroughly investigated. We sought to better characterize the arrhythmia 
      burden of a cohort of patients diagnosed with CS by CMR imaging. Patients with 
      biopsy-proven extracardiac sarcoidosis were referred to the University of Chicago 
      for evaluation of the presence of CS. CMR imaging was used to categorize the 
      patients into 2 groups; those with and those without late gadolinium enhancement 
      (LGE) for comparison of arrhythmic events. Arrhythmic evaluation included Holter 
      monitor, event recorder, electrophysiology testing, or implantable 
      cardioverter-defibrillator (ICD) interrogation; 192 consecutive patients were 
      evaluated with CMR imaging, 57 of whom did not have ambulatory monitoring results 
      and thus were excluded. LGE was present in 44 patients. Atrial arrhythmias were 
      documented in 16 patients (36%) with myocardial LGE and in 11 patients (12%) 
      without myocardial LGE (p = 0.002). Ventricular arrhythmias were documented in 
      27% of patients with myocardial LGE and 2.2% of LGE-negative patients (p = 
      0.00076). Of 26 LGE-positive patients with ICDs, 8 (30.8%) received therapies, 3 
      (11.5%) of which were inappropriate for atrial arrhythmias. In conclusion, atrial 
      arrhythmias were documented more frequently than ventricular arrhythmias in 
      patients with sarcoidosis with cardiac involvement and were 3 times more 
      prevalent than in patients with sarcoidosis without cardiac involvement. 
      Risk-benefit assessment of anticoagulation for primary prevention of stroke 
      should be performed for patients with CS. In patients receiving implantable 
      defibrillators, programming to minimize inappropriate ICD shocks for atrial 
      arrhythmias must be considered.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Cain, Matthew A
AU  - Cain MA
AD  - Department of Medicine, Division of Cardiology, Heart Rhythm Center, University 
      of Chicago, Chicago, Illinois.
FAU - Metzl, Mark D
AU  - Metzl MD
AD  - Department of Medicine, Division of Cardiology, Heart Rhythm Center, University 
      of Chicago, Chicago, Illinois.
FAU - Patel, Amit R
AU  - Patel AR
AD  - Department of Medicine, Division of Cardiology, Heart Rhythm Center, University 
      of Chicago, Chicago, Illinois.
FAU - Addetia, Karima
AU  - Addetia K
AD  - Department of Medicine, Division of Cardiology, Heart Rhythm Center, University 
      of Chicago, Chicago, Illinois.
FAU - Spencer, Kirk T
AU  - Spencer KT
AD  - Department of Medicine, Division of Cardiology, Heart Rhythm Center, University 
      of Chicago, Chicago, Illinois.
FAU - Sweiss, Nadera J
AU  - Sweiss NJ
AD  - Department of Medicine, University of Illinois Medical Center, Chicago, Illinois.
FAU - Beshai, John F
AU  - Beshai JF
AD  - Department of Medicine, Division of Cardiology, Heart Rhythm Center, University 
      of Chicago, Chicago, Illinois. Electronic address: jfbeshai@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20140212
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anticoagulants)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adult
MH  - Anticoagulants/therapeutic use
MH  - Arrhythmias, Cardiac/*complications/physiopathology
MH  - Cardiomyopathies/complications/*diagnosis/drug therapy
MH  - Defibrillators, Implantable
MH  - Electrocardiography, Ambulatory
MH  - Female
MH  - *Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Risk Assessment
MH  - Sarcoidosis/complications/*diagnosis/drug therapy
MH  - Stroke/prevention & control
EDAT- 2014/04/16 06:00
MHDA- 2014/06/05 06:00
CRDT- 2014/04/16 06:00
PHST- 2013/09/11 00:00 [received]
PHST- 2014/01/24 00:00 [revised]
PHST- 2014/01/24 00:00 [accepted]
PHST- 2014/04/16 06:00 [entrez]
PHST- 2014/04/16 06:00 [pubmed]
PHST- 2014/06/05 06:00 [medline]
AID - S0002-9149(14)00636-5 [pii]
AID - 10.1016/j.amjcard.2014.01.434 [doi]
PST - ppublish
SO  - Am J Cardiol. 2014 May 1;113(9):1556-60. doi: 10.1016/j.amjcard.2014.01.434. Epub 
      2014 Feb 12.