Relationship between arrhythmogenesis and disease activity in cardiac sarcoidosis

Kimikazu Banba, Kengo Fukushima Kusano, Kazufumi Nakamura, Hiroshi Morita, Aiko Ogawa, Fuyo Ohtsuka, Keiko Ohta Ogo, Nobuhiro Nishii, Atsuyuki Watanabe, Satoshi Nagase, Satoru Sakuragi, Tohru Ohe

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

Background: In patients with cardiac sarcoidosis, ventricular arrhythmias and/or conduction disturbances are frequently observed and sometimes fatal. However, few reports on disease activity and arrhythmic events in cardiac sarcoidosis are available. Objective: The purpose of this study was to investigate the relationship between disease activity and arrhythmic events in cardiac sarcoidosis and the effect of corticosteroid therapy. Methods: The study population consisted of 15 cardiac sarcoidosis patients with new-onset symptomatic arrhythmia, including eight patients admitted once for complete atrioventricular block (CAVB), five patients admitted once for sustained ventricular tachycardia (VT), and two patients admitted twice for two arrhythmic events (one for CAVB and the other for sustained VT). Disease activity was evaluated by gallium-67 citrate (Ga) scintigraphy. All patients with positive Ga uptake were treated with corticosteroids, and arrhythmic events were evaluated by repeat Holter recordings. Results: Positive uptake of Ga was observed in 8 (80%) of the 10 CAVB events and in 1 (14%) of the 7 sustained VT events (80% vs 14%, P = .02). Corticosteroids abolished myocardial Ga uptake in all nine patients with positive Ga uptake. After corticosteroid therapy was started, AV conduction improved in 5 of 9 CAVB patients (including 8 patients with new-onset CAVB and one patient with history of CAVB). However, ventricular arrhythmias were not improved after corticosteroid therapy. Conclusion: In cardiac sarcoidosis patients, CAVB develops mainly during the active phase of the disease. Early treatment with corticosteroids might improve AV conduction disturbance. However, sustained VT is not closely linked with disease activity and frequently develops in the advanced stage of disease.

Original languageEnglish
Pages (from-to)1292-1299
Number of pages8
JournalHeart Rhythm
Volume4
Issue number10
DOIs
Publication statusPublished - Oct 2007

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Sarcoidosis
Atrioventricular Block
Adrenal Cortex Hormones
Ventricular Tachycardia
Cardiac Arrhythmias
Therapeutics
Radionuclide Imaging

Keywords

  • Cardiac sarcoidosis
  • Corticosteroid
  • Gallium scintigraphy
  • Heart block
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Relationship between arrhythmogenesis and disease activity in cardiac sarcoidosis. / Banba, Kimikazu; Kusano, Kengo Fukushima; Nakamura, Kazufumi; Morita, Hiroshi; Ogawa, Aiko; Ohtsuka, Fuyo; Ohta Ogo, Keiko; Nishii, Nobuhiro; Watanabe, Atsuyuki; Nagase, Satoshi; Sakuragi, Satoru; Ohe, Tohru.

In: Heart Rhythm, Vol. 4, No. 10, 10.2007, p. 1292-1299.

Research output: Contribution to journalArticle

Banba, K, Kusano, KF, Nakamura, K, Morita, H, Ogawa, A, Ohtsuka, F, Ohta Ogo, K, Nishii, N, Watanabe, A, Nagase, S, Sakuragi, S & Ohe, T 2007, 'Relationship between arrhythmogenesis and disease activity in cardiac sarcoidosis', Heart Rhythm, vol. 4, no. 10, pp. 1292-1299. https://doi.org/10.1016/j.hrthm.2007.06.006
Banba, Kimikazu ; Kusano, Kengo Fukushima ; Nakamura, Kazufumi ; Morita, Hiroshi ; Ogawa, Aiko ; Ohtsuka, Fuyo ; Ohta Ogo, Keiko ; Nishii, Nobuhiro ; Watanabe, Atsuyuki ; Nagase, Satoshi ; Sakuragi, Satoru ; Ohe, Tohru. / Relationship between arrhythmogenesis and disease activity in cardiac sarcoidosis. In: Heart Rhythm. 2007 ; Vol. 4, No. 10. pp. 1292-1299.
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abstract = "Background: In patients with cardiac sarcoidosis, ventricular arrhythmias and/or conduction disturbances are frequently observed and sometimes fatal. However, few reports on disease activity and arrhythmic events in cardiac sarcoidosis are available. Objective: The purpose of this study was to investigate the relationship between disease activity and arrhythmic events in cardiac sarcoidosis and the effect of corticosteroid therapy. Methods: The study population consisted of 15 cardiac sarcoidosis patients with new-onset symptomatic arrhythmia, including eight patients admitted once for complete atrioventricular block (CAVB), five patients admitted once for sustained ventricular tachycardia (VT), and two patients admitted twice for two arrhythmic events (one for CAVB and the other for sustained VT). Disease activity was evaluated by gallium-67 citrate (Ga) scintigraphy. All patients with positive Ga uptake were treated with corticosteroids, and arrhythmic events were evaluated by repeat Holter recordings. Results: Positive uptake of Ga was observed in 8 (80{\%}) of the 10 CAVB events and in 1 (14{\%}) of the 7 sustained VT events (80{\%} vs 14{\%}, P = .02). Corticosteroids abolished myocardial Ga uptake in all nine patients with positive Ga uptake. After corticosteroid therapy was started, AV conduction improved in 5 of 9 CAVB patients (including 8 patients with new-onset CAVB and one patient with history of CAVB). However, ventricular arrhythmias were not improved after corticosteroid therapy. Conclusion: In cardiac sarcoidosis patients, CAVB develops mainly during the active phase of the disease. Early treatment with corticosteroids might improve AV conduction disturbance. However, sustained VT is not closely linked with disease activity and frequently develops in the advanced stage of disease.",
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T1 - Relationship between arrhythmogenesis and disease activity in cardiac sarcoidosis

AU - Banba, Kimikazu

AU - Kusano, Kengo Fukushima

AU - Nakamura, Kazufumi

AU - Morita, Hiroshi

AU - Ogawa, Aiko

AU - Ohtsuka, Fuyo

AU - Ohta Ogo, Keiko

AU - Nishii, Nobuhiro

AU - Watanabe, Atsuyuki

AU - Nagase, Satoshi

AU - Sakuragi, Satoru

AU - Ohe, Tohru

PY - 2007/10

Y1 - 2007/10

N2 - Background: In patients with cardiac sarcoidosis, ventricular arrhythmias and/or conduction disturbances are frequently observed and sometimes fatal. However, few reports on disease activity and arrhythmic events in cardiac sarcoidosis are available. Objective: The purpose of this study was to investigate the relationship between disease activity and arrhythmic events in cardiac sarcoidosis and the effect of corticosteroid therapy. Methods: The study population consisted of 15 cardiac sarcoidosis patients with new-onset symptomatic arrhythmia, including eight patients admitted once for complete atrioventricular block (CAVB), five patients admitted once for sustained ventricular tachycardia (VT), and two patients admitted twice for two arrhythmic events (one for CAVB and the other for sustained VT). Disease activity was evaluated by gallium-67 citrate (Ga) scintigraphy. All patients with positive Ga uptake were treated with corticosteroids, and arrhythmic events were evaluated by repeat Holter recordings. Results: Positive uptake of Ga was observed in 8 (80%) of the 10 CAVB events and in 1 (14%) of the 7 sustained VT events (80% vs 14%, P = .02). Corticosteroids abolished myocardial Ga uptake in all nine patients with positive Ga uptake. After corticosteroid therapy was started, AV conduction improved in 5 of 9 CAVB patients (including 8 patients with new-onset CAVB and one patient with history of CAVB). However, ventricular arrhythmias were not improved after corticosteroid therapy. Conclusion: In cardiac sarcoidosis patients, CAVB develops mainly during the active phase of the disease. Early treatment with corticosteroids might improve AV conduction disturbance. However, sustained VT is not closely linked with disease activity and frequently develops in the advanced stage of disease.

AB - Background: In patients with cardiac sarcoidosis, ventricular arrhythmias and/or conduction disturbances are frequently observed and sometimes fatal. However, few reports on disease activity and arrhythmic events in cardiac sarcoidosis are available. Objective: The purpose of this study was to investigate the relationship between disease activity and arrhythmic events in cardiac sarcoidosis and the effect of corticosteroid therapy. Methods: The study population consisted of 15 cardiac sarcoidosis patients with new-onset symptomatic arrhythmia, including eight patients admitted once for complete atrioventricular block (CAVB), five patients admitted once for sustained ventricular tachycardia (VT), and two patients admitted twice for two arrhythmic events (one for CAVB and the other for sustained VT). Disease activity was evaluated by gallium-67 citrate (Ga) scintigraphy. All patients with positive Ga uptake were treated with corticosteroids, and arrhythmic events were evaluated by repeat Holter recordings. Results: Positive uptake of Ga was observed in 8 (80%) of the 10 CAVB events and in 1 (14%) of the 7 sustained VT events (80% vs 14%, P = .02). Corticosteroids abolished myocardial Ga uptake in all nine patients with positive Ga uptake. After corticosteroid therapy was started, AV conduction improved in 5 of 9 CAVB patients (including 8 patients with new-onset CAVB and one patient with history of CAVB). However, ventricular arrhythmias were not improved after corticosteroid therapy. Conclusion: In cardiac sarcoidosis patients, CAVB develops mainly during the active phase of the disease. Early treatment with corticosteroids might improve AV conduction disturbance. However, sustained VT is not closely linked with disease activity and frequently develops in the advanced stage of disease.

KW - Cardiac sarcoidosis

KW - Corticosteroid

KW - Gallium scintigraphy

KW - Heart block

KW - Ventricular tachycardia

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