Catheter ablation for ventricular tachycardia in patients with cardiac sarcoidosis: a systematic review

Papageorgiou, Nikolaos S.; Providência, Rui; Bronis, Konstantinos; Dechering, Dirk G.; Srinivasan, Neil; Eckardt, Lars; Lambiase, Pier D.

doi:10.1093/europace/eux077

Cited by 62 publications

(56 citation statements)

References 38 publications

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“…Recurrence was much higher among patients with ongoing inflammation (58.8%) than in patients with scar (14.2%). The recurrence rate of VT was much higher in the study reported by Kumar et al 9 which was 71%, as compared with our study and case series reported by Naruse et al 10 But, none of these studies reported the relationship of ongoing inflammation to the recurrence of VT 26 . Based on our results we suggest that VTs in patients with inflammatory phase be managed with intensive disease‐specific treatment along with antiarrhythmic medication until the granulomatous inflammation resolves.…”

Section: Discussionsupporting

confidence: 64%

“…There was a recurrence of VT in 11 out of 24 patients (45.83%). But, none of these studies reported the relationship of ongoing inflammation to the recurrence of VT. 26 Based on our results we suggest that VTs in patients with inflammatory phase be managed with intensive disease-specific treatment along with antiarrhythmic medication until the granulomatous inflammation resolves. CA can be considered after the resolution of the inflammatory activity on 18 FDG-PET scan and in patients in whom VT is persistent despite immunosuppressants and AADs.…”

Section: Recurrencementioning

confidence: 68%

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Impact of the inflammation on the outcomes of catheter ablation of drug‐refractory ventricular tachycardia in cardiac sarcoidosis

Kaur¹,

Roukoz

Shah³

et al. 2020

Cardiovasc electrophysiol

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Introduction Catheter ablation (CA) of ventricular tachycardia (VT) in cardiac sarcoidosis (CS) has been reported with varying success. However, there is a scarcity of data on the outcomes of CA based on ongoing inflammation. Objective We hypothesized that the response to VT ablation depends upon the stage of the disease. Methods Between July 2004 and December 2018, 24 patients of CS presented with drug‐refractory VT at CARE Hospital (Hyderabad) and the University of Minnesota (Minneapolis, MN). Patients were classified into two groups based on cardiac magnetic resonance imaging and positron emission tomography: (a) inflammatory phase, (b) scar phase. All patients underwent 3D electro‐anatomic mapping guided CA. Results The clinical VT was ablated in all but one patient. In 16 patients (66.6%), both the clinical and nonclinical VTs were ablated (complete success), while in seven patients (29.1%) nonclinical VTs was still inducible. In patients with inflammation (group A), complete success for VT ablation was achieved in 10 out of 17 (58.8%). In patients without inflammation (group B), complete success was achieved in six out of seven patients (85.7%). Eleven patients (45.8%) had a recurrence of VT. Among patients in the inflammatory phase (group A): 10 out of 17 patients had a recurrence of VT, while only one out of seven patients in the scar phase (group B) had VT recurrence over a mean follow‐up of 5.7 ± 3.9 years. Epicardial ablation was performed in 10 (41.6%) patients. Conclusion CA of drug‐refractory VT in CS is effective, often requiring the epicardial approach. Incomplete success and recurrence of VT were higher in the inflammatory phase of the disease.

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Section: Discussionsupporting

confidence: 64%

Section: Recurrencementioning

confidence: 68%

Impact of the inflammation on the outcomes of catheter ablation of drug‐refractory ventricular tachycardia in cardiac sarcoidosis

Kaur¹,

Roukoz

Shah³

et al. 2020

Cardiovasc electrophysiol

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“…23 In a systematic review of five VT ablation studies in cardiac sarcoidosis patients, approximately 20% of the total 83 patients required epicardial ablation. 24 VT burden is high in cardiac sarcoidosis patients, with a mean of three VTs per patient. It is therefore not surprising that the rate of freedom from VT recurrence was only 50% at a median follow-up point of 24 months, with about one-fourth of patients having to undergo redo procedures.…”

Section: Cardiac Sarcoidosismentioning

confidence: 99%

“…It is therefore not surprising that the rate of freedom from VT recurrence was only 50% at a median follow-up point of 24 months, with about one-fourth of patients having to undergo redo procedures. 24,25 Hypertrophic cardiomyopathy…”

Section: Cardiac Sarcoidosismentioning

confidence: 99%

Patient Selection for Epicardial Ablation—Part I: The Role of Epicardial Ablation in Various Cardiac Disease States

Edward

Nguyen

2019

J Innov Cardiac Rhythm Manage

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Epicardial catheter ablation is most commonly performed following unsuccessful endocardial ablation. Given the frequency of epicardial substrates in certain cardiomyopathic disease states, however, a combined endocardial-epicardial approach should be considered as a primary treatment strategy. Although epicardial ablation is primarily deployed in patients with ventricular arrhythmias, the role of epicardial approaches in supraventricular tachycardias (eg, atrial fibrillation, inappropriate sinus tachycardia, and-rarely-accessory pathways) is growing, with continued advances being made.

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“…Furthermore, 88.4% of these patients either were arrhythmia-free postoperation or experienced a significant reduction in overall VT burden. 41…”

Section: Ablation Of Ventricular Arrhythmiasmentioning

confidence: 99%

Strategies for Managing Arrhythmias in Patients with Cardiac Sarcoidosis

Nilsson

Polsani

Deering

2019

J Innov Cardiac Rhythm Manage.

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Sarcoidosis is a systemic granulomatous disease that frequently involves the myocardium. Unfortunately, the sentinel manifestations of cardiac sarcoidosis are often potentially fatal bradyarrhythmia and tachyarrhythmia. Advanced imaging modalities such as cardiac magnetic resonance have allowed for increased diagnosis of cardiac involvement. The current review article explores diagnosis and treatment strategies for arrhythmias in patients with cardiac sarcoidosis.

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Catheter ablation for ventricular tachycardia in patients with cardiac sarcoidosis: a systematic review

Cited by 62 publications

References 38 publications

Impact of the inflammation on the outcomes of catheter ablation of drug‐refractory ventricular tachycardia in cardiac sarcoidosis

Impact of the inflammation on the outcomes of catheter ablation of drug‐refractory ventricular tachycardia in cardiac sarcoidosis

Patient Selection for Epicardial Ablation—Part I: The Role of Epicardial Ablation in Various Cardiac Disease States

Strategies for Managing Arrhythmias in Patients with Cardiac Sarcoidosis

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