TY - JOUR
T1 - Outcome of implantable cardioverter defibrillator in cardiac sarcoidosis
T2 - a systematic review and meta-analysis
AU - Halawa, Ahmad
AU - Jain, Rahul
AU - Turagam, Mohit K.
AU - Kusumoto, Fred M.
AU - Woldu, Henok G.
AU - Gautam, Sandeep
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Purpose: Cardiac sarcoidosis is a multisystem inflammatory disorder characterized by ventricular arrhythmias. Implantable cardioverter defibrillator (ICD) is used to prevent sudden cardiac death. Methods: We performed literature search for studies that addressed the outcome and complications of ICD in Cardiac Sarcoidosis (CS). Multiple search sites were reviewed from January 1, 2000 until December 1, 2018. We then performed a meta-analysis using a random effects model. Two investigators independently extracted the data and assessed studies’ quality. Results: Ten studies with 585 patients qualified for the analysis. In the pooled analysis, 57% were male with mean left ventricular ejection fraction (LVEF) of 38.4%. Appropriate and inappropriate ICD treatments (AT and IAT) were reported in 39% and 15% of patients respectively over mean follow-up period of 25 months and mortality rate of 8%. A sub-analysis of four studies indicated that patients with appropriate therapy did not differ from the rest of CS population in LVEF% (mean difference (MD) = − 7.37%, 95% confidence interval (CI) − 16.89 to 2.15, p = 0.12), age (MD = − 3.87 years, 95% CI − 10.19 to 2.46, p = 0.23), primary prevention (range difference (RD) = − 0.11, 95% CI − 0.31 to 0.10, p = 0.31) or secondary prevention indication (RD = 0.09, 95% CI − 0.12 to 0.3, p = 0.37). High degree AV block was more common in patients with AT (RD = 0.07, 95% CI 0.00 to 0.14 p = 0.05). Conclusions: ICD placement in CS is associated with high incidence of both appropriate and inappropriate therapy. High degree AV block appears to be predictive of appropriate ICD therapy.
AB - Purpose: Cardiac sarcoidosis is a multisystem inflammatory disorder characterized by ventricular arrhythmias. Implantable cardioverter defibrillator (ICD) is used to prevent sudden cardiac death. Methods: We performed literature search for studies that addressed the outcome and complications of ICD in Cardiac Sarcoidosis (CS). Multiple search sites were reviewed from January 1, 2000 until December 1, 2018. We then performed a meta-analysis using a random effects model. Two investigators independently extracted the data and assessed studies’ quality. Results: Ten studies with 585 patients qualified for the analysis. In the pooled analysis, 57% were male with mean left ventricular ejection fraction (LVEF) of 38.4%. Appropriate and inappropriate ICD treatments (AT and IAT) were reported in 39% and 15% of patients respectively over mean follow-up period of 25 months and mortality rate of 8%. A sub-analysis of four studies indicated that patients with appropriate therapy did not differ from the rest of CS population in LVEF% (mean difference (MD) = − 7.37%, 95% confidence interval (CI) − 16.89 to 2.15, p = 0.12), age (MD = − 3.87 years, 95% CI − 10.19 to 2.46, p = 0.23), primary prevention (range difference (RD) = − 0.11, 95% CI − 0.31 to 0.10, p = 0.31) or secondary prevention indication (RD = 0.09, 95% CI − 0.12 to 0.3, p = 0.37). High degree AV block was more common in patients with AT (RD = 0.07, 95% CI 0.00 to 0.14 p = 0.05). Conclusions: ICD placement in CS is associated with high incidence of both appropriate and inappropriate therapy. High degree AV block appears to be predictive of appropriate ICD therapy.
UR - http://www.scopus.com/inward/record.url?scp=85079732944&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85079732944&partnerID=8YFLogxK
U2 - 10.1007/s10840-020-00705-1
DO - 10.1007/s10840-020-00705-1
M3 - Review article
C2 - 32062788
AN - SCOPUS:85079732944
VL - 58
SP - 233
EP - 242
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
SN - 1383-875X
IS - 2
ER -