B-PO01-086 PHARMACOLOGICAL THERAPIES AND DEVICE IMPLANTATION IN CARDIAC SARCOIDOSIS

Abstract

Cardiac sarcoidosis (CS) has been associated with atrioventricular block (AVB) and other dysrhythmias. To assess the rates of cardiac device implantation following the diagnosis of CS, and the influence of various pharmacologic therapies on AVB. Using a multicenter database (Explorys Inc, Cleveland, OH, USA), which consists of an aggregate of de-identified electronic health record data, a cohort of patients with the diagnosis of CS between 01/2015 and 12/2020 was identified. Subsequently, the rate of cardiac device implantation within up to five years following the diagnosis was analyzed. In patients who did not require device implantation upon initial diagnosis of CS, we assessed the impact of various pharmacological therapies on the rate of subsequent AVB. Of 37,000,320 subjects in the database, we identified 2200 CS patients. Following the diagnosis of CS, device implantation was largely performed within the first 7 days [730 defibrillators (33.2%); 320 pacemakers (14.6%)], with only minimal increase thereafter (Figure 1A). In patients who did not require device implantation upon initial diagnosis, the rates of subsequent AVB were significantly different among various pharmacological agents (P < 0.05, Figure 1B). Cardiac device implantation was common in patients with CS, especially within one week of the initial diagnosis, reflecting a common manifestation of dysrhythmias as an initial presentation. Methotrexate, mycophenolate, and biological therapies demonstrated a statistically significant favorable effect on the rate of subsequent AVB in patients who did not require devices upon initial presentation.