Abstract
Objectives:To identify electrocardiographic (ECG) and clinical predictors of sudden cardiac arrest (SCA) in sarcoidosis.Background:Sudden cardiac death (SCD) is the leading cause of death in patients with cardiac sarcoid (CS) and may be the earliest manifestation of disease. Widespread, repeated advanced imaging is an impractical solution to this problem. ECG is an affordable and widely accessible modality that could help guide diagnostic approaches and risk stratification.Methods:Data were obtained from the National Inpatient Sample from 2005 to 2017 using International Classification of Diseases, Ninth and Tenth Revisions, (ICD‐9 and ICD-10 CM). The primary outcome was to identify predictors of SCA, while predictors of SCA in young individuals and those with normal ventricular function served as secondary outcome measures. Cox regression analysis was used to calculate odds ratios following which, a multivariable Cox regression was employed to adjust for potential confounders. Results: Electrocardiographic markers of AV node dysfunction or bundle branch block are associated with a substantially increased risk of SCA in a limited proportion of patients (8.6%). This association is also observed among younger patients (<40 years) and those with normal ventricular function. Conclusions:Electrocardiographic evidence of AV nodal dysfunction or distal conduction disease should raise suspicion for cardiac involvement in patients with sarcoidosis and are associated with increased risk of SCA. Certain ECG markers could help identify patients who would benefit from advanced imaging studies. The sensitivity of electrocardiograms is however limited and the presence of a normal ECG does not reflect a low-risk of SCA.
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