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Atrial Arrhythmias in Clinically Manifest Cardiac Sarcoidosis: Incidence, Burden, Predictors, and Outcomes

BACKGROUND: Recent data have suggested a substantial incidence of atrial arrhythmias (AAs) in cardiac sarcoidosis (CS). Our study aims were to first assess how often AAs are the presenting feature of previously undiagnosed CS. Second, we used prospective follow‐up data from implanted devices to inve...

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Autores principales: Weng, Willy, Wiefels, Christiane, Chakrabarti, Santabhanu, Nery, Pablo B., Celiker-Guler, Emel, Healey, Jeff S., Hruczkowski, Tomasz W., Quinn, F. Russell, Promislow, Steven, Medor, Maria C., Spence, Stewart, Odabashian, Roupen, Alqarawi, Wael, Juneau, Daniel, de Kemp, Rob, Leung, Eugene, Beanlands, Rob, Birnie, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660760/
https://www.ncbi.nlm.nih.gov/pubmed/32814465
http://dx.doi.org/10.1161/JAHA.120.017086
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author Weng, Willy
Wiefels, Christiane
Chakrabarti, Santabhanu
Nery, Pablo B.
Celiker-Guler, Emel
Healey, Jeff S.
Hruczkowski, Tomasz W.
Quinn, F. Russell
Promislow, Steven
Medor, Maria C.
Spence, Stewart
Odabashian, Roupen
Alqarawi, Wael
Juneau, Daniel
de Kemp, Rob
Leung, Eugene
Beanlands, Rob
Birnie, David
author_facet Weng, Willy
Wiefels, Christiane
Chakrabarti, Santabhanu
Nery, Pablo B.
Celiker-Guler, Emel
Healey, Jeff S.
Hruczkowski, Tomasz W.
Quinn, F. Russell
Promislow, Steven
Medor, Maria C.
Spence, Stewart
Odabashian, Roupen
Alqarawi, Wael
Juneau, Daniel
de Kemp, Rob
Leung, Eugene
Beanlands, Rob
Birnie, David
author_sort Weng, Willy
collection PubMed
description BACKGROUND: Recent data have suggested a substantial incidence of atrial arrhythmias (AAs) in cardiac sarcoidosis (CS). Our study aims were to first assess how often AAs are the presenting feature of previously undiagnosed CS. Second, we used prospective follow‐up data from implanted devices to investigate AA incidence, burden, predictors, and response to immunosuppression. METHODS AND RESULTS: This project is a substudy of the CHASM‐CS (Cardiac Sarcoidosis Multicenter Prospective Cohort Study; NCT01477359). Inclusion criteria were presentation with clinically manifest cardiac sarcoidosis, treatment‐naive status, and implanted with a device that reported accurate AA burden. Data were collected at each device interrogation visit for all patients and all potential episodes of AA were adjudicated. For each intervisit period, the total AA burden was obtained. A total of 33 patients met the inclusion criteria (aged 56.1±7.7 years, 45.5% women). Only 1 patient had important AAs as a part of the initial CS presentation. During a median follow‐up of 49.1 months, 11 of 33 patients (33.3%) had device‐detected AAs, and only 2 (6.1%) had a clinically significant AA burden. Both patients had reduced burden after CS was successfully treated and there was no residual fluorodeoxyglucose uptake on positron emission tomography scan. CONCLUSIONS: First, we found that AAs are a rare presenting feature of clinically manifest cardiac sarcoidosis. Second, AAs occurred in a minority of patients at follow‐up; the burden was very low in most patients. Only 2 patients had clinically significant AA burden, and both had a reduction after CS was treated. REGISTRATION: URL: https://www.clini​caltr​ials.gov; unique identifier NCT01477359.
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spelling pubmed-76607602020-11-17 Atrial Arrhythmias in Clinically Manifest Cardiac Sarcoidosis: Incidence, Burden, Predictors, and Outcomes Weng, Willy Wiefels, Christiane Chakrabarti, Santabhanu Nery, Pablo B. Celiker-Guler, Emel Healey, Jeff S. Hruczkowski, Tomasz W. Quinn, F. Russell Promislow, Steven Medor, Maria C. Spence, Stewart Odabashian, Roupen Alqarawi, Wael Juneau, Daniel de Kemp, Rob Leung, Eugene Beanlands, Rob Birnie, David J Am Heart Assoc Original Research BACKGROUND: Recent data have suggested a substantial incidence of atrial arrhythmias (AAs) in cardiac sarcoidosis (CS). Our study aims were to first assess how often AAs are the presenting feature of previously undiagnosed CS. Second, we used prospective follow‐up data from implanted devices to investigate AA incidence, burden, predictors, and response to immunosuppression. METHODS AND RESULTS: This project is a substudy of the CHASM‐CS (Cardiac Sarcoidosis Multicenter Prospective Cohort Study; NCT01477359). Inclusion criteria were presentation with clinically manifest cardiac sarcoidosis, treatment‐naive status, and implanted with a device that reported accurate AA burden. Data were collected at each device interrogation visit for all patients and all potential episodes of AA were adjudicated. For each intervisit period, the total AA burden was obtained. A total of 33 patients met the inclusion criteria (aged 56.1±7.7 years, 45.5% women). Only 1 patient had important AAs as a part of the initial CS presentation. During a median follow‐up of 49.1 months, 11 of 33 patients (33.3%) had device‐detected AAs, and only 2 (6.1%) had a clinically significant AA burden. Both patients had reduced burden after CS was successfully treated and there was no residual fluorodeoxyglucose uptake on positron emission tomography scan. CONCLUSIONS: First, we found that AAs are a rare presenting feature of clinically manifest cardiac sarcoidosis. Second, AAs occurred in a minority of patients at follow‐up; the burden was very low in most patients. Only 2 patients had clinically significant AA burden, and both had a reduction after CS was treated. REGISTRATION: URL: https://www.clini​caltr​ials.gov; unique identifier NCT01477359. John Wiley and Sons Inc. 2020-08-20 /pmc/articles/PMC7660760/ /pubmed/32814465 http://dx.doi.org/10.1161/JAHA.120.017086 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Weng, Willy
Wiefels, Christiane
Chakrabarti, Santabhanu
Nery, Pablo B.
Celiker-Guler, Emel
Healey, Jeff S.
Hruczkowski, Tomasz W.
Quinn, F. Russell
Promislow, Steven
Medor, Maria C.
Spence, Stewart
Odabashian, Roupen
Alqarawi, Wael
Juneau, Daniel
de Kemp, Rob
Leung, Eugene
Beanlands, Rob
Birnie, David
Atrial Arrhythmias in Clinically Manifest Cardiac Sarcoidosis: Incidence, Burden, Predictors, and Outcomes
title Atrial Arrhythmias in Clinically Manifest Cardiac Sarcoidosis: Incidence, Burden, Predictors, and Outcomes
title_full Atrial Arrhythmias in Clinically Manifest Cardiac Sarcoidosis: Incidence, Burden, Predictors, and Outcomes
title_fullStr Atrial Arrhythmias in Clinically Manifest Cardiac Sarcoidosis: Incidence, Burden, Predictors, and Outcomes
title_full_unstemmed Atrial Arrhythmias in Clinically Manifest Cardiac Sarcoidosis: Incidence, Burden, Predictors, and Outcomes
title_short Atrial Arrhythmias in Clinically Manifest Cardiac Sarcoidosis: Incidence, Burden, Predictors, and Outcomes
title_sort atrial arrhythmias in clinically manifest cardiac sarcoidosis: incidence, burden, predictors, and outcomes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660760/
https://www.ncbi.nlm.nih.gov/pubmed/32814465
http://dx.doi.org/10.1161/JAHA.120.017086
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