{"id":"60385fe8f758","type":"article","url":"https://hartvaat.nl/2026/12/01/ventriculaire-aritmierisico-bij-cardiale-sarcoidose-blijft-klinisch-relevant-bui/","title":"Ventriculaire aritmierisico bij cardiale sarcoïdose blijft klinisch relevant buiten Class I-ICD-indicatie","title_en":"Life-threatening ventricular arrhythmias in cardiac sarcoidosis with implantable devices: Incidence and predictors in a UK cohort.","category":"preventie","category_label":"Preventie","professions":["cardioloog"],"tags":[],"journal":"Current problems in cardiology","doi":"10.1016/j.cpcardiol.2026.103454","source_url":"https://doi.org/10.1016/j.cpcardiol.2026.103454","authors":["Raheel Ahmed","Nitish Behary Paray","Alessia Azzu","Joseph Okafor","Kamleshun Ramphul","Mansimran Singh Dulay","Alexander Liu","Ana Pericao","Evgenia Nikolou","Rajdeep Khattar","Kshama Wechalekar","John Arun Baksi","Peter Collins","Athol Umfrey Wells","Thomas Lüscher","Vasilis Kouranos","Rakesh Sharma"],"significance":5,"published":"2026-10-10","source_date":"2026-12-01","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/residueel-cardiovasculair-risico/"],"congress":"","summary_en":"A single-centre cohort study of 275 patients with cardiac sarcoidosis found a clinically meaningful 5-year incidence of life-threatening ventricular arrhythmias across all guideline-based ICD indication categories. The incidence was 46.1% in patients meeting Class I criteria, compared with 19.3% in Class IIa and 18.7% in those without formal indications. Baseline sustained VT and lower LVEF independently predicted arrhythmic events. These findings underscore the need for ongoing rhythm surveillance and longitudinal risk reassessment in all cardiac sarcoidosis patients with implantable devices, regardless of initial ICD indication class.","created":"2026-10-04T00:53:45Z","updated":"2026-10-04T00:53:45Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een retrospectieve cohortstudie van 275 patiënten met cardiale sarcoïdose toont aan dat het 5-jaar risico op levensbedreigende ventriculaire aritmieën aanzienlijk is, zelfs bij patiënten zonder een Class I-indicatie voor een implanteerbare defibrillator (ICD). Het incidentiepercentage bedroeg 46,1% in de Class I-groep, tegenover 19,3% en 18,7% in de Class IIa- respectievelijk de 'geen indicatie'-groepen. Baseline ventriculaire tachycardie en een lagere linkerhartfunctie waren onafhankelijke voorspellers. Deze bevindingen ondersteunen het belang van continue ritmebewaking en periodieke risicoherschikking bij alle cardiale sarcoïdosepatiënten met een CIED, ongeacht de initiële ICD-indicatieklasse.","abstract_original":"BACKGROUND: In cardiac sarcoidosis (CS), life-threatening ventricular arrhythmias (VAs) are a major determinant of sudden cardiac death risk. The burden of device-detected sustained VA in UK patients with CS, particularly across guideline-based implantable cardioverter-defibrillator (ICD) indication categories, remains incompletely characterised. METHODS: Consecutive patients with CS who received a cardiac implantable electronic device (CIED) at a UK tertiary centre between 2006 and 2024 were analysed. Patients were stratified at device implantation according to the 2014 Heart Rhythm Society ICD indication category (Class I, Class IIa, or Neither). The primary endpoint was sustained VA, defined as appropriate device therapy, resuscitated cardiac arrest with documented ventricular tachycardia (VT) or ventricular fibrillation (VF), or symptomatic sustained VT lasting ≥30 seconds. Clinical, echocardiographic, cardiac magnetic resonance, and positron emission tomography variables were evaluated as predictors of VA. RESULTS: Among 275 patients (Class I, n = 114; Class IIa, n = 91; Neither, n = 70), 5-year Kaplan-Meier VA incidence was 46.1% in Class I, 19.3% in Class IIa, and 18.7% in the Neither group. Crude 5-year VA incidence was 35.1% (40/114), 16.5% (15/91), and 12.9% (9/70), respectively (p < 0.001). On multivariable Cox analysis, baseline sustained VT and lower LVEF were independently associated with incident VA. LGE extent was associated with VA on univariable but not multivariable analysis. CONCLUSIONS: VA risk was highest in patients meeting Class I ICD indications but remained clinically meaningful among those without Class I indications. These findings support continued rhythm surveillance and longitudinal risk reassessment in CS."}