Premature Ventricular Complexes and Nonsustained Ventricular Tachycardia in Cardiac Sarcoidosis

doi:10.1016/j.jacep.2025.03.015

Premature Ventricular Complexes and Nonsustained Ventricular Tachycardia in Cardiac Sarcoidosis

JACC Clin ElectrophysiolPublished 14 May 2025Patients with cardiac sarcoidosis (CS) undergoing clinically indicated Holter monitoring, with multivariable analysis

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Authors' conclusion

These results suggest that an elevated PVC burden and the presence of NSVT are prognostically relevant and may have a role in the risk stratification of patients with CS.

Study context

Population: Patients with definite or probable cardiac sarcoidosis (CS), left ventricular ejection fraction >35%, and no previous history of ventricular tachycardia (VT)/ventricular fibrillation (VF) or sudden cardiac death
Participants: 192 patients

Comparison: PVC burden ≥5% vs <5%, and presence of nonsustained ventricular tachycardia (NSVT), for the composite endpoint
PVC burden ≥5%n = 36
NSVTn = 62

Methodological detailsup to 48 hours of clinically indicated Holter monitoring

Up to 48 hours of clinically indicated Holter monitoring

Main finding

As reported in the abstract

PVC burden

Median PVC burden

0.3%

Q1-Q3: 0.02%–2.5%

Patients with PVC burden ≥5%

36

18.8%

Further findings

Outcome	← Lower risk vs PVC burden <5% ←→ Higher risk vs PVC burden <5% →	HR (95% CI)	P value
Composite endpoint of sustained VT/VF, advanced heart failure therapy, and all-cause mortality · median follow-up of a 3 years — PVC burden ≥5% vs PVC burden <5% · multivariable analysis	0.050.21520	2.84 (1.26–6.40)	P < 0.01
Composite endpoint of sustained VT/VF, advanced heart failure therapy, and all-cause mortality · median follow-up of a 3 years — NSVT vs PVC burden <5% · presence of NSVT; multivariable analysis · multivariable analysis	0.050.21520	4.74 (2.15–10.46)	P < 0.01
	0.050.21520Hazard ratio (log scale)

Composite endpoint of sustained VT/VF, advanced heart failure therapy, and all-cause mortality — Patients experiencing the composite endpoint: 33 patients (17.2%)

NSVT during Holter monitoring

Patients with NSVT: 62 (32.3%)

Association of PVC burden and NSVT with late gadolinium enhancement (LGE) and fluorodeoxyglucose (FDG) uptake

Associated with LGE presence but not with FDG uptake

Original publication

Premature Ventricular Complexes and Nonsustained Ventricular Tachycardia in Cardiac Sarcoidosis. JACC Clin Electrophysiol. Published 14 May 2025. doi:10.1016/j.jacep.2025.03.015

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Summarised from the published abstract; every number is checked against it