Arrhythmias & electrophysiology
Raising the Alarm: Underdiagnosis of Cardiac Sarcoidosis in Young Patients With Unexplained Heart Block
Authors' conclusion
Despite guideline recommendations, diagnostic testing for CS in younger patients with unexplained CHB remains low. This gap likely contributes to significant underdiagnosis and highlights the need for improved adherence to evaluation protocols.
Study context
- Population
- Patients aged 18 to 60 years with unexplained complete heart block (CHB) requiring device placement over the past 5 yearspatients meeting criteria across 55 health care organizations
- Participants
- 1,279 patients
- Exposure
- Subsequent cardiac sarcoidosis (CS) diagnosis rates vs expected prevalence
- Outcome
- Advanced cardiac testing
- Follow-up
- Median 724 days (Q1-Q3: 0-1,117)
Methodological detailsTriNetX data, 55 health care organizations
- TriNetX data
- 55 health care organizations
Main finding
As reported in the abstract
Advanced cardiac testing performed
256 patients
20.0%; 95% CI: 17.8%–22.2%
Observational data: associations, not effects.
Further findings
Specific test utilization
- Cardiac magnetic resonance imaging
- 131 patients (10.2%; 95% CI: 8.6%-11.9%)
- Chest computed tomography
- 141 (11.0%; 95% CI: 9.3%-12.7%)
- Cardiac positron emission tomography
- ≤10 (0.7%; 95% CI: 0.3%-1.3%)
- Myocardial biopsy
- ≤10 (0.7%; 95% CI: 0.3%-1.3%)
CS diagnosis
- Diagnosed with CS
- Fewer than 10 patients (<1%; 95% CI: 0.3%-1.3%)
- Expected prevalence
- 19% to 34%
- Far below the expected prevalence
Baseline characteristics
- Treated at academic centers
- 75%
- Mean age
- 48 ± 11 years
- Male
- 53%
- White
- 73%
Original publication
Raising the Alarm: Underdiagnosis of Cardiac Sarcoidosis in Young Patients With Unexplained Heart Block. JACC Adv. Published 20 June 2025. doi:10.
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