The role of electrophysiology study in risk stratification of cardiac sarcoidosis patients: Meta-analyses and systemic review

Mehul Adhaduk, Bishow Paudel, Kan Liu, Mahi Ashwath, Michael Giudici

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: The utility of an electrophysiologic study (EPS) in the risk stratification of cardiac sarcoidosis (CS) patients is not clear. We conducted a systemic review and meta-analysis to evaluate the utility of EPS in the risk stratification of CS patients. Methods: We searched PubMed, Embase, and Scopus databases from their inception to 12/4/2020 with search terms “Cardiac sarcoidosis” And “Electrophysiological studies OR ablation”. The first and second authors reviewed all the studies. We extracted the data of positive and negative EPS, and outcomes defined as ventricular arrhythmias, implantable cardioverter defibrillator therapy, death, left ventricular assist device placement, or heart transplantation. Risk of bias assessment was done by the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Subgroup analysis of patients with left ventricular ejection fraction (LVEF) >35%, and probable CS, no prior ventricular tachycardia (VT) and LVEF >35% were performed. Results: We found 544 articles after removing duplicates. A total of 52 full articles were reviewed, and eight studies were included in the meta-analysis. The pooled sensitivity and specificity (95% confidence interval) of EPS in predicting clinical outcomes were 0.70 (0.51–0.85) and 0.93 (0.85–0.97), respectively. Subgroup analysis of patients with LVEF >35% resulted in pooled sensitivity of 0.63 (0.29–0.88) and pooled specificity of 0.97 (0.92–0.99), and subgroup analysis of patients with probable CS, no prior VT, and LVEF >35% resulted in pooled sensitivity of 0.71 (0.33–0.93) and pooled specificity of 0.96 (0.88–0.99) in predicting adverse clinical outcomes. Conclusions: EPS is an effective risk stratification tool in patients with CS across all subgroups with high sensitivity and specificity.

Original languageEnglish (US)
Pages (from-to)55-61
Number of pages7
JournalInternational Journal of Cardiology
Volume349
DOIs
StatePublished - Feb 15 2022
Externally publishedYes

Keywords

  • Cardiac sarcoidosis
  • Electrophysiology study
  • Sudden cardiac death
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'The role of electrophysiology study in risk stratification of cardiac sarcoidosis patients: Meta-analyses and systemic review'. Together they form a unique fingerprint.

Cite this