Prognosis after pacemaker implantation in cardiac sarcoidosis in Japan. Clinical evaluation of corticosteroid therapy.

Abstract

Corticosteroids (CS) are useful drugs for the treatment of cardiac sarcoidosis with severe conducting defects due to sarcoid granuloma. Despite the continuous administration of CS, many patients with severe cardiac involvement may eventually die of congestive heart failure. The purpose of this study was to evaluate the efficacy of CS in patients who had a pacemaker implanted. Questionnaires were obtained from 29 institutes, and 34 cardiac sarcoidosis patients (8 males and 26 females) with pacemaker implantation were enrolled in this survey. We analyzed the survival period in these patients by the Kaplan-Meier method. There was no statistically significant difference in the survival of these patients in terms of their age, sex or disease duration (time from the onset of sarcoidosis to cardiac involvement). However, their survival was affected by the grade of dyspnea, the presence of heart failure, and certain abnormal findings on a myocardial scintigram and echocardiogram. In order to evaluate the effect of CS on the prolongation of survival, we measured the survival of the patients treated with CS and those not treated with CS. However, because of the small number of patients not treated with CS, we were unable to detect any statistically significant difference in survival. Therefore, we analyzed 104 cases in order to evaluate CS therapy: the 34 cases from the questionnaires and 70 cases reported in the literature over the last 10 years.(ABSTRACT TRUNCATED AT 250 WORDS)