Impact of ventricular arrhythmia in patients with sarcoidosis: an analysis of the national readmission database.

Background: The impact of ventricular arrhythmia in patients with sarcoidosis has not been well studied. Our objective was to determine the association of ventricular arrhythmia with clinically relevant outcomes in sarcoidosis patients.

Research design and methods: We included adult patients with sarcoidosis from a nationally representative database, the Nationwide Readmission Database, admitted between 1 January 2011 and 31 December 2018. We assessed whether ventricular tachycardia and fibrillation (VTVF) increases mortality risk, the need for automatic implantable cardioverter-defibrillator (AICD), or permanent pacemaker during hospitalization in sarcoidosis patients. Logistic and Cox regressions were performed.

Results: Out of 570,807 sarcoidosis patients 15,459 (2.71%) developed VTVF. In a multivariable-adjusted logistic regression, ventricular arrhythmias were significantly associated with mortality (aOR 2.98; 95% CI 2.66-3.34, p < 0.001), AICD (aOR 17.69; 95% CI 14.8-21.2, p < 0.001) or permanent pacemaker placement (aOR 3.41; 95% CI 2.87-4.06, p < 0.001). In a multivariable-adjusted Cox regression, ventricular arrhythmias were not significantly associated with 30-day all cause readmission (aHR 0.94; 95% CI 0.84-1.05, p = 0.251).

Conclusions: VTVF in sarcoidosis patients was associated with increased mortality risk, AICD, and/or pacemaker placement but not readmissions. Aggressive monitoring of these patients to identify VTVF may improve outcomes.