The role of electrophysiology study in risk stratification of cardiac sarcoidosis patients: Meta-analyses and systemic review
| Autor: | Mehul Adhaduk, Michael C. Giudici, Kan Liu, Mahi Ashwath, Bishow Paudel |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Sarcoidosis medicine.medical_treatment Subgroup analysis Risk Assessment Ventricular Function Left Sudden cardiac death Electrophysiology study Internal medicine medicine Humans Ventricular Assist Device Placement Heart transplantation Ejection fraction medicine.diagnostic_test business.industry Stroke Volume Implantable cardioverter-defibrillator medicine.disease Confidence interval Defibrillators Implantable Electrophysiology Death Sudden Cardiac Tachycardia Ventricular Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | International Journal of Cardiology. 349:55-61 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2021.11.061 |
| Popis: | Background The utility of an electrophysiologic study (EPS) in the risk stratification of 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 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 clinical outcomes. Conclusions EPS is an effective risk stratification tool in patients with CS across all subgroups with high sensitivity and specificity. |
| Databáze: | OpenAIRE |
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