Holter Monitoring as a Noninvasive Indicator of Cardiac Involvement in Sarcoidosis

¹ From the College of Medical Care and Technology, Gunma University School of Medicine, Maebashi, Japan
² From the Second Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan

We investigated the usefulness of 24-h Holter monitoring for identification of myocardial involvement in 38 patients with sarcoidosis, including 12 patients with cardiac sarcoidosis, and 58 healthy controls. Ventricular ectopic beats (VEB) 100 beats per day were detected in 8 (67 percent) of 12 patients with cardiac sarcoidosis, in 2 (8 percent) of 26 patients without cardiac sarcoidosis, and in 3 (5 percent) of 58 healthy controls. Holter monitoring was associated with a sensitivity of 67 percent and a specificity of 62 percent for cardiac sarcoidosis in the overall study population. In patients with sarcoidosis, specificity was 80 percent. Lown's grade 4 A and 4 B VEBs were detected in 8 (67 percent) of 12 patients with cardiac sarcoidosis, in 2 (8 percent) of 26 patients with sarcoidosis without cardiac involvement, and in 2 (3 percent) of 58 controls. Holter monitoring was associated with a sensitivity of 67 percent and a specificity of 80 percent for identification of cardiac involvement in patients with systemic sarcoidosis. Our findings suggest that 24-h Holter monitoring provides a convenient and inexpensive means of noninvasive screening for cardiac involvement in generalized sarcoidosis, even in patients and outpatients who are without symptoms.

Key Words: cardiac sarcoidosis • Holter monitoring • ventricular ectopic beat

Submitted on December 13, 1993
Accepted on February 4, 1994

This article has been cited by other articles:

				J.-P. Smedema, G. Snoep, M. P. G. van Kroonenburgh, R.-J. van Geuns, E. C. Cheriex, A. P. M. Gorgels, and H. J. G. M. Crijns The Additional Value of Gadolinium-Enhanced MRI to Standard Assessment for Cardiac Involvement in Patients With Pulmonary Sarcoidosis Chest, September 1, 2005; 128(3): 1629 - 1637. [Abstract] [Full Text] [PDF]

				S. Ishimaru, I. Tsujino, T. Takei, E. Tsukamoto, S. Sakaue, M. Kamigaki, N. Ito, H. Ohira, D. Ikeda, N. Tamaki, et al. Focal uptake on 18F-fluoro-2-deoxyglucose positron emission tomography images indicates cardiac involvement of sarcoidosis Eur. Heart J., August 1, 2005; 26(15): 1538 - 1543. [Abstract] [Full Text] [PDF]

				J.-P. Smedema, G. Snoep, M. P. G. van Kroonenburgh, R.-J. van Geuns, W. R. M. Dassen, A. P. Gorgels, and H. J. G. M. Crijns Cardiac Involvement in Patients With Pulmonary Sarcoidosis Assessed at Two University Medical Centers in the Netherlands Chest, July 1, 2005; 128(1): 30 - 35. [Abstract] [Full Text] [PDF]