{
  "abstract": "Introduction Cardiac sarcoidosis can lead to complications such as advanced heart failure, high-grade atrioventricular heart block, life-threatening arrhythmias and sudden cardiac death. Accurate diagnosis of CS in suspected patients is associated with improved prognosis. CS can be diagnosed using the 2014 Heart Rhythm Society (HRS) criteria. In practice however, the diagnosis of CS requires a specialist multi-disciplinary team (MDT) approach, assisted by cardiac imaging such as CMR and FDG-PET-CT. In January 2025, we established a new cardiac sarcoidosis service in Sussex, to serve a UK catchment population of ~1.7 million. The service runs over two clinics and provides inpatient care at the regional tertiary centre in Brighton. This study assessed the effectiveness of this service for diagnosing CS.Method In the Sussex CS service, patients are diagnosed with input from an MDT including cardiologists and cardiac imaging specialists, in collaboration with respiratory physicians and rheumatologists experienced in CS management. Patients who do not fulfil HRS criteria can still be given a clinical CS diagnosis if deemed suitable by the MDT opinion. We assessed consecutive clinical referrals after 11 months of the service. We compared these referrals against 26 ‘control’ patients with extra-cardiac sarcoidosis under general cardiology care before the conception of the dedicated CS service.Results Between January and November 2025, the CS Service received 43 new referrals for patients with suspected CS (~1/week). Of these patients, 28 (65%) had evidence of extra-cardiac sarcoidosis; n=14 were biopsy-confirmed (50%). Of the 43 referrals, 20 patients were given a clinical diagnosis of CS (n=12 HRS-criteria-positive; n=8 HRS-criteria-negative). Compared to the 26 controls, the CS service referrals were similar in age (58±11 vs 55±14 yrs; p=0.423) and gender (60% vs 77% males; p=0.163). Whilst the CS service correctly diagnosed all HRS-criteria-positive patients (12/12; 100%), only 3/8 (31%) control patients who met the HRS criteria were given a correct clinical CS diagnosis (100% vs 31%; p=0.002). No control patients who were HRS-criteria-negative were given a clinical CS diagnosis (vs 26% managed by the CS service). Four patients underwent endomyocardial biopsy (EMB); none yielded non-caseating granuloma, possibly reflecting the patchy nature of CS as a condition.Conclusions The Sussex cardiac sarcoidosis service improved the clinical diagnosis of CS patients. In HRS-criteria-positive patients, the service correctly diagnosed all patients. Some HRS-criteria-negative patients were still diagnosed with CS by the MDT, representing a patient group that may otherwise be unintentionally missed. EMB did not identify CS in any patient, indicating the need for technical improvement and refinement. This study supports the clinical recommendation of managing CS patient under dedicated specialist care",
  "authors": [
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Otto Fenske"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Imad Imran"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Raj Selvaraju"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Ana Frappell"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Emine Cicek"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Rebecca Godfrey"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Achuth Hospur"
    },
    {
      "affiliations": [
        "Radiology Department, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Eleonora Manca"
    },
    {
      "affiliations": [
        "Radiology Department, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Nitasha Singh"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Susan Ellery"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Victoria Parish"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "David Hildick-Smith"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Jack McCready"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "John Silberbauer"
    },
    {
      "affiliations": [
        "Nuclear Medicine Department, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Sabina Dizdarevic"
    },
    {
      "affiliations": [
        "Respiratory Medicine Department, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Rachel Buxton-Thomas"
    },
    {
      "affiliations": [
        "Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom"
      ],
      "name": "Alexander Liu"
    }
  ],
  "title": "41 The sussex cardiac sarcoidosis service improves diagnosis of patients with cardiac sarcoidosis",
  "uid": "b53f9e22-d6b2-5c6f-a9e3-4542de2ce464"
}