Table 1.

Heart Rhythm Society Expert Consensus Recommendations on criteria for the diagnosis of cardiac sarcoidosis (2014).

There are 2 pathways to a diagnosis of cardiac sarcoidosis (CS):

1. Histological diagnosis from myocardial tissue

CS is diagnosed if an endomyocardial biopsy shows non-caseating granuloma with no alternative cause for the histological findings identified

2. Clinical diagnosis from invasive and non-invasive studies:

CS is probable* if

(a) There is a histological diagnosis of extra-cardiac sarcoidosis

and

(b) One or more of following is present:

➢ Steroid +/- immunosuppressant responsive cardiomyopathy or heart block

➢ Unexplained reduced left ventricular ejection fraction (40%)

➢ Unexplained sustained (spontaneous or induced) ventricular tachycardia

➢ Mobitz type II, second- or third-degree heart block

➢ Patchy uptake on dedicated cardiac FDG-PET in a pattern consistent with CS

➢ Late Gadolinium Enhancement on CMR consistent with CS pattern

➢ Positive gallium uptake in a pattern consistent with CS

and

(c) Other causes for the cardiac manifestation(s) have been reasonably excluded

*In general, “probable involvement” is considered adequate to establish a clinical diagnosis of CS.

Adapted from [5] with minor modifications. CMR, cardiac magnetic resonance; FDG-PET, 18F-fluorodeoxyglucose positron emission tomography.