Table 3.

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

There are two 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 a 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

There is 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

Note: Adapted from Reference 1 with minor modifications. ◄ criteria that were present in our patient.

^a In general, ‘probable involvement’ is considered adequate to establish a clinical diagnosis of CS.