# Diagnosis and Management of Patients with Cardiac Sarcoidosis by a Regional Specialist Service

## TL;DR

A new regional cardiac sarcoidosis service in the UK improved diagnosis and management of patients with better outcomes compared to previous approaches.

## Contribution

A novel regional multi-disciplinary team-based service for cardiac sarcoidosis with improved diagnostic accuracy and clinical outcomes.

## Key findings

- 13 out of 51 referrals met Heart Rhythm Society criteria and were correctly diagnosed with cardiac sarcoidosis.
- 8 out of 38 HRS-negative referrals still received a clinical diagnosis of cardiac sarcoidosis.
- No deaths or heart failure hospitalizations occurred within the first 11 months of service operation.

## Abstract

Background: Cardiac sarcoidosis (CS) is associated with potentially serious complications, including heart failure and life-threatening arrhythmias. The diagnosis and management of CS is multifaceted, requiring a multi-disciplinary team (MDT)-based approach. A new regional CS clinical service was established in Sussex County (UK) in January 2025. This service is based on a core of cardiologists working with a wider MDT, including specialists in pulmonary sarcoidosis, nuclear medicine and cardiac electrophysiology. This study assessed the clinical performance of this new service. Methods: Patients with suspected CS referred to the Sussex CS Service between January and December 2025 were included, as compared to a control cohort of patients referred for CS assessment before the service was conceived. Results: Of the 51 CS service referrals, 13 patients fulfilled the Heart Rhythm Society (HRS) criteria, all of whom were correctly diagnosed with CS, whilst only two out of seven HRS-positive control patients were correctly diagnosed. In the 38 HRS-negative CS service referrals, 8 patients (21%) were still given a clinical CS diagnosis compared to none in the HRS-negative controls. Of the 21 patients diagnosed with CS, 7 (33%) had active myocardial inflammation and 8 (38%) had LV systolic dysfunction. Where indicated, immunosuppressive and heart failure therapies were initiated in all patients. Eight CS patients (38%) underwent implantable cardioverter defibrillator implantation. No deaths or heart failure hospitalisations occurred within the first 11 months. Conclusions: An MDT-based CS service model can provide multi-faceted care to patients, without major short-term adverse outcomes. The service model replicability and long-term outcomes require further assessment.