Background Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging is commonly used to facilitate diagnosis in suspected cardiac sarcoidosis (CS). However, there is a gap in evidence regarding the diagnoses and outcomes of patients who undergo FDG PET/CT. Objectives Evaluate the diagnoses and outcomes of patients referred for FDG PET/CT imaging for suspected CS. Methods We studied all consecutive patients referred to our center for FDG PET/CT for suspected CS from June 2006 to November 2023. Patients were characterized by their final clinical diagnosis and followed to a composite outcome of left ventricular assist device placement, heart transplant, or death. Results A total of 1646 patients (mean age 58.4 ± 12.4 years; 66 % male) met inclusion criteria: 285 (17.3 %) with Heart Rhythm Society (HRS) criteria positive CS, 83 (5.0 %) with probable CS, 237 (14.4 %) with sarcoidosis but without HRS criteria for CS, and 1041 (63.2 %) with other diagnoses. 227 patients (13.8 %) underwent genetic testing, of whom 32 (14.1 %) were found to have a pathogenic/likely pathogenic variant. Over a median follow up of 4.4 years, 327 patients (19.9 %) met the primary outcome. There was no significant difference in outcomes by diagnosis (log-rank p = 0.4936). Conclusions Most patients referred for FDG PET/CT for suspected CS were not found to have CS in follow up. However, they are at similar risk for the need for advanced therapies and many are found to have genetic CMP. These data highlight the importance of advanced heart disease consultation and referral for genetic testing in this population.

Background Postprocedural pericarditis (PP) can occur in up to 29.4% of patients undergoing epicardial catheter ablation of ventricular tachycardia (VT). Despite several proposed strategies to mitigate this adverse outcome, rates of PP and pericarditic pain remain high. Objectives This study sought to assess the impact of intrapericardial steroids instillation (ISI) combined with periprocedural colchicine on PP after epicardial VT ablation. Methods This prospective multicenter study included patients undergoing epicardial VT ablation between June 2021 and December 2023. The primary outcome was the occurrence of pericarditis, defined as the presence of pericarditic chest pain and pericarditic electrocardiographic (ECG) changes. Secondary outcomes included the pericarditic pain score at 6, 12, 24, and 48 hours after the procedure, pericardial effusion, postprocedural new-onset atrial fibrillation (AF), constrictive pericarditis, admission due to pericarditis, and gastrointestinal side effects. A systematic literature search was performed to identify historical control groups to compare with our cohort. Results A total of 129 patients underwent epicardial VT ablation with subsequent ISI and colchicine therapy. The combination of ISI and colchicine resulted in a nonsignificant trend of lower rates of pericarditis when compared with all historical control groups (3.1% [4 of 129] vs 7.0% [12 of 172]; P = 0.109) and a significant difference when compared to intrapericardial steroids (3.1% vs 13.2%; P = 0.030). The rates of pericarditic pain (10.9% [14 of 129] vs 30.9% [21 of 68]; P = 0.001), pericarditic ECG changes (5.4% [7 of 129] vs 33.8% [23 of 68]; P < 0.001) and new-onset atrial fibrillation (0.8% vs 19.5%; P = <0.001) were significantly lower in our study than in historical control groups. Conclusions The instillation of intrapericardial steroids along with periprocedural colchicine after epicardial VT ablation led to a decreased incidence of adverse effects associated with pericardial inflammation when compared with historical control groups. Further research with contemporary control groups is needed to confirm the suggested impact of the strategy described here.