Abstract 8559: Efficacy of Implantable Cardiac Defibrillators for the Prevention of Sudden Cardiac Death in Patients with Cardiac Sarcoidosis
Bibliographic record
Abstract
Introduction Patients with cardiac sarcoidosis (CS) are at increased risk for sudden death from ventricular arrhythmias. There is little evidence regarding the efficacy and safety of implantable cardiac defibrillators (ICDs) in this population. Hypothesis Data on demographic, clinical, and ICD intervention history was retrospectively collected on 138 CS patients with ICDs from 11 academic centers throughout the U.S., Canada, and India. We hypothesized that patients with CS would have a high incidence of appropriate ICD therapies. Results Sixty-two of 138 CS patients (44.92%) had an appropriate ICD therapy (ATP or shock) with 39 patients (28.3%) receiving 5 or more therapies (Figure). Forty-eight of 131 patients (36.64%) received an appropriate shock. Thirty-seven of 136 patients (27.21%) had an inappropriate shock. The incidence of appropriate therapy (ATP or shock) was 10.4%/year and the incidence of appropriate shock was 8.5%/year. Twenty-two patients (15.9%) experienced an adverse event, the most common being lead dislodgement in 11 patients (8%). Appropriate therapies (ATP or shock) were more common in patients with syncope 24/37 (65%) versus patients who did not have syncope 38/101 (38%) (p = 0.0065). Appropriate therapies were more common in patients who had ventricular pacing on baseline EKG, 9/10 (90%), compared with those who did not, 53/128 (41%) (p=0.0053). The mean age of patients who received an appropriate therapy (n=59) was 51.7 ± 11.6 compared with 56.9 ± 10.2 for those who did not receive appropriate therapy (n=74) (p = 0.0066). Immunosuppressive medications including steroids, methotrexate, azathioprine, and hydroxychloroquine were not associated with reduced number of appropriate therapies. Conclusions Patients with CS have high rates of appropriate ICD therapies. This population also has high rates of inappropriate shocks and adverse events. Syncope, ventricular pacing, and younger age may identify the highest risk CS patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".