{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:55:06Z","timestamp":1755795306526,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"unspecified","delay-in-days":98,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["23K15145"],"award-info":[{"award-number":["23K15145"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2025,3,24]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ventricular parasystole is strongly associated with ventricular fibrillation (VF) in patients with non-ischaemic cardiomyopathy. However, the relationship between ventricular parasystole and cardiac sarcoidosis (CS) remains unclear. The purpose of this study was to examine the prevalence of parasystole in patients with CS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective observational study of 214 consecutive patients diagnosed with CS (mean age: 69\u00b112 years, 104 males, median follow-up period: 6.8 years (IQR: 3.2\u201310.7) in our centre. We investigated parasystole in the patients who developed ventricular arrhythmia (VA) using 9886 ECGs, 280 Holter ECGs and 6391 implantable cardioverter defibrillator interrogation records. Classic parasystole was defined as three ventricular ectopic beats with the same morphology, occurring at integer-multiple intervals but with different coupling intervals (CI) on ECG. New parasystole was defined as two ventricular ectopic beats with a CI difference of more than 120\u2009ms. We also analysed the correlation between inflammation sites and parasystole morphology observed on a 12-lead ECG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>VA was identified in 95 patients (33.7%), and 22 developed VF (23.2%). Parasystole was observed in 12 of the 22 patients with VF (classic: 5, new: 7), 20 of 73 with ventricular tachycardia (classic: 5, new: 15) and 44 of 118 without VA (classic: 16, new: 28). Parasystole was significantly more common in the VF group than in the non-VF group (p=0.049). The site of inflammation observed on <jats:sup>18<\/jats:sup>F-fluorodeoxyglucose positron emission tomography performed within 3\u2009months after the development of VA and the origin of parasystole matched in all four patients with VF who had 12-lead ECG records of parasystole. Inflammation was correlated with the origin of parasystole.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Ventricular parasystole was detected in one-third of patients with CS in this study, especially those with VF. The presence of parasystole and inflammation may predict the occurrence of VF in patients with CS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003196","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T02:10:16Z","timestamp":1744251016000},"page":"e003196","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of ventricular parasystole in patients with cardiac sarcoidosis: correlation between parasystole and inflammation in ventricular fibrillation"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1130-7940","authenticated-orcid":false,"given":"Takashi","family":"Ikee","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1279-6558","authenticated-orcid":false,"given":"Kenzaburo","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Ishibashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emi","family":"Tateishi","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-939X","authenticated-orcid":false,"given":"Reina","family":"Tonegawa-Kuji","sequence":"additional","affiliation":[{"name":"Genomic Medicine Institute, Lerner research institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinori","family":"Wakamiya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiko","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3055-7913","authenticated-orcid":false,"given":"Tsukasa","family":"Kamakura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Nagase","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine 3, Kawasaki Medical School General Medical Center, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1779-7282","authenticated-orcid":false,"given":"Takeshi","family":"Aiba","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kengo","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"2025081710162082000_12.1.e003196.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad067"},{"key":"2025081710162082000_12.1.e003196.2","first-page":"624","article-title":"Cardiac sarcoidosis: Epidemiology, characteristics, and outcome over 25 years in a nationwide study","volume":"131","author":"Kandolin","year":"2015","journal-title":"Circulation Wolters Kluwer Health"},{"key":"2025081710162082000_12.1.e003196.3","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-307877"},{"key":"2025081710162082000_12.1.e003196.4","doi-asserted-by":"crossref","unstructured":"Segawa M , Fukuda K , Nakano M , et al . Time Course and Factors Correlating With Ventricular Tachyarrhythmias After Introduction of Steroid Therapy in Cardiac Sarcoidosis. Circ: Arrhythmia and Electrophysiology 2016;9. doi:10.1161\/CIRCEP.115.003353","DOI":"10.1161\/CIRCEP.115.003353"},{"key":"2025081710162082000_12.1.e003196.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.01.036"},{"key":"2025081710162082000_12.1.e003196.6","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.jacep.2022.11.014","article-title":"Ventricular parasystole in cardiomyopathy patients: A link between his-Purkinje system damage and ventricular fibrillation","volume":"9","author":"Do","year":"2023","journal-title":"JACC Clin Electrophysiol"},{"key":"2025081710162082000_12.1.e003196.7","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-19-0508"},{"key":"2025081710162082000_12.1.e003196.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.02.551"},{"key":"2025081710162082000_12.1.e003196.9","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000548"},{"key":"2025081710162082000_12.1.e003196.10","first-page":"1989","article-title":"Usefulness of fasting 18F-FDG PET in identification of cardiac sarcoidosis","volume":"45","author":"Okumura","year":"2004","journal-title":"J Nucl Med"},{"key":"2025081710162082000_12.1.e003196.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2010.09.015"},{"key":"2025081710162082000_12.1.e003196.12","first-page":"352","article-title":"Group beating resulting from ventricular parasystole","volume":"16","author":"Glancy","year":"2003","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"2025081710162082000_12.1.e003196.13","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.jacep.2022.12.024","article-title":"Ventricular parasystole: Back to the future","volume":"9","author":"Sugrue","year":"2023","journal-title":"JACC Clin Electrophysiol Elsevier BV"},{"key":"2025081710162082000_12.1.e003196.14","article-title":"Arrhythmias in Cardiac Sarcoidosis Bench to Bedside","volume":"14","author":"Rosenfeld","year":"2021","journal-title":"Circ: Arrhythmia and Electrophysiology"},{"key":"2025081710162082000_12.1.e003196.15","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1542-474X.2011.00418.x","article-title":"Effect of Corticosteroid Therapy on Ventricular Arrhythmias in Patients with Cardiac Sarcoidosis","volume":"16","author":"Yodogawa","year":"2011","journal-title":"Noninvasive Electrocardiol"},{"key":"2025081710162082000_12.1.e003196.16","doi-asserted-by":"crossref","DOI":"10.1093\/ehjcr\/ytac334","article-title":"Successful treatment of recurrent cardiac sarcoidosis with the combination of corticosteroid and methotrexate monitored by 18F-fluoro-2-deoxyglucose positron emission tomography: case series","volume":"6","author":"Ishizuka","year":"2022","journal-title":"Eur Heart J Case Rep"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2025-003196","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:16:29Z","timestamp":1755450989000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2025-003196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,4,9]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/openhrt-2025-003196"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2025-003196","relation":{},"ISSN":["2053-3624"],"issn-type":[{"type":"electronic","value":"2053-3624"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}