Sarcoidosis is a multisystem inflammatory disorder of unknown aetiology characterised by the presence of non-necrotizing granulomas. Myocardial involvement, termed cardiac sarcoidosis (CS), occurs in up to 30% of cases and can manifest with an initial presentation of high degree atrioventricular block, ventricular arrhythmias, heart failure and sudden cardiac death (SCD) (1). Investigations to aid diagnosis include echocardiogram, cardiac MRI, FDG-PET scan and endomyocardial biopsy (EMB) (2,3). Implantable cardiac defibrillator (ICD) use in CS has been widely shown to reduce risk of SCD from life-threatening arrhythmias, but factors that identify the most appropriate recipients remains unclear and is the focus of research across the world. One area of excellence spearheading new research around this topic is in Finland (4), with ongoing analysis of the MIDFIN registry – a 5-centre cardiology network first established in the 1980’s.
