Cardiac Sarcoidosis Recommendations for Cardiac Sarcoidosis References that support the recommendations are summarized in Online Data Supplement 33. COR LOE Recommendations I B-NR In patients with cardiac sarcoidosis who have sustained VT or are survivors of SCA or have an LVEF of 35% or less, an ICD is recommended, if meaningful survival of greater than 1 year is expected.S7.6-1 S7.6-5 IIa B-NR In patients with cardiac sarcoidosis and LVEF greater than 35% who have syncope and/ or evidence of myocardial scar by cardiac MRI or positron emission tomographic (PET) scan, and/or have an indication for permanent pacing, implantation of an ICD is reasonable, provided that meaningful survival of greater than 1 year is IIa C-LD In patients with cardiac sarcoidosis and LVEF greater than 35%, it is reasonable to perform an electrophysiological study and to implant an ICD, if sustained VA is inducible, provided that meaningful survival of greater than 1 year is expected.S7.6-11,S7.6-12 IIa C-LD In patients with cardiac sarcoidosis who have an indication for permanent pacing, implantation of an ICD can be IIa C-LD In patients with cardiac sarcoidosis with frequent symptomatic VA and evidence of myocardial inflammation, immunosuppression in combination with antiarrhythmic medication therapy can be useful to reduce VA burden.S7.6-14 S7.6-16 CLINICAL STATEMENTS AND GUIDELINES Recommendation-Specific Supportive Text 1. Sarcoidosis is a systemic granulomatous disease of unknown cause. Pulmonary involvement is most frequent but any organ can be affected. 