Pulmonary involvement is most frequent but any organ can be affected. Cardiac involvement, diagnosed by cardiac MRI or positron emission tomography (PET), has been reported in up to 55% of patients with extra- cardiac disease, while isolated cardiac sarcoidosis was seen in most patients diagnosed with cardiac Cardiac manifesta- tions include conduction abnormalities, VA, and depressed ventricular function with or without HF, and these contribute greatly to a higher mortality in cardiac sarcoidosis compared with sarcoidosis without cardiac involvement.S7.6-2 In a 25-year study of 110 patients with cardiac sarcoidosis in Finland with HF at presentation, marked LV dysfunction at diagnosis (LVEF <35%), and iso- lated cardiac sarcoidosis predicted an adverse VA can also occur in patients with relatively normal LV function, some of whom have RV involvement that can mimic arrhythmo- genic right ventricular cardiomyopathy. Several reports of patients with cardiac sarcoidosis and ICDs implanted for either primary or secondary prevention of SCD show a high frequency of appropriate ICD therapies,S7.6-3 S7.6-5 supporting use of ICDs for primary and secondary prevention of SCD according to the indications applied for other cardiomyopathies. The frequency of con- duction abnormalities often warrants a device that provides bradycardia pacing as well. 2. Patients with cardiac sarcoidosis can experience VA and SCD, even if the LVEF is normal, and approaches to identification of patients at risk of SCD despite preserved LV function are not well defined. A number of studies have evaluated the role of cardiac MRI for predicting VA and SCD. A which included 760 patients in 10 studies, found that late gadolinium enhance- ment was associated with increased all-cause mortality and more VA compared with those with- out late gadolinium enhancement. Applicability is limited by the lack of precise quantification of late gadolinium enhancement burden that may allow for more nuanced risk stratification. 