The prevalence of cardiac sarcoidosis has exponentially increased over the past 
decade, primarily due to increased awareness and diagnostic modalities for the 
disease entity. Despite an expanding patient cohort, the optimal management of 
cardiac sarcoidosis remains yet to be established with a significant lack of 
prospective trials to support current practice. Corticosteroids remain 
first-line treatment of this disorder, and we recommend that immunosuppressive 
therapy should be initiated in all patients diagnosed with cardiac sarcoidosis. 
Additional pharmacotherapy may be necessary based on disease manifestations and 
response to treatment. The use of nuclear imaging with 18fluorodeoxyglucose 
(18FDG) positron emission tomography (PET) to guide treatment has become more 
common, but lacks rigorous data from larger cohorts. Whether an improvement in 
inflammatory burden as assessed by 18FDG-PET is correlated with clinical 
outcomes is as yet unproven. Device therapy with implantable-cardioverter 
defibrillators should be considered in all cardiac sarcoidosis patients for 
either primary or secondary prevention of ventricular arrhythmias and cardiac 
death.