Abstract 14085: Comparison of Tissue Fibrosis and Active Inflammation as Arrhythmogenic Substrate in Patients with Cardiac Sarcoidosis and Monomorphic Ventricular Tachycardia
Background: In patients with ventricular tachycardia (VT) due to cardiac sarcoidosis, the mechanism of VT has not been fully elucidated.
Methods: The arrhythmic substrate was evaluated by contract enhanced MRI, FG-PET, Gallium-67 scintigraphy and electroanatomical mapping (EAM) in 8 patients (4 males, aged 59±12yr, mean LVEF44±20%) with cardiac sarcoidosis and monomorphic sustained VT.
Result: The endocardial mapping demonstrated that the low voltage area (<1.5mV) and/or abnormal electrogram predominantly located at the RV septum in 4 patients, RVOT in 3, RV freewall in 3, LV septum in 1, LV posterior in 3, and LV anterior in 1. In 16 (76%) of 21 inducible VT (cycle length 333±72ms : RBBB in 6, LBBB in 15), the focus of VT was identified by activation map or pacemap. The distribution of focus of VT corresponded with abnormal area in EAM in all 16 VTs. The abnormal uptake in FDG-PET or Gallium-67 scintigraphy was observed in 5 patients and DE-MRI in all 8 patients. The VT focus and MRI-DE was correspond 15 of 16 VTs but VTs focus was related in abnormal uptake area of FDG-PET or Gallium-67 scintigraphy only in 4 of 16 VTs (94% vs 25%: P<0.01).
Conclusions: Arrhythmogenic substrate was well correlate with the location of DE-MRI and poorly correlate with the location of the abnormal uptake in FDG-PET or Gallium-67 scintigraphy in cardiac sarcoidosis.
- © 2012 by American Heart Association, Inc.