title: Re-entry circuit in ventricular tachycardia due to focal fatty-fibrosis in a patient with myotonic dystrophy.
abstract: A 69-year-old man with a recurrent ventricular tachycardia (VT) was admitted. The patient was diagnosed as myotonic dystrophy type 1 (DM1) and DNA analysis revealed 1,800 CTG-repeat expansion in the myotonic dystrophy protein kinase (DMPK) gene. Ultrasonic cardiogram (UCG), left ventriculogram (LVG) and magnetic resonance imaging (MRI) did not show any abnormal sign including fatty infiltration. But, endomyocardial biopsy obtained from ventricular outflow tract revealed severe fatty infiltration and interstitial fibrosis. Radiofrequency catheter ablation at the biopsy site could eliminate VT, so it was strongly suggested that the re-entry circuit was formed by focal fatty-fibrosis. Careful observation should be continued for a long period.
authors.affiliation: First Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki 569-0801.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Muraoka
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Negoro
authors.forename: Fumio
authors.initials: F
authors.lastname: Terasaki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakakoji
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kojima
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hoshiga
authors.forename: Masakazu
authors.initials: M
authors.lastname: Sugino
authors.forename: Takafumi
authors.initials: T
authors.lastname: Hosokawa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ishihara
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000368:Aged; D001706:Biopsy; D009202:Cardiomyopathies / Q000150:complications* / Q000175:diagnosis; D017115:Catheter Ablation; D004247:DNA / Q000032:analysis; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005355:Fibrosis; D006339:Heart Rate / Q000502:physiology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009223:Myotonic Dystrophy / Q000150:complications* / Q000175:diagnosis / Q000201:enzymology; D065636:Myotonin-Protein Kinase; D017346:Protein Serine-Threonine Kinases / Q000235:genetics; D015635:Radionuclide Ventriculography; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D014463:Ultrasonography
chemical_list: C585517:DMPK protein, human; D004247:DNA; D065636:Myotonin-Protein Kinase; D017346:Protein Serine-Threonine Kinases