title: Ventricular fibrillation via torsade des pointes of cardiac sarcoidosis with preserved left ventricular ejection fraction.
abstract: Generally, low left ventricular ejection fraction (LVEF) is a risk for ventricular arrhythmia in patients with cardiac sarcoidosis. We present a case of cardiac sarcoidosis with preserved LVEF that evoked ventricular fibrillation (VF). A 73-year-old woman with VF presented to our emergency department. She had a history of ocular sarcoidosis, with gradual thinning of the basal intraventricular septum. LVEF was 62% on the most recent echocardiography. The electrocardiogram after defibrillation showed complete atrioventricular block (CAVB) with QT segment prolongation and frequent ventricular premature beats. VF via torsade des pointes (TdP) was suspected, and temporary intravenous ventricular pacing and magnesium sulfate infusion suppressed her VF. Cardiac sarcoidosis was diagnosed, and an implantable cardioverter defibrillator was implanted. Patients with cardiac sarcoidosis with CAVB are at risk of evoking VF via TdP regardless of LVEF. If cardiac sarcoidosis is suspected, early diagnosis and risk stratification of ventricular arrhythmia are important.
authors: Cardiovascular Center, Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors: Takayuki
authors: T
authors: Sekihara
authors: Cardiovascular Center, Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors: Eisaku
authors: E
authors: Nakane
authors: Cardiovascular Center, Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors: Kazutaka
authors: K
authors: Nakasone
authors: Cardiovascular Center, Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors: Moriaki
authors: M
authors: Inoko
mesh_terms: D000368:Aged; D001706:Biopsy; D009202:Cardiomyopathies / Q000175:diagnosis / Q000503:physiopathology*; D003287:Contrast Media; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012507:Sarcoidosis / Q000175:diagnosis / Q000503:physiopathology*; D013318:Stroke Volume / Q000502:physiology*; D016171:Torsades de Pointes / Q000175:diagnosis / Q000503:physiopathology*; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000503:physiopathology*
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18