Pleomorphism during Ventricular Tachycardia: A Distinguishing Feature between Cardiac Sarcoidosis and Idiopathic VT

Pacing and Clinical Electrophysiology : PACE
Subhanarayan PandaCalambur Narasimhan

Abstract

Ventricular tachycardia (VT), a common manifestation of cardiac sarcoidosis (CS), is associated with high morbidity and mortality. It could be mistaken for idiopathic VT (IVT) in the absence of systemic manifestations and overt cardiac structural abnormality. We studied the electrocardiogram (ECG) characteristics of VT in CS that may distinguish from IVT and also explored the relationship of the ECG characteristics with imaging findings in patients with CS. Twelve-lead ECG characteristics of VT in CS patients (Group I = 37) were compared with IVT (Group II = 49). QRS duration, axis, morphology, VT cycle length, and cycle length variation (CLV) were analyzed. In Group I, 18 (49%) had pleomorphic VT (PLVT) and none in Group II. CLV was seen only in Group I (24%). Mean QRS duration (milliseconds) and cycle length (milliseconds) were greater in Group I (QRSd 152.49 [39.3] vs 140.9 [19.2]) and (332.2 [136.5] vs 312.9 [56.2]), the differences not statistically significant. In Group I, myocardial scar was present in 22 of 25 patients and myocardial inflammation in 28 of 29 patients as assessed by cardiac magnetic resonance imaging (delayed enhancement) and 18-fluorodeoxyglucose positron emission computed tomography, respectively. PLVT...Continue Reading

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Citations

Jul 28, 2016·JACC. Cardiovascular Imaging·G Cameron ColemanMichael Salerno
Apr 23, 2020·Pacing and Clinical Electrophysiology : PACE·Debabrata BeraCalambur Narasimhan
Oct 24, 2020·JACC. Clinical Electrophysiology·C Narasimhan, Muthiah Subramanian

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