Send to

Choose Destination
J Arrhythm. 2017 Feb;33(1):69-72. doi: 10.1016/j.joa.2016.05.003. Epub 2016 Jun 4.

Bidirectional ventricular tachycardia in cardiac sarcoidosis.

Author information

Department of Internal Medicine (Division of Cardiology), University of Wisconsin Hospital and Clinics, 600 Highland Ave, Madison, WI 53713, United States.
Department of Internal Medicine (Division of Cardiology), University of California in San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143, United States.


A 73-year-old man with history of pulmonary sarcoidosis was found to have runs of non-sustained bidirectional ventricular tachycardia (BVT) with two different QRS morphologies on a Holter monitor. Cardiac magnetic resonance delayed gadolinium imaging revealed a region of patchy mid-myocardial enhancement within the left ventricular basal inferolateral myocardium. An 18-fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased uptake in the same area, consistent with active sarcoid, with no septal involvement. Follow-up FDG-PET one year later showed disease progression with new septal involvement. Cardiac sarcoidosis, characterized by myocardial inflammation and interstitial fibrosis that can lead to conduction system disturbance and macro re-entrant arrhythmias, should be considered in differential diagnosis of BVT. BVT may indicate septal involvement with sarcoidosis before the lesions are large enough to be detected radiologically.


Arrhythmias; BVT, Bidirectional ventricular tachycardia; Cardiac sarcoidosis; ICD, Implantable cardioverter defibrillator; Magnetic resonance tomography; PET, Positron emission tomography; PVC, Premature ventricular contraction; Positron emission tomography; VT, Ventricular tachycardia.; Ventricular tachycardia

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center