Journal of Arrhythmia (Oct 2017)

Sudden failure of ventricular pacing and recovery in a patient with cardiac sarcoidosis

  • Yosuke Terui,
  • Akihiro Nakamura,
  • Hideaki Endo,
  • Takahide Kadosaka,
  • Takashi Nakata,
  • Tasuku Watanabe,
  • Kenjiro Sato,
  • Masanori Kanazawa,
  • Masateru Kondo,
  • Tohru Takahashi,
  • Eiji Nozaki

DOI
https://doi.org/10.1016/j.joa.2017.06.004
Journal volume & issue
Vol. 33, no. 5
pp. 521 – 522

Abstract

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A 76-year-old woman with sarcoidosis who had an implantable pacemaker for complete atrioventricular block was admitted with syncope. Electrocardiogram revealed ventricular pacing failure, and a marked rise in the ventricular pacing threshold. 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) indicated increased uptake of FDG in the ventricular septum. Three days after steroid therapy, the ventricular pacing threshold reverted to normal, and FDG-PET showed decreased FDG uptake in the ventricular septum. In this case report, we demonstrate that a sudden deterioration in the ventricular pacing threshold due to worsening cardiac sarcoidosis can be reversed with early steroid therapy.

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