Indian Pacing and Electrophysiology Journal (2012-11-01)

Electrophysiological Features of Atrial Flutter in Cardiac Sarcoidosis: A Report of Two Cases

  • Narayanan Namboodiri, MD,
  • Martin K. Stiles, MBChB, PhD,
  • Glenn D. Young, MBBS,
  • Prashanthan Sanders, MBBS, PhD

Journal volume & issue
Vol. 12, no. 6
pp. 284 – 289


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We report two cases of systemic sarcoidosis with atrial flutter as the clinical manifestation. In one patient, who had symptoms of shorter duration, the arrhythmia was no longer inducible after a course of glucocorticoid therapy. Electroanatomical mapping in the other case revealed patchy fibrosis of the left atrial myocardium and multiple macro-reentrant circuits. Sinus rhythm could be restored with ablation of these reentrant circuits. To our knowledge, this is the first report on the demonstration of atrial scarring in a patient with sarcoidosis using 3-D electroanatomical mapping. These two cases illustrate that the inflammation of atrial myocardium is the primary mechanism of atrial arrhythmias in patients with cardiac sarcoidosis.