Open AccessIt all starts with the ECG: cardiac MRI in combination with electrophysiological study to stratify arrhythmic risk in a patient with non-ischemic cardiomyopathy and preserved LVEF
Author(s) -
Ștefan Ailoaei,
Carina-Gabriela Ureche,
Alex Bostan,
Laura Țăpoi,
Daniel C. Ursu,
Anatolie Cazacu,
Radu Andy Sascău,
Cristian Stătescu,
Mihaela Grecu
Publication year - 2021
Publication title -
romanian journal of cardiology
Language(s) - English
Resource type - Journals
eISSN - 2734-6382
pISSN - 1220-658X
DOI - 10.47803/rjc.2020.30.4.639
Subject(s) - medicine , cardiology , palpitations , sudden cardiac death , left bundle branch block , ejection fraction , electrophysiology study , ventricle , sinus tachycardia , cardiomyopathy , dilated cardiomyopathy , qrs complex , myocarditis , bundle branch block , ventricular tachycardia , heart failure , electrocardiography , catheter ablation , atrial fibrillation
A 45-year-old male, hypertensive and obese presented with a 3-months history of short episodes of intermittent palpitations. Clinical examination was unremarkable; however, the electrocardiogram documented major right bundle branch block and the presence of fragmented QRS in all precordial leads. His echocardiography documented a dilated left ventricle, with mild systolic dysfunction and moderate biventricular reduction of the global longitudinal strain. On angiography, the epicardial coronary arteries were normal. A cardiac MRI revealed diffuse transmural fi brotic lesions with non ischemic pattern of the ventricles, suggestive of chronic myocarditis. The electrophysiological study induced two ventricular tachycardia morphologies which were ablated and an ICD for sudden cardiac death primary prevention was implanted. Fortunately, at 6 months follow-up our patient had no ICD therapies and reported an alleviation of symptoms.