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Updated: Mar 7, 2026

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
Published on: February 17, 2018
Bidirectional ventricular tachycardia in cardiac sarcoidosis
Mina M Benjamin1, Kevin Hayes1, Michael E Field1
1Department of Internal Medicine (Division of Cardiology), University of Wisconsin Hospital and Clinics, 600 Highland Ave, Madison, WI 53713, United States.
Abstract:
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.
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