[Diagnostic and therapeutic approach to myocarditis patients presenting with arrhythmias]

Myocarditis is a complex inflammatory disease of the myocardium, occurring secondary to viral infections or autoimmune mechanisms in most cases. Among its multiple clinical manifestations, arrhythmias are often underdiagnosed, in spite of their important prognostic value. In particular, ventricular arrhythmias complicating either active or previous myocarditis, are a significant cause of sudden cardiac death, especially in young people. Because of the absence of clinical trials specifically addressing this topic, nowadays updated international guidelines report extremely generic recommendations about optimal clinical management of patients with arrhythmic myocarditis. This review aims at both (i) showing the state of the art about patients with myocarditis and arrhythmias (ventricular arrhythmias in particular); and (ii) suggesting optimal diagnostic and therapeutic strategies for these patients, based on the experience of a high-volume referral center for arrhythmic myocarditis and ventricular arrhythmia management.