{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:42Z","timestamp":1753876302382,"version":"3.41.2"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T00:00:00Z","timestamp":1634688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background\u2003<\/jats:title>\n                  <jats:p>The diagnosis of inflammatory cardiomyopathy remains challenging in cases presenting with arrhythmia as sole manifestation. An early diagnosis is critical as it may prevent life-threatening complications such as sudden cardiac death and atrioventricular block (AVB). The diagnostic workup of suspected cases includes multimodality imaging that requires an adequate interpretation in order to limit the risk of overdiagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary\u2003<\/jats:title>\n                  <jats:p>Herein, we report three cases presenting with various new-onset arrhythmias. The first patient was admitted for a third-degree AVB. The second patient suffered from a supraventricular tachycardia which degenerated into ventricular fibrillation. The third case was investigated for symptomatic premature ventricular complexes. No apparent heart disease was observed on standard exams (clinical, biological examinations, and echocardiography). However, cardiac magnetic resonance imaging (MRI) and nuclear imaging (68Ga-DOTATOC and\/or 18F-FDG PET\/CT) suggested an inflammatory substrate that seemed to correlate with the arrhythmic phenotype. Cardiac inflammation disappeared on immunotherapy for the first case and spontaneously for the third case.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion\u2003<\/jats:title>\n                  <jats:p>These cases emphasize the incremental diagnostic yield of multimodality imaging to highlight myocardial inflammation. Nuclear imaging modalities may complement MRI by enabling the detection of active inflammation. The 18F-FDG PET\/CT is well established for the diagnosis of cardiac sarcoidosis but its role remains to be clarified for the diagnosis of myocarditis. An alternative radiotracer, 68Ga-DOTATOC, appears promising by overcoming the main limitation of 18F-FDG but its specificity is not yet well established. The role of functional investigations is discussed as well as the benefit of immunosuppressive treatments.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab418","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T22:30:38Z","timestamp":1634769038000},"source":"Crossref","is-referenced-by-count":0,"title":["From trivial to severe arrhythmias: the diagnostic role of multimodality imaging in inflammatory cardiomyopathy through a case series"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6289-0799","authenticated-orcid":false,"given":"Christelle","family":"Haddad","sequence":"first","affiliation":[{"name":"National Reference Center for Inherited Arrhythmias of Lyon, Arrhythmias Unit, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500 Bron, France"},{"name":"Arrhythmias Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6881-3073","authenticated-orcid":false,"given":"Claudia","family":"Herrera-Siklody","sequence":"additional","affiliation":[{"name":"Arrhythmias Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7950-8090","authenticated-orcid":false,"given":"Alessandra Pia","family":"Porretta","sequence":"additional","affiliation":[{"name":"Arrhythmias Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8049-0702","authenticated-orcid":false,"given":"Patrice","family":"Carroz","sequence":"additional","affiliation":[{"name":"Arrhythmias Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7328-2481","authenticated-orcid":false,"given":"Patrizio","family":"Pascale","sequence":"additional","affiliation":[{"name":"Arrhythmias Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1386-9285","authenticated-orcid":false,"given":"Etienne","family":"Pruvot","sequence":"additional","affiliation":[{"name":"Arrhythmias Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,10,20]]},"reference":[{"key":"2021111719383873200_ytab418-B1","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1161\/CIRCEP.110.959254","article-title":"Cardiac sarcoidosis and giant cell myocarditis as causes of atrioventricular block in young and middle-aged adults","volume":"4","author":"Kandolin","year":"2011","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2021111719383873200_ytab418-B2","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1111\/jce.12401","article-title":"Atrioventricular block as the initial manifestation of cardiac sarcoidosis in middle-aged adults: cardiac sarcoidosis presenting as atrioventricular block","volume":"25","author":"Nery","year":"2014","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021111719383873200_ytab418-B3","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.hrthm.2006.03.031","article-title":"Refractory ventricular tachycardia secondary to cardiac sarcoid: electrophysiologic characteristics, mapping, and ablation","volume":"3","author":"Koplan","year":"2006","journal-title":"Heart Rhythm"},{"key":"2021111719383873200_ytab418-B4","doi-asserted-by":"crossref","first-page":"e007520","DOI":"10.1161\/CIRCEP.119.007520","article-title":"Myocarditis causing premature ventricular contractions: insights from the MAVERIC registry","volume":"12","author":"Lakkireddy","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2021111719383873200_ytab418-B5","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1253\/circj.CJ-19-0508","article-title":"JCS 2016 Guideline on diagnosis and treatment of cardiac sarcoidosis\u2014digest version","volume":"83","author":"Terasaki","year":"2019","journal-title":"Circ J"},{"key":"2021111719383873200_ytab418-B6","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.hrthm.2014.03.043","article-title":"HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis","volume":"11","author":"Birnie","year":"2014","journal-title":"Heart Rhythm"},{"key":"2021111719383873200_ytab418-B7","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.hrthm.2016.09.018","article-title":"How to map and ablate left ventricular summit arrhythmias","volume":"14","author":"Enriquez","year":"2017","journal-title":"Heart Rhythm"},{"key":"2021111719383873200_ytab418-B8","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1093\/eurheartj\/eht210","article-title":"Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases","volume":"34","author":"Caforio","year":"2013","journal-title":"Eur Heart J"},{"key":"2021111719383873200_ytab418-B9","doi-asserted-by":"crossref","first-page":"241","DOI":"10.2967\/jnumed.111.090662","article-title":"The use of 18F-FDG PET in the diagnosis of cardiac sarcoidosis: a systematic review and meta-analysis including the Ontario experience","volume":"53","author":"Youssef","year":"2012","journal-title":"J Nucl Med"},{"key":"2021111719383873200_ytab418-B10","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1007\/s00259-007-0650-8","article-title":"Myocardial imaging with 18F-fluoro-2-deoxyglucose positron emission tomography and magnetic resonance imaging in sarcoidosis","volume":"35","author":"Ohira","year":"2008","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2021111719383873200_ytab418-B11","doi-asserted-by":"crossref","first-page":"e007030","DOI":"10.1161\/CIRCIMAGING.117.007030","article-title":"Complementary value of cardiac magnetic resonance imaging and positron emission tomography\/computed tomography in the assessment of cardiac sarcoidosis","volume":"11","author":"Vita","year":"2018","journal-title":"Circ Cardiovasc Imaging"},{"key":"2021111719383873200_ytab418-B12","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.jcmg.2016.01.010","article-title":"Imaging of inflammation in unexplained cardiomyopathy","volume":"9","author":"Kadkhodayan","year":"2016","journal-title":"JACC Cardiovasc Imaging"},{"key":"2021111719383873200_ytab418-B13","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1002\/ehf2.12243","article-title":"Cardiovascular magnetic resonance imaging and clinical performance of somatostatin receptor positron emission tomography in cardiac sarcoidosis: CMR and SSTR PET in cardiac sarcoidosis","volume":"5","author":"Pizarro","year":"2018","journal-title":"ESC Heart Fail"},{"key":"2021111719383873200_ytab418-B14","doi-asserted-by":"crossref","first-page":"2496","DOI":"10.1007\/s00259-019-04489-z","article-title":"Somatostatin receptor imaging by SPECT and PET in patients with chronic inflammatory disorders: a systematic review","volume":"46","author":"Anzola","year":"2019","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2021111719383873200_ytab418-B15","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ijcard.2015.05.073","article-title":"Imaging of myocardial inflammation with somatostatin receptor based PET\/CT\u2014a comparison to cardiac MRI","volume":"194","author":"Lapa","year":"2015","journal-title":"Int J Cardiol"},{"key":"2021111719383873200_ytab418-B16","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/j.cjca.2013.02.004","article-title":"Corticosteroid therapy for cardiac sarcoidosis: a systematic review","volume":"29","author":"Sadek","year":"2013","journal-title":"Can J Cardiol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytab418\/40775877\/ytab418.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/11\/ytab418\/41135073\/ytab418.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/11\/ytab418\/41135073\/ytab418.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T19:39:02Z","timestamp":1637177942000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab418\/6404588"}},"subtitle":[],"editor":[{"given":"Chrisopher","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ugur","family":"Canpolat","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Reshma","family":"Amin","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Elhosseyn","family":"Guella","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,10,20]]},"references-count":16,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab418","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2021,11,1]]},"published":{"date-parts":[[2021,10,20]]},"article-number":"ytab418"}}