Cardiac Sarcoidosis Presenting With Complete Atrioventricular Block and Sustained Monomorphic Ventricular Tachycardia

Sarcoidosis is a rare but potentially fatal multisystem granulomatous disease of unknown etiology. While a number of clinical manifestations may develop, cardiac involvement (prior to or coincident with sarcoidosis of other organs) is an important prognostic factor. Recently, we encountered a patient with cardiac sarcoidosis who presented with complete atrioventricular (AV) block and sustained ventricular tachycardia. An implantable cardioverter-defibrillator was inserted as a precautionary measure for ventricular tachycardia and symptomatic complete AV block. (18)F-fluoro-2-deoxyglucose positron emission tomography confirmed a dramatic response to high-dose steroid at four weeks, as demonstrated by a marked decrease in cardiac sarcoid activity from baseline status.