Cor Vasa 2015, 57(5):e347-e353 | DOI: 10.1016/j.crvasa.2015.05.006

Electrical storm due to myocarditis in post-infarct patient: When two diseases meet

Elena M. Gupalo^a,*, Marina V. Kostyukevich^a, Natalia A. Mironova^a, Nikolay B. Shlevkov^a, Vyacheslav G. Kiktev^a, Sergey A. Bakalov^a, Tatiana V. Sharf^a, Evgeniy E. Efremov^a, Petr V. Chumachenko^a, Elena D. Kotina^c, Evgeniy N. Ostroumov^b, Dmitriy V. Shumakov^b, Sergey P. Golitsyn^a

^a Russian Cardiology Research Complex, Moscow, Russia

^b Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russia

^c Saint-Petersburg State University, Saint-Petersburg, Russia

This case presents an episode of electrical storm (ES) in post-myocardial infarction patient results from myocarditis. ES was interrupted by aneurysmectomy and additional isolation of VT origins by radiofrequency catheter ablation. The histological evaluation of aneurysm material proved acute myocarditis. The key findings indicating acute inflammation in myocardium was an increased level of peripheral inflammatory biomarker IL6 and autoantibodies to beta1-adrenergic receptor (β1-AAbs). Gated SPECT with phase images analysis turned out to be appropriate imaging strategy in visualizing potentially reversible causes of ventricular arrhythmias such as myocarditis. Taking together our findings might add some information on the pathogenesis and predisposing factors of ventricular arrhythmias especially in the cases of electrical storm.

Keywords: Aneurysm; Autoantibodies to beta1-adrenergic receptor; Electrical storm; Myocarditis; Ventricular tachycardia; Radiofrequency catheter ablation

Received: February 1, 2015; Revised: May 7, 2015; Accepted: May 8, 2015; Published: October 1, 2015  Show citation