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A challenging case of ventricular arrhythmia in a patient with myocarditis: ICD yes/no after ablation

In patients with myocarditis, early diagnosis and appropriate therapy are mandatory, as well as close clinical and strumental follow-up with particular regard on progression of disease and ventricular arrhythmias relapse. The management of ventricular arrhythmias should follow current guidelines for ICD implantation, but new therapeutic options could be evaluated in these patients as combined epicardial/endocardial ablation and external wereable defibrillator. Particularly, left ventricular ejection fraction (LVEF) represented the only risk stratifier for sudden cardiac death currently used in myocarditis, although the use of single risk factor have limited utility. On this regard, combined analysis of structural myocardial tissue definition by cardiac magnetic resonance (CMR) and endomyocardial biopsy, in association with resting cardiac systolic function could improve predictive accuracy for sudden death in patients with myocarditis.

Credits: Maria L Narducci; Teresa Rio; Francesco Perna; Domenico D’Amario; Biagio Merlino; Riccardo Marano; Gianluigi Bencardino; Frediano Inzani; Gemma Pelargonio; Filippo Crea

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