Re-entry circuit in ventricular tachycardia due to focal fatty-fibrosis in a patient with myotonic dystrophy |
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| Authors: | Muraoka Hideyuki Negoro Nobuyuki Terasaki Fumio Nakakoji Takahiro Kojima Shigeyuki Hoshiga Masaaki Sugino Masakazu Hosokawa Takafumi Ishihara Tadashi Hanafusa Toshiaki |
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| Affiliation: | First Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki 569-0801. |
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| Abstract: | A 69-year-old man with a recurrent ventricular tachycardia (VT) was admitted. The patient was diagnosed as myotonic dystrophy type 1 (DM1) and DNA analysis revealed 1,800 CTG-repeat expansion in the myotonic dystrophy protein kinase (DMPK) gene. Ultrasonic cardiogram (UCG), left ventriculogram (LVG) and magnetic resonance imaging (MRI) did not show any abnormal sign including fatty infiltration. But, endomyocardial biopsy obtained from ventricular outflow tract revealed severe fatty infiltration and interstitial fibrosis. Radiofrequency catheter ablation at the biopsy site could eliminate VT, so it was strongly suggested that the re-entry circuit was formed by focal fatty-fibrosis. Careful observation should be continued for a long period. |
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