Katano Kosuke, Sato Yuriko, Mizumura Taisuke, Arai Satoru, Sugimura Yoichi
Cardiovascular Center, Kawakita General Hospital, Tokyo, JPN.
Cureus. 2025 Mar 11;17(3):e80444. doi: 10.7759/cureus.80444. eCollection 2025 Mar.
Cardiac sarcoidosis is a relatively rare disease that can lead to arrhythmia or sudden death. Herein, we report a case of isolated cardiac sarcoidosis presenting as syncope with a paroxysmal atrioventricular block in a 34-year-old man. After reviewing the results of standard cardiac testing, we administered an implantable loop recorder, which confirmed paroxysmal atrioventricular block. Based on the information gathered from the loop recorder and subsequent testing, the patient underwent pacemaker implantation. After implantation, the ventricular thresholds rapidly increased due to the spread of inflammation related to cardiac sarcoidosis. Steroid therapy was initiated and subsequently weaned per protocol. An implantable loop recorder is commonly used to investigate the cause of unknown syncope. This modality can facilitate the identification of both the cause and the underlying disease, allowing for relatively early intervention. This case highlights the usefulness of implantable loop recorders in diagnosing or confirming the causes of syncope of unknown origin suspected to be of a cardiogenic nature.
心脏结节病是一种相对罕见的疾病，可导致心律失常或猝死。在此，我们报告一例34岁男性孤立性心脏结节病，表现为晕厥伴阵发性房室传导阻滞。在回顾标准心脏检查结果后，我们植入了一个植入式循环记录仪，证实存在阵发性房室传导阻滞。根据从循环记录仪和后续检查收集到的信息，患者接受了起搏器植入。植入后，由于与心脏结节病相关的炎症扩散，心室阈值迅速升高。开始使用类固醇治疗，随后按照方案逐渐减量。植入式循环记录仪常用于调查不明原因晕厥的病因。这种方式有助于识别病因和潜在疾病，从而实现相对早期的干预。本病例突出了植入式循环记录仪在诊断或确认疑似心源性不明原因晕厥病因方面的作用。
