We report two cases of systemic sarcoidosis with atrial flutter as the clinical manifestation.In one patient, who had symptoms of shorter duration, the arrhythmia was no longer inducible after a course of glucocorticoid therapy.Electroanatomical mapping in the other case revealed patchy fibrosis of the left atrial myocardium and Accessories multiple macro-reentrant circuits.Sinus rhythm Dining could be restored with ablation of these reentrant circuits.To our knowledge, this is the first report on the demonstration of atrial scarring in a patient with sarcoidosis using 3-D electroanatomical mapping.
These two cases illustrate that the inflammation of atrial myocardium is the primary mechanism of atrial arrhythmias in patients with cardiac sarcoidosis.