Electroanatomic mapping can be used to characterize right ventricular substrate and activation abnormalities in cardiac sarcoidosis presenting with a giant epsilon wave.
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May clarify unusual ECG patterns in cardiac sarcoidosis; single case leaves open generalizability and practice change.
A 47-year-old man presented with sustained monomorphic ventricular tachycardia of right ventricular origin. Surface ECG recorded during sinus rhythm showed a bizarre "double QRS" pattern. Biventricular cardiomyopathy was found with predominant right ventricular involvement, due to cardiac sarcoidosis. Electroanatomic mapping was used to characterize the right ventricular substrate abnormalities and to decipher the specific activation abnormalities responsible for the ECG findings.
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Santucci et al. (2004) studied this question.
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