Accelerated Junctional Rhythm on a Routine Electrocardiogram: An Unusual Presentation of Cardiac Sarcoidosis

Abstract

Cardiac sarcoidosis is an uncommon cause of cardiac arrhythmias and cardiomyopathy. We describe a case of cardiac sarcoidosis presenting as an accelerated junctional rhythm and complete atrioventricular (AV) block, without severe left ventricular (LV) dysfunction or pulmonary symptoms. Computer tomography (CT) of the chest and mediastinal lymph node biopsy confirmed the diagnosis. Dual-chamber implantable cardioverter-defibrillator was implanted due to reported risk of sudden cardiac death due to ventricular tachyarrhythmia despite negative programmed ventricular stimulation.