Arrhythmias in Viral Myocarditis and Pericarditis

Cardiac Electrophysiology Clinics

Volumn 7, Issue 2, 2015, Pages 269-281

  Baksi, A John ^a   Kanaganayagam, G Sunthar ^a   Prasad, Sanjay K ^a  

^a ROYAL BROMPTON HOSPITAL   (United Kingdom)

Author keywords

Acute pericarditis; CMR; Ventricular arrhythmia; Viral myocarditis

Indexed keywords

COLCHICINE; IMMUNOGLOBULIN; INTERFERON; NONSTEROID ANTIINFLAMMATORY AGENT;

CARDIOVASCULAR MAGNETIC RESONANCE; COMPUTER ASSISTED TOMOGRAPHY; CONSTRICTIVE PERICARDITIS; DIAGNOSTIC VALUE; ECHOCARDIOGRAPHY; ELECTROCARDIOGRAM; FOLLOW UP; HEART ARRHYTHMIA; HUMAN; IMMUNOPATHOGENESIS; MYOPERICARDITIS; NONHUMAN; PERICARDITIS; PERIMYOCARDITIS; PRIORITY JOURNAL; PROGNOSIS; REVIEW; ST SEGMENT ELEVATION; THORAX PAIN; VIRUS MYOCARDITIS; MYOCARDITIS; PATHOPHYSIOLOGY; VIROLOGY; VIRUS INFECTION;

ARRHYTHMIAS, CARDIAC; HUMANS; MYOCARDITIS; PERICARDITIS; VIRUS DISEASES;

EID: 84930273645     PISSN: 18779182     EISSN: 18779190     Source Type: Journal    
DOI: 10.1016/j.ccep.2015.03.009     Document Type: Review

References (82)

1. Sagar S., Liu P.P., Cooper L.T. Myocarditis. Lancet 2012, 379:738-747.
2. Fabre A., Sheppard M.N. Sudden adult death syndrome and other non-ischaemic causes of sudden cardiac death. Heart 2006, 92(3):316-320.
3. Doolan A., Semsarian C., Langlois N. Causes of sudden cardiac death in young Australians. Med J Aust 2004, 180(3):110-112.
4. Grün S., Schumm J., Greulich S., et al. Long-term follow-up of biopsy-proven viral myocarditis: predictors of mortality and incomplete recovery. JAm Coll Cardiol 2012, 59:1604-1615.
5. Shauer A., Gotsman I., Keren A., et al. Acute viral myocarditis: current concepts in diagnosis and treatment. Isr Med Assoc J 2013, 15:180-185.
6. Bowles N.E., Ni J., Kearney D.L., et al. Detection of viruses in myocardial tissues by polymerase chain reaction. Evidence of adenovirus as a common cause of myocarditis in children and adults. JAm Coll Cardiol 2003, 42:466-472.
7. Bock C.T., Klingel K., Kandolf R. Human parvovirus B19-associated myocarditis. NEngl J Med 2010, 362:1248-1249.
8. Phillips M.P., Robinowitz M., Higgins J.R., et al. Sudden cardiac death in Air Force recruits. JAMA 1986, 256:2696-2699.
9. Mason J.W., Trehan S., Renlund D.G. Myocarditis. Cardiovascular medicine 2007, 1314-1347. Springer, London. 3rd edition. J.T. Willerson, J.N. Cohn, H.J. Wellens (Eds.).
10. Li H.S., Ligons D.L., Rose N.R. Genetic complexity of autoimmune myocarditis. Autoimmun Rev 2008, 7(3):168-173.
11. Kawai C. From myocarditis to cardiomyopathy: mechanisms of inflammation and cell death. Learning from the past for the future. Circulation 1999, 99:1091-1100.
12. D'Ambrosio A., Patti G., Manzoli A., et al. The fate of acute myocarditis between spontaneous improvement and evolution to dilated cardiomyopathy: a review. Heart 2001, 85:499-504.
13. Kuhl U., Pauschinger M., Noutsias M., et al. High prevalence of viral genomes and multiple viral infections in the myocardium of adults with "idiopathic" left ventricular dysfunction. Circulation 2005, 111:887-893.
14. Kühl U., Pauschinger M., Seeberg B., et al. Viral persistence in the myocardium is associated with progressive cardiac dysfunction. Circulation 2005, 112:1965-1970.
15. Hershberger R.E., Hedges D.J., Morales A. Dilated cardiomyopathy: the complexity of a diverse genetic architecture. Nat Rev Cardiol 2013, 10(9):531-547.
16. Roberts A.M., Ware J.S., Herman D.S., et al. Integrated allelic, transcriptional, and phenotypic dissection of the cardiac effects of titin truncations in health and disease. Sci Transl Med 2015, 7(270):270.
17. Andreoletti L., Leveque N., Boulagnon C., et al. Viral causes of human myocarditis. Arch Cardiovasc Dis 2009, 102(6-7):559-568.
18. Bezzina C.R., Pazoki R., Bardai A., et al. Genome-wide association study identifies a susceptibility locus at 21q21 for ventricular fibrillation in acute myocardial infarction. Nat Genet 2010, 42(8):688-691.
19. Punja M., Mark D.G., McCoy J.V., et al. Electrocardiographic manifestations of cardiac infectious-inflammatory disorders. Am J Emerg Med 2010, 28:364-377.
20. Smith S.C., Ladenson J.H., Mason J.W., et al. Elevations of cardiac troponin I associated with myocarditis. Experimental and clinical correlates. Circulation 1997, 95:163-168.
21. Guo J.G. Detection of cardiac troponin and high-sensitivity C reactive protein in children with viral myocarditis. Na Fang Yi ke Da Xue Xue Bao 2008, 28(6):1076-1077.
22. Pieroni M., Smaldone C., Bellocci F. Myocarditis presenting with ventricular arrhythmias: role of electroanatomical mapping-guided endomyocardial biopsy in differential diagnosis. Myocarditis 2011, 365-386. InTech, ISBN: 978-953-307-289-0. Available at:, Accessed March 04, 2015. http://www.intechopen.com/books/myocarditis/myocarditis-presenting-with-ventricular-arrhythmias-role-of-electroanatomical-mapping-guided-endomyo, 10.5772/22123. D. Cihakova (Ed.).
23. Mahrholdt H., Goedecke C., Wagner A., et al. Cardiovascular magnetic resonance assessment of human myocarditis: a comparison to histology and molecular pathology. Circulation 2004, 109:1250-1258.
24. De Cobelli F., Pieroni M., Esposito A., et al. Delayed gadolinium-enhanced cardiac magnetic resonance in patients with chronic myocarditis presenting with heart failure or recurrent arrhythmias. JAm Coll Cardiol 2006, 47:1649-1654.
25. Saito J., Niwano S., Niwano H., et al. Electrical remodeling of the ventricular myocardium in myocarditis: studies of rat experimental autoimmune myocarditis. Circ J 2002, 66:97-103.
26. Zhang A., Zhang H., Wu S. Immunomodulation by atorvastatin upregulates expression of gap junction proteins in coxsackievirus B3 (CVB3)-induced myocarditis. Inflamm Res 2010, 59(4):255-262.
27. Li Y., Ge S., Peng Y., et al. Inflammation and cardiac dysfunction during sepsis, muscular dystrophy, and myocarditis. Burns Trauma 2013, 1(3):109-121.
28. Thiene G., Basso C. Arrhythmogenic right ventricular cardiomyopathy: an update. Cardiovasc Pathol 2001, 10:109-117.
29. Pieroni M., Dello Russo A., Marzo F., et al. High prevalence of myocarditis mimicking arrhythmogenic right ventricular cardiomyopathy differential diagnosis by electroanatomic mapping-guided endomyocardial biopsy. JAm Coll Cardiol 2009, 53(8):681-689.
30. Salerno F., Girerd N., Chalabreysse L., et al. Myocarditis and cardiac channelopathies: a deadly association?. Int J Cardiol 2011, 147(3):468-470.
31. Buob A., Siaplaouras S., Janzen I., et al. Focal parvovirus B19 myocarditis in a patient with Brugada syndrome. Cardiol Rev 2003, 11(1):45-49.
32. Frustaci A., Priori S.G., Pieroni M., et al. Cardiac histological substrate in patients with clinical phenotype of Brugada syndrome. Circulation 2005, 112:3680-3687.
33. McMurray J.J., Adamopoulos S., Anker S.D., et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J 2012, 33:1787-1847.
34. Pelliccia A., Corrado D., Bjornstad H.H., et al. Recommendations for participation in competitive sport and leisure-time physical activity in individuals with cardiomyopathies, myocarditis and pericarditis. Eur J Cardiovasc Prev Rehabil 2006, 13:876-885.
35. Chau E.M., Chow W.H., Chiu C., et al. Treatment and outcome in biopsy proven fulminant myocarditis in adults. Int J Cardiol 2006, 110(3):405-406.
36. Gulati A., Jabbour A., Ismail T.F., et al. Association of fibrosis with mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy. JAMA 2013, 309:896-908.
37. Schumm J., Greulich S., Wagner A., et al. Cardiovascular magnetic resonance risk stratification in patients with clinically suspected myocarditis. J Cardiovasc Magn Reson 2014, 16:14.
38. Imazio M., Cecchi E., Demichelis B., et al. Myopericarditis versus viral or idiopathic acute pericarditis. Heart 2008, 94:498-501.
39. Imazio M., Brucato A., Maestroni S., et al. Prevalence of C-reactive protein elevation and time course of normalisation in acute pericarditis: implications for the diagnosis, therapy, and prognosis of pericarditis. Circulation 2011, 123:1092-1097.
40. Imazio M., Demichelis B., Cecchi E., et al. Cardiac troponin I in acute pericarditis. JAm Coll Cardiol 2003, 42:2144-2148.
41. Imazio M., Cooper L.T. Management of myopericarditis. Expert Rev Cardiovasc Ther 2013, 11:193-201.
42. Oakley C.M. Myocarditis, pericarditis and other pericardial diseases. Heart 2000, 84:449-454.
43. Abu Fanne R., Banai S., Chorin U., et al. Diagnostic yield of extensive infectious panel testing in acute pericarditis. Cardiology 2011, 119:134-139.
44. Fancello L., Monteil S., Popgeorgiev N., et al. Viral communities associated with human pericardial fluids in idiopathic pericarditis. PLoS One 2014, 9:e93367.
45. Cantarini L., Lopalco G., Selmi C., et al. Autoimmunity and autoinflammation as the yin and yang of idiopathic recurrent acute pericarditis. Autoimmun Rev 2015, 14:90-97.
46. Ristic A.D., Pankuweit S., Maksimovic R., et al. Pericardial cytokines in neoplastic, autoreactive and viral pericarditis. Heart Fail Rev 2013, 18:345-353.
47. Kanaganayagam G.S., Ngo A.T., Alsafi A., et al. CT coronary angiography in the investigation of chest pain-beyond coronary artery atherosclerosis: a pictorial review. Int J Cardiol 2014, 176:618-629.
48. Verhaert D., Gabriel R.S., Johnston D., et al. The role of multimodality imaging in the management of pericardial disease. Circ Cardiovasc Imaging 2010, 3:333-343.
49. Fowler N.O., Harbin A.D. Recurrent acute pericarditis: follow-up study of 31 patients. JAm Coll Cardiol 1986, 7:300-305.
50. Imazio M., Bobbio M., Cecchi E., et al. Colchicine in addition to conventional therapy for acute pericarditis: results of the Colchicine for Acute Pericarditis (COPE) trial. Circulation 2005, 112:2012-2016.
51. Soler-soler J., Sagrista-Sauleda J., Permanyer-Miralda G. Relapsing pericarditis. Heart 2004, 90:1364-1368.
52. Troughton R.W., Asher C.R., Klein A.L. Pericarditis. Lancet 2004, 363:717-727.
53. Hakim J.G., Ternouth I., Mushangi E., et al. Double blind randomised placebo controlled trial of adjunctive prednisolone in the treatment of effusive tuberculous pericarditis in HIV seropositive patients. Heart 2000, 84:183-188.
54. Durakovic Z., Misigoj Durakovic M., Skavic J., et al. Myopericarditis and sudden cardiac death due to physical exercise in male athletes. Coll Anthropol 2008, 32:399-401.
55. Imazio M., Brucato A., Ferrazzi P., et al. Colchicine for prevention of postpericardiotomy syndrome and postoperative atrial fibrillation: the COPPS-2 randomised clinical trial. JAMA 2014, 312:1016-1023.
56. Imazio M., Brucato A., Mestroni S., et al. Risk of constrictive pericarditis after acute pericarditis. Circulation 2011, 124:1270-1275.
57. Braunwald E., Zipes D.P., Libby P., et al. Pericardial diseases. Heart disease: a textbook of cardiovascular medicine 2001, 1823-1876. Saunders, Philadelphia. 6th edition. M.G. Khan (Ed.).
58. Spodick D.H. Diagnostic electrocardiographic sequences in acute pericarditis. Significance of PR segment and PR vector changes. Circulation 1973, 48:575-580.
59. Khandaker M.H., Espinosa R.E., Nishimura R.A., et al. Pericardial disease: diagnosis and management. Mayo Clin Proc 2010, 85:572-593.
60. Ginzton L.E., Laks M.M. The differential diagnosis of acute pericarditis from the normal variant: new electrocardiographic criteria. Circulation 1982, 65:1004-1009.
61. Bhardwaj R., Berzingi C., Miller C., et al. Differential diagnosis of acute pericarditis from normal variant early repolarisation and left ventricular hypertrophy with early repolarisation: an electrocardiographic study. Am J Med Sci 2013, 345:28-32.
62. James T.N. Pericarditis and the sinus node. Arch Intern Med 1962, 110:305-311.
63. Le Kieffre J., Medvedowsky J.L., Thery C. Le node sinusale normale et pathologie 1979, 162. Sandoz ed, Rueil-Malmaison (France).
64. Lee W.S., Lee K.J., Kwon J.E., et al. Acute viral myopericarditis presenting as a transient effusive constrictive pericarditis caused by coinfection with coxsackieviruses A4 and B3. Korean J Intern Med 2012, 27:216-220.
65. De A., Myridakis D., Kerrigan M., et al. Varicella myopericaeditis mimicking myocardial infarction in a 17 year old boy. Tex Heart Inst J 2011, 38:288-290.
66. Morita H., Kitaura Y., Deguchi H., et al. Coxsackie B5 myopericarditis in a young adult-clinical course and endomyocardial biopsy findings. Jpn Circ J 1983, 47:1077-1083.
67. Biton A., Herman J. Perimyocarditis. Report on an unusual case. Postgrad Med 1989, 85:77-80.
68. Ward C. Severe arrhythmias in coxsackievirus B3 myopericarditis. Arch Dis Child 1978, 53:174-176.
69. Gosselink A.T., Van den Berg M.P., Crijns H.J. Acute pericarditis presenting with sinus bradycardia. Int J Cardiol 1997, 60:307-310.
70. Dressler W. Sinus tachycardia complicating and outlasting pericarditis. Am Heart J 1966, 72:422-423.
71. Kindermann I., Kindermann M., Kandolf R., et al. Predictors of outcome in patients with suspected myocarditis. Circulation 2008, 118:639-648.
72. Roubille F., Tournoux F., Roubille C., et al. Management of pericarditis and myocarditis: could heart rate reducing drugs hold a promise?. Arch Cardiovasc Dis 2013, 106:672-679.
73. Khoueiry Z., Roubille C., Nagot N., et al. Could heart rate play a role in pericardial inflammation?. Med Hypotheses 2012, 79:512-515.
74. Spodick D.H. Frequency of arrhythmias in acute pericarditis determined by Holter monitoring. Am J Cardiol 1984, 53:842-845.
75. Leitman M., Tyomkin V., Peleg E., et al. Left ventricular function in acute inflammatory peri-myocardial diseases - new insights and long term follow up. Cardiovasc Ultrasound 2012, 10:42.
76. Imazio M., Demichelis B., Parrini I., et al. Day hospital treatment of acute pericarditis: a management program for outpatient therapy. JAm Coll Cardiol 2004, 43:1042-1046.
77. Imazio M., Brucato A., Barbieri A., et al. Good prognosis for pericarditis with and without myocardial involvement: results from a multicentre, prospective cohort study. Circulation 2013, 128:42-49.
78. Ristic A.D., Maisch B., Hufnagel G., et al. Arrhythmias in acute pericarditis. An endomyocardial biopsy study. Herz 2000, 25:729-733.
79. Tschabrun C.M., Haggani H.M., Cooper J.M., et al. Percutaneous epicardial ventricular tachycardia ablation after non-coronary cardiac surgery or pericarditis. Heart Rhythm 2013, 10:165-169.
80. Chevalier P., Scridon A. Ventricular arrhythmias complicating acute myocarditis. E-Journal of the ESC Council for Cardiology Practice 2011, 9(26). Available at, Accessed March 04, 2015. http://www.escardio.org/communities/councils/ccp/e-journal/volume9/Pages/Ventricular-arrhythmias-complicating-acute-myocarditis-Chevalier-Scridon.aspx#.VQ8lnOFvLr4.
81. Imazio M., Brucato A., Ferrazzi P., et al. Colchicine reduced postoperative atrial fibrillation: results of the Colchicine for the Prevention of the Postpericardiotomy Syndrome (COPPS) atrial fibrillation substudy. Circulation 2011, 124:2290-2295.
82. Caforio A.L., Pankuweit S., Arbustini E., et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013, 34:2636-2648.