Sarcoidosis may affect the heart in ≤25% of patients with known involvement of other organs.¹ Because of the patchy and unpredictable nature of the infiltrate location, traditional endomyocardial biopsy of the right ventricular septum lacks sensitivity, and imaging and electroanatomic mapping (EAM) guidance can increase sensitivity.^2,3 Involved areas may be difficult to reach with standard bioptome. We present a case using robotic assistance to overcome such limitation.

A 44-year-old healthy white female presented with syncope and dyspnea on exertion. Her electrocardiogram showed complete atrioventricular block with ventricular escape rhythm. Echocardiogram was normal, but cardiac magnetic resonance showed hypokinesis and hyperenhancement post-gadolinium in the basal anterior septum, right ventricle free wall, and mid anterolateral left ventricular (LV) wall suspicious for infiltrative cardiomyopathy. An electrophysiological study was performed showing inducible monomorphic ventricular tachycardia (VT) leading to a defibrillator placement. Standard biopsy, angiogram, and contrast chest computed tomography were noncontributory. She represented within 2 weeks with multiple defibrillator shocks because of multiple VT episodes, failed amiodarone, and hence an ablation was planned. Empirical …

在已知累及其他器官的患者中，小于 25% 的结节病可能会影响心脏。¹由于浸润位置的斑片状和不可预测性，传统的右室间隔心内膜心肌活检缺乏敏感性，而影像学和电解剖标测 (EAM) 引导可以提高敏感性。^{2 , 3}使用标准活检钳可能难以触及受累区域。我们提出了一个使用机器人辅助来克服这种限制的案例。

一名 44 岁的健康白人女性出现晕厥和劳力性呼吸困难。她的心电图显示完全性房室传导阻滞伴心室逃逸节律。超声心动图正常，但心脏磁共振显示基底前间隔、右心室游离壁和左心室前外侧（LV）中壁钆后运动减退和高强化，疑似浸润性心肌病。进行了一项电生理研究，显示可诱发单形室性心动过速 (VT) 导致放置除颤器。标准活检、血管造影和对比胸部计算机断层扫描是无贡献的。由于多次 VT 发作、胺碘酮失效，她在 2 周内多次除颤器电击，因此计划进行消融。经验…