Key result
Endomyocardial biopsy guided by three-dimensional electroanatomical mapping systems and intracardiac echo significantly improves diagnostic yield and reduces complications.
Why the study?
Does the combined use of three-dimensional electroanatomical mapping systems and intracardiac echo improve diagnostic yield and reduce complications compared to classical fluoroscopy-guided endomyocardial biopsy?
Does the combined use of three-dimensional electroanatomical mapping systems and intracardiac echo improve diagnostic yield and reduce complications compared to classical fluoroscopy-guided endomyocardial biopsy?
The integration of 3D electroanatomical mapping and intracardiac echo for endomyocardial biopsy improves diagnostic yield and safety compared to traditional fluoroscopy.
Answers are grounded in this paper and cite their sources.
May support 3D EAM/ICE-guided EMB in experienced centers; hypothesis-generating pending prospective RCTs.
INTRODUCTION: During the past years, endomyocardial biopsy (EMB) has gradually spread into clinical practice. However, the role of EMB in the diagnosis and treatment of cardiovascular diseases remains a controversial issue, especially in the setting of unexplained ventricular arrhythmias. Areas covered: This review describes the methodology of EMB guided by combined use of three-dimensional electroanatomical mapping systems and intracardiac echo and summarizes the classical, fluoroscopy-guided EMB technique. Finally, the personal experience acquired with the 'electrophysiologist-made' integration methodology has been reported. Expert commentary: Since EMB has been considered in the setting of arrhythmogenic cardiomyopathy, myocarditis, cardiac sarcoidosis, drug toxicity, and/or other diseases causing malignant ventricular arrhythmias, the electrophysiologists have started to perform firsthand biopsy. The electrophysiologists introduced the use of electroanatomical mapping systems and intracardiac echo. This new methodology improved significantly biopsy diagnostic yield and allowed to reduce complications.
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Casella et al. (2017) conducted a review in Unexplained ventricular arrhythmias. Electroanatomical mapping systems and intracardiac echo guided endomyocardial biopsy vs. Fluoroscopy-guided endomyocardial biopsy was evaluated. Endomyocardial biopsy guided by three-dimensional electroanatomical mapping systems and intracardiac echo significantly improves diagnostic yield and reduces complications.
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