Focus-Guided Endomyocardial Byopsy in Diagnostics of Arrhythmogenic Dysplasia of the Right Ventricle in Patients Scheduled for Catheter Ablation of Ventricular Arrhythmias

Endomyocardial biopsy (EMB) is one of diagnostical tools for arrhythmogenic dysplasia of the right ventricle (ADRB). However sensitivity and specificity of EMB relay on the methodics of its performing. Aim. To compare “focus-guided” and “voluntary” EMB in diagnostics of ADRB in patients, scheduled for catheter ablation of ventricular rhythm disorders. Material and methods. To retrospective study 122 patients included, among those scheduled for catheter ablation of ventricular tachicardia and sympthomatic ventricular extrasystoly, underwent EMB (64 males, mean age 39±14 y.). Patients were selected to 2 groups: 1) 44 patients (36%) with “focus-guided” biopsy (minimum 1 fragment of endomyocardium from the area(s) of ectopy); 2) 78 patients (64%) with “voluntary” EMB (specimens taken from any area except the focus). Results. Sixteen (13,1%) patients took the definite dignosis of ADRB according to 2010 Criteria. Short-term effect of ablation reached 69,7% of patients, much less efficacy had ADRB group (43,8%). Sensitivity and specificity of EMB in the big criteria of ADRB revealing, by histology, was higher in the group with “focus-guided” EMB, comparing to the “voluntary” group (100% and 91,7% vs. 80% and 81,4%, respectively). Conclusion. To improve sensitivity and specificity of EMB in ADRB diagnostics it is aimful to take myocardium specimens from the area of researched ventricular ectopy.