Diagnosis of arrhythmogenic right ventricular cardiomyopathy: the role of endomyocardial biopsy guided by electroanatomic voltage map: reply

We really appreciate Drs Avella, d'Amati, and Tondo for their interest in our case report. 1 We obviously share a common interest in the research of endomyocardial biopsy (EMB) guided by electroanatomical voltage mapping and applaud their successful approach and results. 2 , 3 We had independently performed a similar EMB approach on 6 August 2007, before their case report was published. 2 I would, however, like to point out a difference in our research that was published in 2009. In our present case, we performed EMB not only for making a correct diagnosis of arrhythmogenic right ventricular cardiomyopathy, but also applied this approach for therapeutic radiofrequency catheter ablation for ventricular tachycardia. We discussed this approach at a local Japanese congress in January 2008 and we are in agreement with Dr Avella et al. that a prospective clinical study is necessary to verify the diagnostic accuracy of this method. We are thankful for the feedback and hope that both of our research generates interest to further the clinical benefits of this approach.