Key result
Voltage-guided endomyocardial biopsy during EP procedures alters immunosuppressive therapy in ~83% of inflammatory cardiomyopathy patients.
Why the study?
Endomyocardial biopsy is essential for diagnosing inflammatory cardiomyopathy but limited by patchy disease distribution and procedural burden.
Is hybrid voltage-guided endomyocardial biopsy performed concurrently with clinically indicated electrophysiology procedures feasible, safe, and clinically impactful in patients with suspected inflammatory cardiomyopathy?
Observational (n=23)
No
Is hybrid voltage-guided endomyocardial biopsy performed concurrently with clinically indicated electrophysiology procedures feasible, safe, and clinically impactful in patients with suspected inflammatory cardiomyopathy?
Integrating voltage-guided endomyocardial biopsy into routine EP procedures is safe and frequently provides actionable diagnostic data to refine immunosuppression management in patients with suspected inflammatory cardiomyopathy.
Condensed Abstract: Endomyocardial biopsy (EMB) remains essential for diagnosing inflammatory cardiomyopathy but is limited by patchy disease distribution and procedural burden. We describe a hybrid strategy integrating voltage-guided EMB into clinically indicated electrophysiology procedures. In 23 patients with PET-avid myocardial inflammation, hybrid voltage-guided EMB was feasible, safe, and frequently clinically impactful, with no major procedural complications. Biopsy findings directly influenced immunosuppression management in 83% of patients, including initiation, discontinuation, or intentional withholding of therapy. Incorporating targeted EMB into routine electrophysiology workflows may reduce the need for separate biopsy procedures and refine treatment decisions in suspected inflammatory cardiomyopathy.
No takes yet. Share an insight, caveat, or question.
Chen et al. (2026) conducted an observational in Suspected inflammatory cardiomyopathy (n=23). Hybrid voltage-guided endomyocardial biopsy (V-EMB) vs. None (single-arm study) was evaluated on Direct influence of biopsy findings on immunosuppression management (initiation, discontinuation, or intentional withholding). Integrating voltage-guided endomyocardial biopsy into concurrent electrophysiology procedures was feasible, safe, and directly influenced immunosuppression management in 83% of patients with suspected inflammatory cardiomyopathy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:
More from JACC. Clinical electrophysiology