TY - JOUR
T1 - Endomyocardial biopsy-integrating electrode at the bioptome tip
AU - Konecny, Tomas
AU - Noseworthy, Peter A.
AU - Kapa, Suraj
AU - Cooper, Leslie T.
AU - Mulpuru, Siva K.
AU - Sandhu, Gurpreet S.
AU - Asirvatham, Samuel
N1 - Funding Information:
This study was supported in part by the Mayo Clinic Foundation and the European Regional Development Fund – Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123).
PY - 2015/6
Y1 - 2015/6
N2 - Background: The addition of electroanatomic mapping to a standard echo-guided endomyocardial biopsy could identify areas of abnormal pathology and increase the diagnostic yield of the procedure. Methods and results: In this demonstration of a novel technique, a 45-year-old woman with clinical suspicion for cardiac sarcoidosis underwent right ventricular bipolar electroanatomical mapping with identification of areas of signal fractionation and low voltage. A bioptome, configured to record an electrogram from the tip, was then visualized on the three-dimensional electroanatomic mapping (3DEAM) system, and directed to these areas. The biopsy was assisted by the use of a steerable introducer sheath, and by recording unipolar and extended bipolar signals from the bioptome tip. A prominent change in the signal was detected by the electrode at the bioptome tip when the jaws closed on the endomyocardial tissue. Patient tolerated the procedure without complications, and the biopsied samples were appropriate for pathological analysis. Using existing technology, the 3DEAM, which integrates unipolar and bipolar signal from the bioptome tip, is feasible, and can be safely added to a standard echocardiographically guided endomyocardial biopsy. Future studies should investigate whether such a technique could increase the safety and diagnostic yield of endomyocardial biopsies in patients with suspected cardiomyopathies.
AB - Background: The addition of electroanatomic mapping to a standard echo-guided endomyocardial biopsy could identify areas of abnormal pathology and increase the diagnostic yield of the procedure. Methods and results: In this demonstration of a novel technique, a 45-year-old woman with clinical suspicion for cardiac sarcoidosis underwent right ventricular bipolar electroanatomical mapping with identification of areas of signal fractionation and low voltage. A bioptome, configured to record an electrogram from the tip, was then visualized on the three-dimensional electroanatomic mapping (3DEAM) system, and directed to these areas. The biopsy was assisted by the use of a steerable introducer sheath, and by recording unipolar and extended bipolar signals from the bioptome tip. A prominent change in the signal was detected by the electrode at the bioptome tip when the jaws closed on the endomyocardial tissue. Patient tolerated the procedure without complications, and the biopsied samples were appropriate for pathological analysis. Using existing technology, the 3DEAM, which integrates unipolar and bipolar signal from the bioptome tip, is feasible, and can be safely added to a standard echocardiographically guided endomyocardial biopsy. Future studies should investigate whether such a technique could increase the safety and diagnostic yield of endomyocardial biopsies in patients with suspected cardiomyopathies.
KW - electroanatomic mapping
KW - endomyocardial biopsy
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U2 - 10.1177/1753944715574660
DO - 10.1177/1753944715574660
M3 - Article
C2 - 25731185
AN - SCOPUS:84930319943
SN - 1753-9447
VL - 9
SP - 66
EP - 69
JO - Therapeutic Advances in Cardiovascular Disease
JF - Therapeutic Advances in Cardiovascular Disease
IS - 3
ER -