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Electrogramâguided endomyocardial biopsy yield in patients with suspected cardiac sarcoidosis and relation to outcomes
- Source :
- Journal of Cardiovascular Electrophysiology. 32:2486-2495
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Objective Endomyocardial biopsy (EMB) is a useful diagnostic tool though the yield may be limited in many myocardial diseases. Data on the diagnostic yield and prognostic significance of EMB guided by abnormal electrograms (EGM-Bx) in suspected cardiac sarcoidosis (CS) are scarce. Methods Seventy-nine patients (mean age: 56 ± 12 years; 61% men) with suspected CS based on clinical and imaging features underwent right or left ventricular EGM-Bx guided by electroanatomic mapping. Tissue samples were obtained from sites with abnormal EGMs and/or abnormal cardiac imaging. The diagnostic yield of EGM-Bx was evaluated in reference to histopathologic analysis. Left ventricular assist device (LVAD) and transplantation-free survival were compared between patients with positive and negative EGM-Bx for CS. Results A total of 254 samples were obtained from abnormal EGM sites, and 126 samples from normal EGM sites guided by pre-procedure imaging findings. Abnormal histopathology was noted in 65 (26%) and 10 (8%) samples from abnormal and normal EGM sites, respectively. Histopathology confirmed CS in 16 (20%) patients, while an alternative tissue diagnosis emerged in 10 (13%) patients. Abnormal EGMs at the biopsy site had sensitivity 89% and specificity 33% for a histopathologic diagnosis of CS. LVAD and transplantation-free survival were not significantly associated with the EGM-Bx result (log-rank p = .91). Conclusion In patients with suspected CS, abnormal EGM-Bx has high sensitivity and low specificity for establishing a definite CS diagnosis. Consideration of substrate abnormalities apparent on preprocedural imaging as an adjunct for selection of biopsy sites may further improve EGM-Bx yield.
- Subjects :
- Adult
Male
Cardiac Catheterization
medicine.medical_specialty
Sarcoidosis
Biopsy
medicine.medical_treatment
Cardiomyopathy
Cardiac sarcoidosis
Endomyocardial biopsy
Biopsy Site
Physiology (medical)
medicine
Humans
Cardiac imaging
Aged
medicine.diagnostic_test
business.industry
Middle Aged
medicine.disease
Myocarditis
Ventricular assist device
Female
Histopathology
Radiology
Cardiomyopathies
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15408167 and 10453873
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiovascular Electrophysiology
- Accession number :
- edsair.doi.dedup.....c05a1dc8ca6afe6cf504783febe804f4