Background: Patients with an indication for a cardiovascular implantable electronic device (CIED) are complicated with special cardiomyopathy or other unspecified cardiac abnormalities and may need endomyocardial biopsy (EMB). However, EMB by a bioptome is usually avoided to reduce the risk of lead displacement in the CIED periprocedural period.
Objective: We aimed to assess the safety and feasibility of a novel approach for transvenous right ventricular (RV) EMB using the lead sheath method (L-S-M) during CIED implantation and compared it with the traditional bioptome method (T-B-M).
Methods: A consecutive 80 patients referred for EMB were enrolled. In the L-S-M group, a sheath with a lumenless pacing lead was positioned toward the middle to apical interventricular septum under fluoroscopy (n = 60). The CIED implantation was performed through the same venous access site. In the T-B-M group, a bioptome was used (n = 20). The clinical characteristics, procedural details, success rate, and complications were evaluated.
Results: There were 380 RV EMB procedures performed with comparable numbers of samples per patient, 4.1 ± 0.8 in the L-S-M group and 3.8 ± 0.8 in the T-B-M group. In the L-S-M group, 7 (11.7%) patients experienced minor complications with 3 transient right bundle branch blocks, 2 transient atrioventricular blocks, and 2 regional minor device pocket hematomas. In the T-B-M group, 3 (15%) experienced 1 temporary pacing for transient atrioventricular block, 1 chest discomfort, and 1 regional hematoma. No cardiac tamponade was detected.
Conclusion: RV EMB by the innovative L-S-M is technically feasible and safe. It can yield valuable and early diagnostic insights for patients who are candidates for CIEDs.
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http://dx.doi.org/10.1016/j.hrthm.2024.11.018 | DOI Listing |
Brain Commun
November 2024
Division of Neurology, University of British Columbia, Vancouver, Canada V6T 2B5.
Nature
November 2024
Texas Children's Cancer Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Heart Rhythm
November 2024
Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China; Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, People's Republic of China. Electronic address:
Target Oncol
November 2024
Department of Urology, The Jikei University School of Medicine, 3-19-18 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
Nat Commun
November 2024
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, USA.
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