Electroanatomical mapping systems and intracardiac echo integration for guided endomyocardial biopsy

Michela Casella, Antonio Dello Russo, Giulia Vettor, Giuseppe Lumia, Valentina Catto, Elena Sommariva, Valentina Ribatti, Viviana Biagioli, Fabrizio Tundo, Corrado Carbucicchio, Luigi Di Biase, Andrea Natale, Claudio Tondo

Research output: Contribution to journalReview articlepeer-review


Introduction: During the past years, endomyocardial biopsy (EMB) has gradually spread into clinical practice. However, the role of EMB in the diagnosis and treatment of cardiovascular diseases remains a controversial issue, especially in the setting of unexplained ventricular arrhythmias. Areas covered: This review describes the methodology of EMB guided by combined use of three-dimensional electroanatomical mapping systems and intracardiac echo and summarizes the classical, fluoroscopy-guided EMB technique. Finally, the personal experience acquired with the ‘electrophysiologist-made’ integration methodology has been reported. Expert commentary: Since EMB has been considered in the setting of arrhythmogenic cardiomyopathy, myocarditis, cardiac sarcoidosis, drug toxicity, and/or other diseases causing malignant ventricular arrhythmias, the electrophysiologists have started to perform firsthand biopsy. The electrophysiologists introduced the use of electroanatomical mapping systems and intracardiac echo. This new methodology improved significantly biopsy diagnostic yield and allowed to reduce complications.

Original languageEnglish
Pages (from-to)609-619
Number of pages11
JournalExpert Review of Medical Devices
Issue number8
Publication statusPublished - Aug 3 2017


  • arrhythmogenic cardiomyopathy
  • cardiomyopathies
  • electroanatomical mapping
  • Endomyocardial biopsy
  • intracardiac echocardiography
  • ventricular arrhythmias

ASJC Scopus subject areas

  • Surgery
  • Biomedical Engineering

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