Koji Sudo, Kenji Kuroki, Kazuto Nakamura, Yosuke Watanabe, Manabu Uematsu, Chisa Asahina, Yuya Tanaka, Tsuyoshi Kobayashi, Akira Sato
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引用次数: 0
Abstract
Background: Early cardiomyopathy diagnosis allows timely treatment and may help resolve problems that occur after cardiac implantable electronic device (CIED) implantation.
Objective: This study aims to describe a novel technique for endomyocardial biopsy (EMB) using a 3-dimensional (3D) delivery sheath during CIED implantation. In addition, we investigated 3D delivery-sheath characteristics using sheath deflection during bioptome insertion.
Methods: This study of 20 patients undergoing CIED implantation analyzed the EMB success rate and pathologic findings. Fluoroscopic images assessed 3D delivery sheath characteristics before and after bioptome insertion in 3 sheaths. CIEDs were implanted for sick sinus syndrome (n =3), atrioventricular conduction disorder (n = 16), and left ventricular dysfunction (n = 1). Fluoroscopic verification was performed using right anterior oblique (RAO) and left anterior oblique (LAO) views. EMB was performed with Selectra 3D (BIOTRONIK, Berlin, Germany), CSP Locator 3D (Abbott, Chicago, IL), and SSPC (Boston Scientific, Marlborough, MA) (12, 4, and 4 patients, respectively). The distance moved toward the right ventricular apex (RVA) in RAO was defined as Dis-RAO (mm) and that moved toward the RVA in LAO was defined as Dis-LAO (mm).
Results: Among the 3 sheaths, only the CSP Locator 3D and Selectra 3D showed significant differences in Dis-RAO (13.2 ± 2.0 mm vs 19.8 ± 3.8 mm, P < .01) and Dis-LAO (8.1 ± 1.3 mm vs 15.3 ± 3.9 mm, P < .01). A total of 77 EMB samples from 20 patients were collected without any complication, and 4 patients (20%) were diagnosed with cardiac amyloidosis (CA) based on pathologic findings.
Conclusion: All 3D delivery sheaths were safe and effective for performing EMB from the RVS during CIED implantation, enabling early CA diagnosis in 20% of patients.
期刊介绍：
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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