High Prevalence of Myocarditis Mimicking Arrhythmogenic Right Ventricular Cardiomyopathy Differential Diagnosis by Electroanatomic Mapping-Guided Endomyocardial Biopsy
作者： Maurizio Pieroni , Antonio Dello Russo , Francesca Marzo , Gemma Pelargonio , Michela Casella
DOI: 10.1016/J.JACC.2008.11.017
关键词:
摘要: Objectives We evaluated the diagnostic contribution and therapeutic prognostic implications of 3-dimensional electroanatomic mapping (EAM)-guided endomyocardial biopsy (EMB) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Background ARVC is a frequent cause life-threatening arrhythmias sudden death young people. The value current criteria role imaging techniques EMB are still debated. Methods studied 30 consecutive (17 male, mean age 43 ± 17 years) noninvasive diagnosis according to criteria. All underwent EAM-guided EMB. Results Twenty-nine (97%) presented an abnormal voltage map. Histology immunohistochemistry confirmed 15 patients, showed active myocarditis Dallas remaining patients. Patients were not distinguishable on basis clinical features, presence, severity structural functional abnormalities EAM findings. On histological cardioverter-defibrillator was implanted 13 biopsy-proven 1 patient only myocarditis. At follow-up 21 8 months, 7 (47%) experienced recurrence symptomatic sustained appropriate defibrillator intervention all cases. remained asymptomatic free from arrhythmic events. Conclusions Right frequently mimics ARVC. Three-dimensional safe effective tool differential selection most strategy.
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