endomyocardial biopsy

Indications

• unexplained, new-onset heart failure (class B)
  • of <2 weeks' duration associated hemodynamic compromise, regardless of ventricular size
  • 2 weeks' to 3 months' duration associated with:
    • dilated left ventricle &
      • new ventricular arrhythmias, Mobitz type II 2nd-degree AV block or 3rd-degree AV block, or
      • failure to respond to usual care within 1 to 2 weeks
• unexplained heart failure with other characteristics (class C)
• unexplained cardiomyopathy (class C)
  • myocarditis
• unexplained ventricular arrhythmias (class C)
• unexplained atrial fibrillation (class C)
• suspected cardiac tumor (class C) excepting typical myxomas
• suspected hemochromatosis, cardiac sarcoidosis, amyloidosis

Contraindications

• prior to cardiac magnetic resonance imaging* if cardiac sarcoidosis suspected

* 18F-fluorodeoxyglucose (FDG) PET scan if CMRi is negative prior to biopsy

More general terms

• myocardial biopsy