{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T23:51:59Z","timestamp":1784850719728,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Integration of endomyocardial biopsy (EMB) in the diagnostic workup of cardiac sarcoidosis (CS) is under\u2010recognized in current clinical practice, since capturing focal granulomas is challenging. Our aim was to describe our experience with electro\u2010anatomic mapping (EAM)\u2010guided EMB and provide a comprehensive review of the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Five patients (age 49.4\u00a0\u00b1\u00a011.4) with suspected CS underwent EAM\u2010guided EMB in Isala Heart Center (Zwolle, the Netherlands) between 2017 and 2019. In all patients, a 3D bipolar voltage map (&lt;0.5\u20101.5\u00a0mV) and unipolar voltage map (LV\u00a0&lt;\u00a08.3\u00a0mV, RV\u00a0&lt;\u00a05.5\u00a0mV) was created using a high\u2010density mapping catheter. The bioptome was connected to the mapping system to guide targeted EMB. Biopsy samples (2\u20109 samples) were taken from both LV and RV sites, guided by EAM and areas with abnormal electrograms, without complications. CS diagnosis was based on EMB in 2\/5 patients. A granuloma was captured in one patient at the LV basal septum with normal bipolar and abnormal unipolar voltage. All patients with delayed enhancement on cardiac magnetic resonance, revealed fibrosis in the biopsy sample. In one patient with suspected isolated cardiac sarcoidosis, diagnosis could not be confirmed by histopathology analysis, while unipolar voltage mapping was abnormal and diastolic potentials were present. Literature search revealed 7 reports (18 patients) describing EAM\u2010guided EMB in CS patients, with 100% of the EMB taken form the RV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Unipolar voltage mapping may be superior to target active inflamed tissue and should be evaluated in future research regarding EAM\u2010guided EMB in CS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13497","type":"journal-article","created":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T05:26:14Z","timestamp":1611379574000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Value of 3D mapping\u2010guided endomyocardial biopsy in cardiac sarcoidosis"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1112-5928","authenticated-orcid":false,"given":"Danielle M.","family":"Haanschoten","sequence":"first","affiliation":[{"name":"Department of Cardiology Isala Hospital Zwolle 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