Table 4

Findings in Reports of Endomyocardial Biopsy in Patients With Primary (Idiopathic) Arrhythmias and Conduction Abnormalities

AuthorDate of PublicationAbnormalityPatients, nFindings
Strain et al (157)1983Ventricular tachycardia or ventricular fibrillation1816 of 18 patients (89%) with abnormal findings Nonspecific myocellular hypertrophy, interstitial and perivascular fibrosis, and vascular sclerosis in 9 of 18 patients, subacute inflammatory myocarditis in 3 of 18 patients, diffuse abnormalities of the intramyocardial arteries in 2 of 18 patients, and changes consistent with ARVD/C in 2 of 18 patients
Vignola et al (141)1984Malignant ventricular arrhythmias12“Clinically unsuspected myocarditis” in 6 of 12 cases and “early cardiomyopathy” in 3 of 12 cases
Sugrue et al (140)1984Ventricular arrhythmias1211 of 12 patients with histological abnormalities 1 of 12 patients with acute lymphocytic myocarditis
Morgera et al (158)1985Ventricular tachycardia101 of 6 patients without echocardiographic evidence of ARVD/C or right ventricular cardiomyopathy had evidence of myocarditis
Hosenpud et al (138)1986Life-threatening arrhythmias12Various forms of myocarditis in 4 of 12 patients, vasculitis in 1 of 12 patients, and “cardiomyopathic changes” in 6 of 12 patients
Dunnigan et al (159)1987Ventricular tachycardia11Various nonspecific abnormalities in all 11 of 11 patients
Kobayashi et al (145)1988Various supraventricular tachycardias50Myocarditis changes in 6 of 50 patients, postmyocarditic changes in 15 of 50 patients, and nonspecific abnormalities in 9 of 50 patients
Nishikawa et al (160)1990Various arrhythmias or AV block23 (pediatric)Myocyte hypertrophy, disarrangement of muscle bundles, and/or interstitial fibrosis with or without myocyte degeneration in 7 of 11 atrioventricular block cases, 1 of 6 premature ventricular contraction cases, and 0 of 3 sick sinus syndrome cases
Frustaci et al (147)1991Lone atrial fibrillation14“Cardiomyopathic” changes in 3 of 14 patients, active myocarditis in 3 of 14 patients, and “nonspecific necrosis and/or fibrosis” in 8 of 14 patients
Sekiguchi et al (161)1992Ventricular tachycardia or premature ventricular contractions43“Active myocarditis” in 1 patient and “postmyocarditic” changes in 9 patients
Oakes et al (139)1992Ventricular arrhythmias14Fibrosis in 6 of 14 patients and monocytes containing aminosalicylic acid–positive vacuoles in 1 of 14 patients No specific treatable diagnosis present in any biopsy
Thongtang et al (162)1993Various dysrhythmias53Myocarditis diagnosed in 18 of 53 patients
Frustaci et al (142)1994Young sudden cardiac death survivors17 (9 of whom had structurally normal hearts)Histological diagnosis of myocarditis in 6 of 9 patients with macroscopically structurally normal hearts Left ventricular biopsy revealed a diagnosis of myocarditis in 3 of 7 total study patients with normal right ventricular histology
Yonesaka et al (143)1996Children with supraventricular tachycardia11 (4 of whom had cardiomyopathy)Frequent nonspecific hypertrophy, degeneration, disarray, and endomyocardial changes Speculated that the supraventricular tachycardia causes the histological changes rather than vice versa
Teragaki et al (144)1999AV block10Myocardial fibrosis with hypertrophy and/or disarray in 7 of 10 patients
Uemura et al (146)2001Second- or third-degree AV block50Frequent myocyte hypertrophy, lymphocytic infiltration, myocyte disarrangement, myocytolysis, and nuclear deformity Myocarditis diagnosed in 6% of patients
Uemura et al (148)2004Sick sinus syndrome25Frequent myocyte hypertrophy, myocyte size variation, myocyte disorganization, myocytolysis, and interstitial large mononuclear cell proliferation