Table 2

The Role of Endomyocardial Biopsy in 14 Clinical Scenarios

Scenario NumberClinical ScenarioClass of Recommendation (I, IIa, IIb, III)Level of Evidence (A, B, C)
1New-onset heart failure of <2 weeks'duration associated with a normal-sized or dilated left ventricle and hemodynamic compromiseIB
2New-onset heart failure of 2 weeks' to 3 months'duration associated with a dilated left ventricle and new ventricular arrhythmias, second- or third-degree heart block, or failure to respond to usual care within 1 to 2 weeksIB
3Heart failure of >3 months'duration associated with a dilated left ventricle and new ventricular arrhythmias, second- or third-degree heart block, or failure to respond to usual care within 1 to 2 weeksIIaC
4Heart failure associated with a DCM of any duration associated with suspected allergic reaction and/or eosinophiliaIIaC
5Heart failure associated with suspected anthracycline cardiomyopathyIIaC
6Heart failure associated with unexplained restrictive cardiomyopathyIIaC
7Suspected cardiac tumorsIIaC
8Unexplained cardiomyopathy in childrenIIaC
9New-onset heart failure of 2 weeks' to 3 months'duration associated with a dilated left ventricle, without new ventricular arrhythmias or second- or third-degree heart block, that responds to usual care within 1 to 2 weeksIIbB
10Heart failure of >3 months'duration associated with a dilated left ventricle, without new ventricular arrhythmias or second- or third-degree heart block, that responds to usual care within 1 to 2 weeksIIbC
11Heart failure associated with unexplained HCMIIbC
12Suspected ARVD/CIIbC
13Unexplained ventricular arrhythmiasIIbC
14Unexplained atrial fibrillationIIIC