{
  "abstract": "Leadless pacemakers (LPMs) are increasingly used especially in elderly patients; however, the safety of subsequent intracardiac procedures remains uncertain. We report a case of a 76-year-old man on maintenance hemodialysis with suspected cardiac amyloidosis who had previously undergone LPM implantation. Despite grade 3 uptake on technetium-99 m pyrophosphate scintigraphy, the presence of monoclonal protein and negative extracardiac biopsies necessitated endomyocardial biopsy (EMB) for definitive diagnosis. Preprocedural cardiac computed tomography demonstrated precise localization of the LPM near the right ventricular outflow tract. Based on these findings, EMB was safely performed via a femoral vein approach without device-related complications. Histopathology and gene test confirmed wild-type transthyretin amyloid cardiomyopathy. This case highlights the importance of individualized, imaging-guided procedural planning to safely perform EMB after LPM implantation.\n\nLearning objective: Endomyocardial biopsy remains essential for definitive diagnosis and amyloid typing in patients with suspected transthyretin amyloid cardiomyopathy who have concomitant monoclonal protein, even when bone scintigraphy is strongly positive. In patients with a previously implanted leadless pacemaker, preprocedural imaging to evaluate the spatial relationship between the device and the intended biopsy site is critical for procedural safety.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan",
    "Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan",
    "Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Naoto Kuyama"
    },
    {
      "affs": [
        0
      ],
      "name": "Yasuhiro Izumiya"
    },
    {
      "affs": [
        0
      ],
      "name": "Akihisa Tabira"
    },
    {
      "affs": [
        0
      ],
      "name": "Yosuke Matsumoto"
    },
    {
      "affs": [
        0
      ],
      "name": "Kyoko Hirakawa"
    },
    {
      "affs": [
        0
      ],
      "name": "Naoki Nakayama"
    },
    {
      "affs": [
        0
      ],
      "name": "Shinsuke Hanatani"
    },
    {
      "affs": [
        0
      ],
      "name": "Hiroki Usuku"
    },
    {
      "affs": [
        1
      ],
      "name": "Masafumi Kidoh"
    },
    {
      "affs": [
        1
      ],
      "name": "Seitaro Oda"
    },
    {
      "affs": [
        0
      ],
      "name": "Yasushi Matsuzawa"
    },
    {
      "affs": [
        0
      ],
      "name": "Eiichiro Yamamoto"
    },
    {
      "affs": [
        2
      ],
      "name": "Mitsuharu Ueda"
    },
    {
      "affs": [
        0
      ],
      "name": "Kenichi Tsujita"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cczz7ce2zfxcj.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jccase.2026.07.004",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13732531/",
  "id": "cczz7ce2zfxcj",
  "issns": [
    "1878-5409"
  ],
  "landing_url": "https://doi.org/10.1016/j.jccase.2026.07.004",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2724|Amyloidosis: Diagnosis, Treatment, Outcomes"
    ]
  ],
  "openalex": "W7172325440",
  "pdf_url": null,
  "pmcid": "PMC13732531",
  "pmid": "42985527",
  "published": "2026-08-04",
  "publisher": "Japanese College of Cardiology",
  "ris": "https://research.draconitic.com/paper/cczz7ce2zfxcj.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:22:30Z",
      "native_id": "PMC13732531",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jccase.2026.07.004"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2705|Cardiac tumors and thrombi",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Endomyocardial biopsy after leadless pacemaker implantation in patient with suspected cardiac amyloidosis",
  "title_text": "Endomyocardial biopsy after leadless pacemaker implantation in patient with suspected cardiac amyloidosis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:22:30Z",
  "url": "https://research.draconitic.com/paper/cczz7ce2zfxcj",
  "venue": "Journal of Cardiology Cases",
  "versions": []
}