Table 1.

Indication to endomyocardial biopsy based on a recent international expert consensus document on myocarditis

Expert consensus document on management of AM and Infl-CMP Ammirati et al. [4••]	ESC/HFSA/JHFS position statement on EMB—indications for myocarditis Seferovic et al. [15••]
*Acute myocarditis presenting with cardiogenic shock (i.e., fulminant myocarditis)/acute HF, ventricular arrhythmias, or high-degree atrioventricular block, especially in case of non/mildly dilated left ventricle and recent onset of symptoms (< 1 month)	*Suspected fulminant myocarditis or acute myocarditis with acute HF, left ventricular dysfunction, and/or rhythm disorders
	* High-degree atrioventricular block, syncope, and/or unexplained ventricular arrhythmias refractory to treatment, without obvious cardiac disease or with minimal structural abnormalities
*Myocarditis in the setting of immune checkpoint inhibitors therapy where the appropriate diagnosis has implications for the patient receiving additional cancer therapy and accuracy of cardiac magnetic resonance imaging for diagnosis is not known	*Suspected immune checkpoint inhibitors-mediated cardiotoxicity: acute HF with/without haemodynamic instability early after drug initiation (∼ first 4 cycles)
*Acute myocarditis or hypokinetic dilated or non-dilated cardiomyopathy suspected for chronic inflammatory cardiomyopathy with persistent/relapsing release of myocardial necrosis markers, especially if associated with suspected/known autoimmune disorders or ventricular arrhythmias or II/III-degree atrioventricular block for therapeutic implications	*Autoimmune disorders with progressive HF unresponsive to treatment with/without sustained ventricular arrhythmias and/or conduction abnormalities
*Acute myocarditis or chronic inflammatory cardiomyopathy associated with peripheral eosinophilia	*Dilated cardiomyopathy with recent-onset HF, moderate-to-severe left ventricular dysfunction, refractory to standard treatment