Visual Abstract - Real-Time Magnetic Resonance Imaging Guidance Improves the Diagnostic Yield of Endomyocardial Biopsy: 10.1016/j.jacbts.2016.05.007

• The diagnostic yield of endomyocardial biopsy is low, particularly in diseases that affect the myocardium in a nonuniform distribution.

• It is feasible to perform real-time MRI-guided endomyocardial biopsy using a dedicated active-visualization bioptome.

• In an animal model of focal myocardial disease, real-time MRI guidance improved the diagnostic yield compared with x-ray fluoroscopy.