PRACTICE GUIDELINE: EXECUTIVE SUMMARY
ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: Executive SummaryA Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons
Andrew E. Epstein, MD, FACC, FAHA, FHRS, Chair, Writing Committee Member*,
John P. DiMarco, MD, PhD, FACC, FAHA, FHRS, Writing Committee Member*,
Kenneth A. Ellenbogen, MD, FACC, FAHA, FHRS, Writing Committee Member*,
N.A. Mark Estes, III, MD, FACC, FAHA, FHRS, Writing Committee Member,
Roger A. Freedman, MD, FACC, FHRS, Writing Committee Member*,
Leonard S. Gettes, MD, FACC, FAHA, Writing Committee Member,
A. Marc Gillinov, MD, FACC, FAHA, Writing Committee Member*, ,
Gabriel Gregoratos, MD, FACC, FAHA, Writing Committee Member,
Stephen C. Hammill, MD, FACC, FHRS, Writing Committee Member,
David L. Hayes, MD, FACC, FAHA, FHRS, Writing Committee Member*,
Mark A. Hlatky, MD, FACC, FAHA, Writing Committee Member,
L. Kristin Newby, MD, FACC, FAHA, Writing Committee Member,
Richard L. Page, MD, FACC, FAHA, FHRS, Writing Committee Member,
Mark H. Schoenfeld, MD, FACC, FAHA, FHRS, Writing Committee Member,
Michael J. Silka, MD, FACC, Writing Committee Member,
Lynne Warner Stevenson, MD, FACC, FAHA, Writing Committee Member and
Michael O. Sweeney, MD, FACC, Writing Committee Member*
Key Words: ACC/AHA practice guideline • device-based therapy • implantable cardioverter-defibrillator • implantable coronary device • arrhythmia • pacemaker • pacing • cardiomyopathy
 |
ACC/AHA Task Force Members
|
|---|
Sidney C. Smith, JR, MD, FACC, FAHA, Chair
Alice K. Jacobs, MD, FACC, FAHA, Vice-Chair
Cynthia D. Adams, RN, PHD, FAHA
Jeffrey L. Anderson, MD, FACC, FAHA
Christopher E. Buller, MD, FACC
Mark A. Creager, MD, FACC, FAHA
Steven M. Ettinger, MD, FACC
David P. Faxon, MD, FACC, FAHA
Jonathan L. Halperin, MD, FACC, FAHA
Loren F. Hiratzka, MD, FACC, FAHA
Sharon A. Hunt, MD, FACC, FAHA
Harlan M. Krumholz, MD, FACC, FAHA
Frederick G. Kushner, MD, FACC, FAHA
Bruce W. Lytle, MD, FACC, FAHA
Rick A. Nishimura, MD, FACC, FAHA
Joseph P. Ornato, MD, FACC, FAHA
Richard L. Page, MD, FACC, FAHA
Barbara Riegel, DNSC, RN, FAHA
Lynn G. Tarkington, RN
Clyde W. Yancy, MD, FACC, FAHA
|
Table of Contents
|
|---|
- Preamble......2086
- 1 Introduction......2087
- 1.1 Organization of Committee......2087
- 1.2 Document Review and Approval......2087
- 1.3 Methodology and Evidence......2088
- 2 Recommendations for Permanent Pacing in Sinus Node Dysfunction......2090
- 3 Recommendations for Acquired Atrioventricular Block in Adults......2091
- 4 Recommendations for Permanent Pacing in Chronic Bifascicular Block......2093
- 5 Recommendations for Permanent Pacing After the Acute Phase of Myocardial Infarction......2093
- 6 Recommendations for Permanent Pacing in Hypersensitive Carotid Sinus Syndrome and Neurocardiogenic Syncope......2093
- 7 Recommendations for Pacing After Cardiac Transplantation......2093
- 8 Recommendations for Permanent Pacemakers That Automatically Detect and Pace to Terminate Tachycardias......2094
- 9 Recommendations for Pacing to Prevent Tachycardia......2094
- 10 Recommendation for Pacing to Prevent Atrial Fibrillation......2094
- 11 Recommendations for Cardiac Resynchronization Therapy in Patients With Severe Systolic Heart Failure......2094
- 12 Recommendations for Pacing in Patients With Hypertrophic Cardiomyopathy......2094
- 13 Recommendations for Permanent Pacing in Children, Adolescents, and Patients With Congenital Heart Disease......2095
- 14 Recommendations for Implantable Cardioverter-Defibrillators......2095
- 15 Recommendations for Implantable Cardioverter-Defibrillators in Pediatric Patients and Patients With Congenital Heart Disease......2097
- References......2097
- Appendix 1. Author Relationships With Industry......2101
- Appendix 2. Peer Reviewer Relationships With Industry......2103
- Appendix 3. Abbreviations List......2105
View this table:
[in this window]
[in a new window]
|
Appendix 1 AUTHOR RELATIONSHIPS WITH INDUSTRY—ACC/AHA/HRS GUIDELINES FOR DEVICE-BASED THERAPY OF CARDIAC RHYTHM ABNORMALITIES
|
|
View this table:
[in this window]
[in a new window]
|
Appendix 2 PEER REVIEWER RELATIONSHIPS WITH INDUSTRY—ACC/AHA/HRS GUIDELINES FOR DEVICE-BASED THERAPY OF CARDIAC RHYTHM ABNORMALITIES
|
|
|
Preamble
|
|---|
It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced and tested in the detection, management, or prevention of disease states. Rigorous and expert analysis of the available data documenting absolute and relative benefits and risks of those procedures and therapies can produce helpful guidelines that improve the effectiveness of care, optimize patient outcomes, and favorably affect the overall cost of care by focusing resources on the most effective strategies.
The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have jointly engaged in the production of such guidelines in the area of cardiovascular disease since 1980. The American College of Cardiology (ACC)/AHA Task Force on Practice Guidelines, whose charge is to develop, update, or revise practice guidelines for important cardiovascular diseases and procedures, directs this effort. Writing committees are charged with the task of performing an assessment of the evidence and acting as an independent group of authors to develop, update, or revise written recommendations for clinical practice.
Experts in the subject under consideration have been selected from both organizations to examine subject-specific data and write guidelines. The process includes additional representatives from other medical practitioner and specialty groups when appropriate. Writing committees are specifically charged to perform a formal literature review, weigh the strength of evidence for or against a particular treatment or procedure, and include estimates of expected health outcomes where data exist. Patient-specific modifiers and comorbidities and issues of patient preference that may influence the choice of particular tests or therapies are considered, as well as frequency of follow-up and cost-effectiveness. When available, information from studies on cost will be considered; however, review of data on efficacy and clinical outcomes will constitute the primary basis for preparing recommendations in these guidelines.
The ACC/AHA Task Force on Practice Guidelines makes every effort to avoid any actual, potential, or perceived conflicts of interest that may arise as a result of an industry relationship or personal interest of the writing committee. Specifically, all members of the writing committee, as well as peer reviewers of the document, were asked to provide disclosure statements of all such relationships that may be perceived as real or potential conflicts of interest. Writing committee members are also strongly encouraged to declare a previous relationship with industry that may be perceived as relevant to guideline development. If a writing committee member develops a new relationship with industry during his or her tenure, he or she is required to notify guideline staff in writing. The continued participation of the writing committee member will be reviewed. These statements are reviewed by the parent task force, reported orally to all members of the writing committee at each meeting, and updated and reviewed by the writing committee as changes occur. Please refer to the methodology manual for ACC/AHA guideline writing committees for further description of the relationships with industry policy (1). See Appendix 1 for author relationships with industry and Appendix 2 for peer reviewer relationships with industry that are pertinent to this guideline.
These practice guidelines are intended to assist health care providers in clinical decision making by describing a range of generally acceptable approaches for the diagnosis, management, and prevention of specific diseases or conditions. Clinical decision making should consider the quality and availability of expertise in the area where care is provided. These guidelines attempt to define practices that meet the needs of most patients in most circumstances. These guideline recommendations reflect a consensus of expert opinion after a thorough review of the available current scientific evidence and are intended to improve patient care.
Patient adherence to prescribed and agreed upon medical regimens and lifestyles is an important aspect of treatment. Prescribed courses of treatment in accordance with these recommendations will only be effective if they are followed. Because lack of patient understanding and adherence may adversely affect treatment outcomes, physicians and other health care providers should make every effort to engage the patient in active participation with prescribed medical regimens and lifestyles.
If these guidelines are used as the basis for regulatory or payer decisions, the ultimate goal is quality of care and serving the patient's best interests. The ultimate judgment regarding care of a particular patient must be made by the health care provider and the patient in light of all of the circumstances presented by that patient. There are circumstances in which deviations from these guidelines are appropriate.
The guidelines will be reviewed annually by the ACC/AHA Task Force on Practice Guidelines and will be considered current unless they are updated, revised, or sunsetted and withdrawn from distribution. The executive summary and recommendations are published in the May 27, 2008, issue of the Journal of the American College of Cardiology, May 27, 2008, issue of Circulation, and the June 2008 issue of Heart Rhythm. The full-text guidelines are e-published in the same issue of the journals noted above, as well as posted on the ACC (www.acc.org), AHA (http://my.americanheart.org), and Heart Rhythm Society (HRS) (www.hrsonline.org) Web sites. Copies of the full-text and the executive summary are available from each organization.
Sidney C. Smith, Jr, MD, FACC, FAHA Chair, ACC/AHA Task Force on Practice Guidelines
|
1. Introduction
|
|---|
1.1 Organization of Committee.
This revision of the "ACC/AHA/NASPE Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices" updates the previous versions published in 1984, 1991, 1998, and 2002. Revision of the statement was deemed necessary for multiple reasons: 1) Major studies have been reported that have advanced our knowledge of the natural history of bradyarrhythmias and tachyarrhythmias, which may be treated optimally with device therapy; 2) there have been tremendous changes in the management of heart failure that involve both drug and device therapy; and 3) major advances in the technology of devices to treat, delay, and even prevent morbidity and mortality from bradyarrhythmias, tachyarrhythmias, and heart failure have occurred.
The committee to revise the "ACC/AHA/NASPE Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices" was composed of physicians who are experts in the areas of device therapy and follow-up and senior clinicians skilled in cardiovascular care, internal medicine, cardiovascular surgery, ethics, and socioeconomics. The committee included representatives of the American Association for Thoracic Surgery, Heart Failure Society of America, and Society of Thoracic Surgeons.
1.2 Document Review and Approval.
The document was reviewed by 2 official reviewers nominated by each of the ACC, AHA, and HRS and by 11 additional peer reviewers. Of the total 17 peer reviewers, 10 had no significant relevant relationships with industry. In addition, this document has been reviewed and approved by the governing bodies of the ACC, AHA, and HRS, which include 19 ACC Board of Trustees members (none of whom had any significant relevant relationships with industry), 15 AHA Science Advisory Coordinating Committee members (none of whom had any significant relevant relationships with industry), and 14 HRS Board of Trustees members (6 of whom had no significant relevant relationships with industry). All guideline recommendations underwent a formal, blinded writing committee vote. Writing committee members were required to recuse themselves if they had a significant relevant relationship with industry. The guideline recommendations were unanimously approved by all members of the writing committee who were eligible to vote.
1.3 Methodology and Evidence.
The recommendations listed in this document are, whenever possible, evidence based. An extensive literature survey was conducted and limited to studies, reviews, and other evidence conducted in human subjects and published in English. Additionally, the committee reviewed documents related to the subject matter previously published by the ACC, AHA, and HRS. References selected and published in this document are representative and not all-inclusive.
The committee reviewed and ranked evidence supporting current recommendations, with the weight of evidence ranked as Level A if the data were derived from multiple randomized clinical trials that involved a large number of individuals. The committee ranked available evidence as Level B when data were derived either from a limited number of trials that involved a comparatively small number of patients or from well-designed data analyses of nonrandomized studies or observational data registries. Evidence was ranked as Level C when the consensus of experts was the primary source of the recommendation. In the narrative portions of these guidelines, evidence is generally presented in chronological order of development. Studies are identified as observational, randomized, prospective, or retrospective. The committee emphasizes that for certain conditions for which no other therapy is available, the indications for device therapy are based on expert consensus and years of clinical experience and are thus well supported, even though the evidence was ranked as Level C. An analogous example is the use of penicillin in pneumococcal pneumonia, for which there are no randomized trials and only clinical experience. When indications at Level C are supported by historical clinical data, appropriate references (e.g., case reports and clinical reviews) are cited if available. When Level C indications are based strictly on committee consensus, no references are cited. In areas where sparse data were available (e.g., pacing in children and adolescents), a survey of current practices of major centers in North America was conducted to determine whether there was a consensus regarding specific pacing indications.
The schema for classification of recommendations and level of evidence is summarized in Table 1, which also illustrates how the grading system provides an estimate of the size of the treatment effect and an estimate of the certainty of the treatment effect.
The focus of these guidelines is the appropriate use of devices (e.g., pacemakers for bradyarrhythmias and heart failure management, cardiac resynchronization, and implantable cardioverter-defibrillators [ICDs]), not the treatment of cardiac arrhythmias. The fact that the use of a device for treatment of a particular condition is listed as a Class I indication (beneficial, useful, and effective) does not preclude the use of other therapeutic modalities that may be equally effective. As with all clinical practice guidelines, the recommendations in this document focus on treatment of an average patient with a specific disorder and may be modified by patient comorbidities, limitation of life expectancy because of coexisting diseases, and other situations that only the primary treating physician may evaluate appropriately.
The term "symptomatic bradycardia" is used in this document. Symptomatic bradycardia is defined as a documented bradyarrhythmia that is directly responsible for development of the clinical manifestations of syncope or near syncope, transient dizziness or lightheadedness, or confusional states resulting from cerebral hypoperfusion attributable to slow heart rate. Fatigue, exercise intolerance, and congestive heart failure may also result from bradycardia. These symptoms may occur at rest or with exertion. Definite correlation of symptoms with a bradyarrhythmia is required to fulfill the criteria that define symptomatic bradycardia. Caution should be exercised not to confuse physiological sinus bradycardia (as occurs in highly trained athletes) with pathological bradyarrhythmias. Occasionally, symptoms may become apparent only in retrospect after antibradycardia pacing. Nevertheless, the universal application of pacing therapy to treat a specific heart rate cannot be recommended except in specific circumstances, as detailed subsequently.
In these guidelines, the terms "persistent," "transient," and "not expected to resolve" are used but not specifically defined because the time element varies in different clinical conditions. The treating physician must use appropriate clinical judgment and available data in deciding when a condition is persistent or when it can be expected to be transient.
Recommendations for ICD implantation have been updated to reflect the numerous new developments in this field and the voluminous literature related to the efficacy of these devices in the treatment and prophylaxis of sudden cardiac death (SCD) and malignant ventricular arrhythmias. Indications for ICDs, cardiac resynchronization therapy (CRT) devices, and combined ICDs and CRT devices are continuously changing and can be expected to change further as new trials are reported. Indeed, it is inevitable that the indications for device therapy will be refined with respect to both expanded use and the identification of patients expected to benefit the most from these therapies. Furthermore, it is emphasized that when a patient has an indication for both a pacemaker (whether it be single-chamber, dual-chamber, or biventricular) and an ICD, a combined device with appropriate programming is indicated.
The 2008 revision reflects what the committee believes are the most relevant and significant advances in pacemaker/ICD therapy since the publication of these guidelines in the Journal of the American College of Cardiology and Circulation in 2002 (2,3).
All recommendations assume that patients are treated with optimal medical therapy according to published guidelines, as had been required in all the randomized controlled clinical trials on which these guidelines are based. The committee believes that comorbidities, life expectancy, and quality-of-life issues must be addressed forthrightly with patients and their families. We have repeatedly used the phrase "reasonable expectation of survival with a good functional status for more than 1 year" to emphasize this integration of factors in decision making. Even when physicians believe that the anticipated benefits warrant device implantation, patients have the option to decline intervention after having been provided with a full explanation of the potential risks and benefits of device therapy. Finally, the committee is aware that other guidelines/expert groups have interpreted the same data differently (4–7).
In preparing this revision, the committee was guided by the following principles: - 1 Changes in recommendations and levels of evidence were made either because of new randomized trials or because of the accumulation of new clinical evidence and the development of clinical consensus.
- 2 The committee was cognizant of the health care, logistic, and financial implications of recent trials and factored in these considerations to arrive at the classification of certain recommendations.
- 3 For recommendations taken from other guidelines, wording changes were made to render some of the original recommendations more precise.
- 4 The committee would like to re-emphasize that the recommendations in this guideline apply to most patients but may require modification because of existing situations that only the primary treating physician can evaluate properly.
- 5 All of the listed recommendations for implantation of a device presume the absence of inciting causes that may be eliminated without detriment to the patient (e.g., nonessential drug therapy).
- 6 The committee endeavored to maintain consistency of recommendations in this and other previously published guidelines. The recommendations on atrioventricular (AV) block associated with acute myocardial infarction closely follow those in the "ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction" (8). However, because of the rapid evolution of pacemaker/ICD science, it has not always been possible to maintain consistency with other published guidelines.
The following represents the complete set of recommendations for the implantation of antiarrhythmia devices. Prior executive summaries of ACC/AHA guidelines have included variable amounts of explanatory text ranging from none to large amounts. Because the supporting text in the full-text document was important to the present writing committee, we decided to provide only the recommendations in the Executive Summary and recommend readers access the full-text document for more explanation. Table 2
and Figures 1 and 2
 are provided to help practitioners choose which pacing device is appropriate for an individual patient.
View larger version (16K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 1 Selection of Pacemaker Systems for Patients With Sinus Node Dysfunction
Decisions are illustrated by diamonds. Shaded boxes indicate type of pacemaker. AV indicates atrioventricular.
|
|
View larger version (18K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 2 Selection of Pacemaker Systems for Patients With Atrioventricular Block
Decisions are illustrated by diamonds. Shaded boxes indicate type of pacemaker. AV indicates atrioventricular.
|
|
|
2. Recommendations for Permanent Pacing in Sinus Node Dysfunction
|
|---|
Class I.
- 1 Permanent pacemaker implantation is indicated for sinus node dysfunction (SND) with documented symptomatic bradycardia, including frequent sinus pauses that produce symptoms. (Level of Evidence: C) (9–11)
- 2 Permanent pacemaker implantation is indicated for symptomatic chronotropic incompetence. (Level of Evidence: C) (9–13)
- 3 Permanent pacemaker implantation is indicated for symptomatic sinus bradycardia that results from required drug therapy for medical conditions. (Level of Evidence: C)
Class IIa.
- 1 Permanent pacemaker implantation is reasonable for SND with heart rate less than 40 bpm when a clear association between significant symptoms consistent with bradycardia and the actual presence of bradycardia has not been documented. (Level of Evidence: C) (9–11,14–16)
- 2 Permanent pacemaker implantation is reasonable for syncope of unexplained origin when clinically significant abnormalities of sinus node function are discovered or provoked in electrophysiological studies. (Level of Evidence: C) (17,18)
Class IIb.
- 1 Permanent pacemaker implantation may be considered in minimally symptomatic patients with chronic heart rate less than 40 bpm while awake. (Level of Evidence: C) (9,11,12,14–16)
Class III.
- 1 Permanent pacemaker implantation is not indicated for SND in asymptomatic patients. (Level of Evidence: C)
- 2 Permanent pacemaker implantation is not indicated for SND in patients for whom the symptoms suggestive of bradycardia have been clearly documented to occur in the absence of bradycardia. (Level of Evidence: C)
- 3 Permanent pacemaker implantation is not indicated for SND with symptomatic bradycardia due to nonessential drug therapy. (Level of Evidence: C)
|
3. Recommendations for Acquired Atrioventricular Block in Adults
|
|---|
Class I.
- 1 Permanent pacemaker implantation is indicated for third-degree and advanced second-degree AV block at any anatomic level associated with bradycardia with symptoms (including heart failure) or ventricular arrhythmias presumed to be due to AV block. (Level of Evidence: C) (15,19–21)
- 2 Permanent pacemaker implantation is indicated for third-degree and advanced second-degree AV block at any anatomic level associated with arrhythmias and other medical conditions that require drug therapy that results in symptomatic bradycardia. (Level of Evidence: C) (15,19–21)
- 3 Permanent pacemaker implantation is indicated for third-degree and advanced second-degree AV block at any anatomic level in awake, symptom-free patients in sinus rhythm, with documented periods of asystole greater than or equal to 3.0 seconds (22) or any escape rate less than 40 bpm, or with an escape rhythm that is below the AV node. (Level of Evidence: C) (9,14)
- 4 Permanent pacemaker implantation is indicated for third-degree and advanced second-degree AV block at any anatomic level in awake, symptom-free patients with atrial fibrillation and bradycardia with 1 or more pauses of at least 5 seconds or longer. (Level of Evidence: C)
- 5 Permanent pacemaker implantation is indicated for third-degree and advanced second-degree AV block at any anatomic level after catheter ablation of the AV junction. (Level of Evidence: C) (23,24)
- 6 Permanent pacemaker implantation is indicated for third-degree and advanced second-degree AV block at any anatomic level associated with postoperative AV block that is not expected to resolve after cardiac surgery. (Level of Evidence: C) (21,25–27)
- 7 Permanent pacemaker implantation is indicated for third-degree and advanced second-degree AV block at any anatomic level associated with neuromuscular diseases with AV block, such as myotonic muscular dystrophy, Kearns-Sayre syndrome, Erb dystrophy (limb-girdle muscular dystrophy), and peroneal muscular atrophy, with or without symptoms. (Level of Evidence: B) (28–34)
- 8 Permanent pacemaker implantation is indicated for second-degree AV block with associated symptomatic bradycardia regardless of type or site of block. (Level of Evidence: B) (35)
- 9 Permanent pacemaker implantation is indicated for asymptomatic persistent third-degree AV block at any anatomic site with average awake ventricular rates of 40 bpm or faster if cardiomegaly or left ventricular (LV) dysfunction is present or if the site of block is below the AV node. (Level of Evidence: B) (20,36)
- 10 Permanent pacemaker implantation is indicated for second- or third-degree AV block during exercise in the absence of myocardial ischemia. (Level of Evidence: C) (37,38)
Class IIa.
- 1 Permanent pacemaker implantation is reasonable for persistent third-degree AV block with an escape rate greater than 40 bpm in asymptomatic adult patients without cardiomegaly. (Level of Evidence: C) (15,19–21,38,39)
- 2 Permanent pacemaker implantation is reasonable for asymptomatic second-degree AV block at intra- or infra-His levels found at electrophysiological study. (Level of Evidence: B) (20,35,36)
- 3 Permanent pacemaker implantation is reasonable for first- or second-degree AV block with symptoms similar to those of pacemaker syndrome or hemodynamic compromise. (Level of Evidence: B) (40,41)
- 4 Permanent pacemaker implantation is reasonable for asymptomatic type II second-degree AV block with a narrow QRS. When type II second-degree AV block occurs with a wide QRS, including isolated right bundle-branch block, pacing becomes a Class I recommendation. (See Section 2.1.3, "Chronic Bifascicular Block," in the full-text guidelines.) (Level of Evidence: B) (20,21,40,42)
Class IIb.
- 1 Permanent pacemaker implantation may be considered for neuromuscular diseases such as myotonic muscular dystrophy, Erb dystrophy (limb-girdle muscular dystrophy), and peroneal muscular atrophy with any degree of AV block (including first-degree AV block), with or without symptoms, because there may be unpredictable progression of AV conduction disease. (Level of Evidence: B) (28–34)
- 2 Permanent pacemaker implantation may be considered for AV block in the setting of drug use and/or drug toxicity when the block is expected to recur even after the drug is withdrawn. (Level of Evidence: B) (43,44)
Class III.
- 1 Permanent pacemaker implantation is not indicated for asymptomatic first-degree AV block. (Level of Evidence: B) (45) (See Section 2.1.3, "Chronic Bifascicular Block," in the full-text guidelines.)
- 2 Permanent pacemaker implantation is not indicated for asymptomatic type I second-degree AV block at the supra-His (AV node) level or that which is not known to be intra- or infra-Hisian. (Level of Evidence: C) (35)
- 3 Permanent pacemaker implantation is not indicated for AV block that is expected to resolve and is unlikely to recur (46) (e.g., drug toxicity, Lyme disease, or transient increases in vagal tone, or during hypoxia in sleep apnea syndrome in the absence of symptoms). (Level of Evidence: B) (44,46)
|
4. Recommendations for Permanent Pacing in Chronic Bifascicular Block
|
|---|
Class I.
- 1 Permanent pacemaker implantation is indicated for advanced second-degree AV block or intermittent third-degree AV block. (Level of Evidence: B) (19,39,47–51)
- 2 Permanent pacemaker implantation is indicated for type II second-degree AV block. (Level of Evidence: B) (52–55)
- 3 Permanent pacemaker implantation is indicated for alternating bundle-branch block. (Level of Evidence: C) (56)
Class IIa.
- 1 Permanent pacemaker implantation is reasonable for syncope not demonstrated to be due to AV block when other likely causes have been excluded, specifically ventricular tachycardia (VT). (Level of Evidence: B) (55,57–74)
- 2 Permanent pacemaker implantation is reasonable for an incidental finding at electrophysiological study of a markedly prolonged HV interval (greater than or equal to 100 milliseconds) in asymptomatic patients. (Level of Evidence: B) (65)
- 3 Permanent pacemaker implantation is reasonable for an incidental finding at electrophysiological study of pacing-induced infra-His block that is not physiological. (Level of Evidence: B) (72)
Class IIb.
- 1 Permanent pacemaker implantation may be considered in the setting of neuromuscular diseases such as myotonic muscular dystrophy, Erb dystrophy (limb-girdle muscular dystrophy), and peroneal muscular atrophy with bifascicular block or any fascicular block, with or without symptoms. (Level of Evidence: C) (28–34)
Class III.
- 1 Permanent pacemaker implantation is not indicated for fascicular block without AV block or symptoms. (Level of Evidence: B) (59,61,64,65)
- 2 Permanent pacemaker implantation is not indicated for fascicular block with first-degree AV block without symptoms. (Level of Evidence: B) (59,61,64,65)
|
5. Recommendations for Permanent Pacing After the Acute Phase of Myocardial Infarction*
|
|---|
Class I.
- 1 Permanent ventricular pacing is indicated for persistent second-degree AV block in the His-Purkinje system with alternating bundle-branch block or third-degree AV block within or below the His-Purkinje system after ST-segment elevation myocardial infarction. (Level of Evidence: B) (54,75–79)
- 2 Permanent ventricular pacing is indicated for transient advanced second- or third-degree infranodal AV block and associated bundle-branch block. If the site of block is uncertain, an electrophysiological study may be necessary. (Level of Evidence: B) (75,76)
- 3 Permanent ventricular pacing is indicated for persistent and symptomatic second- or third-degree AV block. (Level of Evidence: C)
Class IIb.
- 1 Permanent ventricular pacing may be considered for persistent second- or third-degree AV block at the AV node level, even in the absence of symptoms. (Level of Evidence: B) (14)
Class III.
- 1 Permanent ventricular pacing is not indicated for transient AV block in the absence of intraventricular conduction defects. (Level of Evidence: B) (75)
- 2 Permanent ventricular pacing is not indicated for transient AV block in the presence of isolated left anterior fascicular block. (Level of Evidence: B) (77)
- 3 Permanent ventricular pacing is not indicated for new bundle-branch block or fascicular block in the absence of AV block. (Level of Evidence: B) (48,75)
- 4 Permanent ventricular pacing is not indicated for persistent asymptomatic first-degree AV block in the presence of bundle-branch or fascicular block. (Level of Evidence: B) (75)
|
6. Recommendations for Permanent Pacing in Hypersensitive Carotid Sinus Syndrome and Neurocardiogenic Syncope
|
|---|
Class I.
- 1 Permanent pacing is indicated for recurrent syncope caused by spontaneously occurring carotid sinus stimulation and carotid sinus pressure that induces ventricular asystole of more than 3 seconds. (Level of Evidence: C) (80,81)
Class IIa.
- 1 Permanent pacing is reasonable for syncope without clear, provocative events and with a hypersensitive cardioinhibitory response of 3 seconds or longer. (Level of Evidence: C) (80)
Class IIb.
- 1 Permanent pacing may be considered for significantly symptomatic neurocardiogenic syncope associated with bradycardia documented spontaneously or at the time of tilt-table testing. (Level of Evidence: B) (82–85)
Class III.
- 1 Permanent pacing is not indicated for a hypersensitive cardioinhibitory response to carotid sinus stimulation without symptoms or with vague symptoms. (Level of Evidence: C)
- 2 Permanent pacing is not indicated for situational vasovagal syncope in which avoidance behavior is effective and preferred. (Level of Evidence: C)
|
7. Recommendations for Pacing After Cardiac Transplantation
|
|---|
Class I.
- 1 Permanent pacing is indicated for persistent inappropriate or symptomatic bradycardia not expected to resolve and for other Class I indications for permanent pacing. (Level of Evidence: C)
Class IIb.
- 1 Permanent pacing may be considered when relative bradycardia is prolonged or recurrent, which limits rehabilitation or discharge after postoperative recovery from cardiac transplantation. (Level of Evidence: C)
- 2 Permanent pacing may be considered for syncope after cardiac transplantation even when bradyarrhythmia has not been documented. (Level of Evidence: C)
|
8. Recommendations for Permanent Pacemakers That Automatically Detect and Pace to Terminate Tachycardias
|
|---|
Class IIa.
- 1 Permanent pacing is reasonable for symptomatic recurrent supraventricular tachycardia that is reproducibly terminated by pacing when catheter ablation and/or drugs fail to control the arrhythmia or produce intolerable side effects. (Level of Evidence: C) (86–90)
Class III.
- 1 Permanent pacing is not indicated in the presence of an accessory pathway that has the capacity for rapid anterograde conduction. (Level of Evidence: C)
|
9. Recommendations for Pacing to Prevent Tachycardia
|
|---|
Class I.
- 1 Permanent pacing is indicated for sustained pause-dependent VT, with or without QT prolongation. (Level of Evidence: C) (91,92)
Class IIa.
- 1 Permanent pacing is reasonable for high-risk patients with congenital long-QT syndrome. (Level of Evidence: C) (91,92)
Class IIb.
- 1 Permanent pacing may be considered for prevention of symptomatic, drug-refractory, recurrent atrial fibrillation in patients with coexisting SND. (Level of Evidence: B) (93–95)
Class III.
- 1 Permanent pacing is not indicated for frequent or complex ventricular ectopic activity without sustained VT in the absence of the long-QT syndrome. (Level of Evidence: C) (97)
- 2 Permanent pacing is not indicated for torsade de pointes VT due to reversible causes. (Level of Evidence: A) (98,99)
|
10. Recommendation for Pacing to Prevent Atrial Fibrillation
|
|---|
Class III.
- 1 Permanent pacing is not indicated for the prevention of atrial fibrillation in patients without any other indication for pacemaker implantation. (Level of Evidence: B) (100)
|
11. Recommendations for Cardiac Resynchronization Therapy in Patients With Severe Systolic Heart Failure
|
|---|
Class I.
- 1 For patients who have LV ejection fraction (LVEF) less than or equal to 35%, a QRS duration greater than or equal to 0.12 seconds, and sinus rhythm, CRT with or without an ICD is indicated for the treatment of New York Heart Association (NYHA) functional Class III or ambulatory Class IV heart failure symptoms with optimal recommended medical therapy. (Level of Evidence: A) (101,101a–101c)
Class IIa.
- 1 For patients who have LVEF less than or equal to 35%, a QRS duration greater than or equal to 0.12 seconds, and atrial fibrillation, CRT with or without an ICD is reasonable for the treatment of NYHA functional Class III or ambulatory Class IV heart failure symptoms on optimal recommended medical therapy. (Level of Evidence: B) (101,102)
- 2 For patients with LVEF less than or equal to 35% with NYHA functional Class III or ambulatory Class IV symptoms who are receiving optimal recommended medical therapy and who have frequent dependence on ventricular pacing, CRT is reasonable. (Level of Evidence: C) (101)
Class IIb.
- 1 For patients with LVEF less than or equal to 35% with NYHA functional Class I or II symptoms who are receiving optimal recommended medical therapy undergoing implantation of a permanent pacemaker and/or ICD with anticipated frequent ventricular pacing, CRT may be considered. (Level of Evidence: C) (101)
Class III.
- 1 CRT is not indicated for asymptomatic patients with reduced LVEF in the absence of other indications for pacing. (Level of Evidence: B) (101,101a–101c)
- 2 CRT is not indicated for patients whose functional status and life expectancy are limited predominantly by chronic noncardiac conditions. (Level of Evidence: C) (101)
|
12. Recommendations for Pacing in Patients With Hypertrophic Cardiomyopathy
|
|---|
Class I.
- 1 Permanent pacing is indicated for SND or AV block in patients with hypertrophic cardiomyopathy as described previously (see Section 2.1.1, "Sinus Node Dysfunction," and Section 2.1.2, "Acquired Atrioventricular Block in Adults," in the full-text guidelines). (Level of Evidence: C)
Class IIb.
- 1 Permanent pacing may be considered in medically refractory symptomatic patients with hypertrophic cardiomyopathy and significant resting or provoked LV outflow tract obstruction. (Level of Evidence: A) As for Class I indications, when risk factors for SCD are present, consider a DDD ICD (seeSection 3, "Indications for Implantable Cardioverter-Defibrillator Therapy," in the full-text guidelines). (103–108)
Class III.
- 1 Permanent pacemaker implantation is not indicated for patients who are asymptomatic or whose symptoms are medically controlled. (Level of Evidence: C)
- 2 Permanent pacemaker implantation is not indicated for symptomatic patients without evidence of LV outflow tract obstruction. (Level of Evidence: C)
|
13. Recommendations for Permanent Pacing in Children, Adolescents, and Patients With Congenital Heart Disease
|
|---|
Class I.
- 1 Permanent pacemaker implantation is indicated for advanced second- or third-degree AV block associated with symptomatic bradycardia, ventricular dysfunction, or low cardiac output. (Level of Evidence: C)
- 2 Permanent pacemaker implantation is indicated for SND with correlation of symptoms during age-inappropriate bradycardia. The definition of bradycardia varies with the patient's age and expected heart rate. (Level of Evidence: B) (9,22,109,110)
- 3 Permanent pacemaker implantation is indicated for postoperative advanced second- or third-degree AV block that is not expected to resolve or that persists at least 7 days after cardiac surgery. (Level of Evidence: B) (35,111)
- 4 Permanent pacemaker implantation is indicated for congenital third-degree AV block with a wide QRS escape rhythm, complex ventricular ectopy, or ventricular dysfunction. (Level of Evidence: B) (113–115)
- 5 Permanent pacemaker implantation is indicated for congenital third-degree AV block in the infant with a ventricular rate less than 55 bpm or with congenital heart disease and a ventricular rate less than 70 bpm. (Level of Evidence: C) (116,117)
Class IIa.
- 1 Permanent pacemaker implantation is reasonable for patients with congenital heart disease and sinus bradycardia for the prevention of recurrent episodes of intra-atrial re-entrant tachycardia; SND may be intrinsic or secondary to antiarrhythmic treatment. (Level of Evidence: C) (118–120)
- 2 Permanent pacemaker implantation is reasonable for congenital third-degree AV block beyond the first year of life with an average heart rate less than 50 bpm, abrupt pauses in ventricular rate that are 2 or 3 times the basic cycle length, or associated with symptoms due to chronotropic incompetence. (Level of Evidence: B) (121,122)
- 3 Permanent pacemaker implantation is reasonable for sinus bradycardia with complex congenital heart disease with a resting heart rate less than 40 bpm or pauses in ventricular rate longer than 3 seconds. (Level of Evidence: C)
- 4 Permanent pacemaker implantation is reasonable for patients with congenital heart disease and impaired hemodynamics due to sinus bradycardia or loss of AV synchrony. (Level of Evidence: C) (123)
- 5 Permanent pacemaker implantation is reasonable for unexplained syncope in the patient with prior congenital heart surgery complicated by transient complete heart block with residual fascicular block after a careful evaluation to exclude other causes of syncope. (Level of Evidence: B) (115,124–126)
Class IIb.
- 1 Permanent pacemaker implantation may be considered for transient postoperative third-degree AV block that reverts to sinus rhythm with residual bifascicular block. (Level of Evidence: C) (127)
- 2 Permanent pacemaker implantation may be considered for congenital third-degree AV block in asymptomatic children or adolescents with an acceptable rate, a narrow QRS complex, and normal ventricular function. (Level of Evidence: B) (113,122)
- 3 Permanent pacemaker implantation may be considered for asymptomatic sinus bradycardia after biventricular repair of congenital heart disease with a resting heart rate less than 40 bpm or pauses in ventricular rate longer than 3 seconds. (Level of Evidence: C)
Class III.
- 1 Permanent pacemaker implantation is not indicated for transient postoperative AV block with return of normal AV conduction in the otherwise asymptomatic patient. (Level of Evidence: B) (127,127a)
- 2 Permanent pacemaker implantation is not indicated for asymptomatic bifascicular block with or without first-degree AV block after surgery for congenital heart disease in the absence of prior transient complete AV block. (Level of Evidence: C)
- 3 Permanent pacemaker implantation is not indicated for asymptomatic type I second-degree AV block. (Level of Evidence: C)
- 4 Permanent pacemaker implantation is not indicated for asymptomatic sinus bradycardia with the longest relative risk interval less than 3 seconds and a minimum heart rate more than 40 bpm. (Level of Evidence: C)
|
14. Recommendations for Implantable Cardioverter-Defibrillators
|
|---|
Secondary prevention refers to the prevention of SCD in those patients who have survived a prior cardiac arrest or sustained VT. Primary prevention refers to the prevention of SCD in individuals without a history of cardiac arrest or sustained VT. Patients with cardiac conditions associated with a high risk of sudden death who have unexplained syncope that is likely to be due to ventricular arrhythmias are considered to have a secondary indication.
Recommendations for consideration of ICD therapy, particularly those for primary prevention, apply only to patients who are receiving optimal medical therapy and have a reasonable expectation of survival with good functional status for more than 1 year. It is difficult to estimate survival with heart failure in the general population, for whom comorbidities and age differ from those in trial populations from which the predictive models have been derived. Patients with repeated heart failure hospitalizations, particularly in the presence of reduced renal function, are at high risk for early death due to heart failure (128–130). Please see Section 3, "Indications for Implantable Cardioverter-Defibrillator Therapy," in the full-text guidelines for discussion regarding the use of LVEFs on the basis of trial inclusion criteria.
We acknowledge that the "ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death" (4) used an LVEF of less than 40% as a critical point to justify ICD implantation for primary prevention of SCD. The LVEF used in clinical trials assessing the ICD for primary prevention of SCD ranged from less than 40% in MUSTT (Multicenter Unsustained Ventricular Tachycardia Trial) to less than 30% in MADIT II (Multicenter Automatic Defibrillator Implantation Trial II) (131,132). Two trials, MADIT I (Multicenter Automatic Defibrillator Implantation Trial I) (6) and SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial) (7) used LVEFs of less than 35% as entry criteria. The present writing committee reached the consensus that it would be best to offer ICDs to patients with clinical profiles as similar to those included in the trials as possible. Having given careful consideration to the issues related to LVEF for these updated ICD guidelines, we have written these indications for ICDs on the basis of the specific inclusion criteria for LVEF in the trials. Because of this, there may be some variation from previously published guidelines (4).
We also acknowledge that the determination of LVEF lacks a "gold standard" and that there may be variation among the commonly used clinical techniques of LVEF determination. All clinical methods of LVEF determination lack precision, and the accuracy of techniques varies among laboratories and institutions. On the basis of these considerations, the present writing committee recommends that clinicians use the LVEF determination that they believe is the most clinically accurate and appropriate in their institution.
Class I.
- 1 ICD therapy is indicated in patients who are survivors of cardiac arrest due to ventricular fibrillation or hemodynamically unstable sustained VT after evaluation to define the cause of the event and to exclude any completely reversible causes. (Level of Evidence: A) (4,133–138)
- 2 ICD therapy is indicated in patients with structural heart disease and spontaneous sustained VT, whether hemodynamically stable or unstable. (Level of Evidence: B) (4,133–138)
- 3 ICD therapy is indicated in patients with syncope of undetermined origin with clinically relevant, hemodynamically significant sustained VT or ventricular fibrillation induced at electrophysiological study. (Level of Evidence: B) (4,136)
- 4 ICD therapy is indicated in patients with LVEF less than 35% due to prior myocardial infarction who are at least 40 days post--myocardial infarction and are in NYHA functional Class II or III. (Level of Evidence: A) (4,139)
- 5 ICD therapy is indicated in patients with nonischemic dilated cardiomyopathy who have an LVEF less than or equal to 35% and who are in NYHA functional Class II or III. (Level of Evidence: B) (4,139–141)
- 6 ICD therapy is indicated in patients with LV dysfunction due to prior myocardial infarction who are at least 40 days post--myocardial infarction, have an LVEF less than 30%, and are in NYHA functional Class I. (Level of Evidence: A) (4,132)
- 7 ICD therapy is indicated in patients with nonsustained VT due to prior myocardial infarction, LVEF less than 40%, and inducible ventricular fibrillation or sustained VT at electrophysiological study. (Level of Evidence: B) (4,131,142)
Class IIa.
- 1 ICD implantation is reasonable for patients with unexplained syncope, significant LV dysfunction, and nonischemic dilated cardiomyopathy. (Level of Evidence: C)
- 2 ICD implantation is reasonable for patients with sustained VT and normal or near-normal ventricular function. (Level of Evidence: C)
- 3 ICD implantation is reasonable for patients with hypertrophic cardiomyopathy who have 1 or more major risk factor for SCD. (Level of Evidence: C)
- 4 ICD implantation is reasonable for the prevention of SCD in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy who have 1 or more risk factor for SCD. (Level of Evidence: C)
- 5 ICD implantation is reasonable to reduce SCD in patients with long-QT syndrome who are experiencing syncope and/or VT while receiving beta blockers. (Level of Evidence: B) (143–148)
- 6 ICD implantation is reasonable for nonhospitalized patients awaiting transplantation. (Level of Evidence: C)
- 7 ICD implantation is reasonable for patients with Brugada syndrome who have had syncope. (Level of Evidence: C)
- 8 ICD implantation is reasonable for patients with Brugada syndrome who have documented VT that has not resulted in cardiac arrest. (Level of Evidence: C)
- 9 ICD implantation is reasonable for patients with catecholaminergic polymorphic VT who have syncope and/or documented sustained VT while receiving beta blockers. (Level of Evidence: C)
- 10 ICD implantation is reasonable for patients with cardiac sarcoidosis, giant cell myocarditis, or Chagas disease. (Level of Evidence: C)
Class IIb.
- 1 ICD therapy may be considered in patients with nonischemic heart disease who have an LVEF of less than or equal to 35% and who are in NYHA functional Class I. (Level of Evidence: C)
- 2 ICD therapy may be considered for patients with long-QT syndrome and risk factors for SCD. (Level of Evidence: B) (4,143–148)
- 3 ICD therapy may be considered in patients with syncope and advanced structural heart disease in whom thorough invasive and noninvasive investigations have failed to define a cause. (Level of Evidence: C)
- 4 ICD therapy may be considered in patients with a familial cardiomyopathy associated with sudden death. (Level of Evidence: C)
- 5 ICD therapy may be considered in patients with LV noncompaction. (Level of Evidence: C)
Class III.
- 1 ICD therapy is not indicated for patients who do not have a reasonable expectation of survival with an acceptable functional status for at least 1 year, even if they meet ICD implantation criteria specified in the Class I, IIa, and IIb recommendations above. (Level of Evidence: C)
- 2 ICD therapy is not indicated for patients with incessant VT or ventricular fibrillation. (Level of Evidence: C)
- 3 ICD therapy is not indicated in patients with significant psychiatric illnesses that may be aggravated by device implantation or that may preclude systematic follow-up. (Level of Evidence: C)
- 4 ICD therapy is not indicated for NYHA Class IV patients with drug-refractory congestive heart failure who are not candidates for cardiac transplantation or implantation of a CRT device that incorporates both pacing and defibrillation capabilities. (Level of Evidence: C)
- 5 ICD therapy is not indicated for syncope of undetermined cause in a patient without inducible ventricular tachyarrhythmias and without structural heart disease. (Level of Evidence: C)
- 6 ICD therapy is not indicated when ventricular fibrillation or VT is amenable to surgical or catheter ablation (e.g., atrial arrhythmias associated with Wolff-Parkinson-White syndrome, right ventricular or LV outflow tract VT, idiopathic VT, or fascicular VT in the absence of structural heart disease). (Level of Evidence: C)
- 7 ICD therapy is not indicated for patients with ventricular tachyarrhythmias due to a completely reversible disorder in the absence of structural heart disease (e.g., electrolyte imbalance, drugs, or trauma). (Level of Evidence: B) (4)
|
15. Recommendations for Implantable Cardioverter-Defibrillators in Pediatric Patients and Patients With Congenital Heart Disease
|
|---|
Class I.
- 1 ICD implantation is indicated in the survivor of cardiac arrest after evaluation to define the cause of the event and to exclude any reversible causes. (Level of Evidence: B) (149–152)
- 2 ICD implantation is indicated for patients with symptomatic sustained VT in association with congenital heart disease who have undergone hemodynamic and electrophysiological evaluation. Catheter ablation or surgical repair may offer possible alternatives in carefully selected patients. (Level of Evidence: C) (153)
Class IIa.
- 1 ICD implantation is reasonable for patients with congenital heart disease with recurrent syncope of undetermined origin in the presence of either ventricular dysfunction or inducible ventricular arrhythmias at electrophysiological study. (Level of Evidence: B) (6,154)
Class Ib.
- 1 ICD implantation may be considered for patients with recurrent syncope associated with complex congenital heart disease and advanced systemic ventricular dysfunction when thorough invasive and noninvasive investigations have failed to define a cause. (Level of Evidence: C) (155,156)
Class III.
- 1 All Class III recommendations found inSection 3 of the full-text guidelines, "Indications for Implantable Cardioverter-Defibrillator Therapy," apply to pediatric patients or patients with congenital heart disease, and ICD implantation is not indicated in these patient populations. (Level of Evidence: C)
|
Staff
|
|---|
American College of Cardiology Foundation
John C. Lewin, MD, Chief Executive Officer
Charlene May, Senior Director, Clinical Policy and Guidelines
Lisa Bradfield, Associate Director, Practice Guidelines
Mark D. Stewart, MPH, Associate Director, Evidence-Based Medicine
Kristen N. Fobbs, MS, Senior Specialist, Practice Guidelines
Erin A. Barrett, Senior Specialist, Clinical Policy and Guidelines
American Heart Association
M. Cass Wheeler, Chief Executive Officer
Gayle R. Whitman, RN, PhD, FAAN, FAHA, Vice President, Office of Science Operations
Kathryn A. Taubert, PhD, FAHA, Senior Science Advisor
Appendices.
Appendix 1
Appendix 2
Appendix 3
|
Footnotes
|
|---|
This document was approved by the American College of Cardiology Foundation Board of Trustees, the American Heart Association Science Advisory and Coordinating Committee, and the Heart Rhythm Society Board of Trustees in February 2008.
The American College of Cardiology Foundation, American Heart Association, and Heart Rhythm Society request that this document be cited as follows: Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). J Am Coll Cardiol 2008;51:2085–105.
This article has been copublished in the May 27, 2008, issue of Circulation and the June 2008 issue of Heart Rhythm.
Copies: This document is available on the World Wide Web sites of the American College of Cardiology (www.acc.org), the American Heart Association (www.americanheart.org), and the Heart Rhythm Society (www.hrsonline.org). For copies of this document, please contact the Elsevier Inc. Reprint Department, fax (212) 633-3820, e-mail reprints{at}elsevier.com.
Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American College of Cardiology Foundation, American Heart Association, or Heart Rhythm Society. Please contact Elsevier's permission department at healthpermissions{at}elsevier.com.
* Recused from voting on guideline recommendations (see Section 1.2, "Document Review and Approval," for more detail); 
 American Association for Thoracic Surgery and Society of Thoracic Surgeons official representative;
 Heart Failure Society of America official representative
 Former Task Force member during this writing effort
* These recommendations are consistent with the "ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction" (8).
See Section 3.2.4, "Hypertrophic Cardiomyopathy," in the full-text guidelines for definition of major risk factors.
|
References
|
|---|
1. ACC/AHA Task Force on Practice Guidelines. Manual for ACC/AHA Guideline Writing Committees: Methodologies and Policies from the ACC/AHA Task Force on Practice Guidelines. Available at http://www.acc.org/qualityandscience/clinical/manual/pdfs/methodology.pdf and http://circ.ahajournals.org/manual/. Accessed February 2008.2. Gregoratos G, Abrams J, Epstein AE, et al. ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices—summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines) J Am Coll Cardiol 2002;40:1703-1719.[Free Full Text] 3. Gregoratos G, Abrams J, Epstein AE, et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines) Circulation 2002;106:2145-2161.[Free Full Text] 4. Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J Am Coll Cardiol 2006;48:e247-e346.[Free Full Text] 5. Zwanziger J, Hall WJ, Dick AW, et al. The cost effectiveness of implantable cardioverter-defibrillators: results from the Multicenter Automatic Defibrillator Implantation Trial (MADIT)-II J Am Coll Cardiol 2006;47:2310-2318.[Abstract/Free Full Text] 6. Mushlin AI, Hall WJ, Zwanziger J, et al. The cost-effectiveness of automatic implantable cardiac defibrillators: results from MADIT. Multicenter Automatic Defibrillator Implantation Trial. Circulation 1998;97:2129-2135.[Abstract/Free Full Text] 7. Mark DB, Nelson CL, Anstrom KJ, et al. Cost-effectiveness of defibrillator therapy or amiodarone in chronic stable heart failure: results from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Circulation 2006;114:135-142.[Abstract/Free Full Text] 8. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction) J Am Coll Cardiol 2004;44:e1-e211.[CrossRef][Medline] 9. Kay R, Estioko M, Wiener I. Primary sick sinus syndrome as an indication for chronic pacemaker therapy in young adults: incidence, clinical features, and long-term evaluation Am Heart J 1982;103:338-342.[CrossRef][Web of Science][Medline] 10. Kusumoto FM, Goldschlager N. Cardiac pacing N Engl J Med 1996;334:89-97.[Free Full Text] 11. Rasmussen K. Chronic sinus node disease: natural course and indications for pacing Eur Heart J 1981;2:455-459.[Abstract/Free Full Text] 12. Linde-Edelstam C, Nordlander R, Pehrsson SK, Ryden L. A double-blind study of submaximal exercise tolerance and variation in paced rate in atrial synchronous compared to activity sensor modulated ventricular pacing Pacing Clin Electrophysiol 1992;15:905-915.[CrossRef][Medline] 13. Gammage M, Schofield S, Rankin I, Bennett M, Coles P, Pentecost B. Benefit of single setting rate responsive ventricular pacing compared with fixed rate demand pacing in elderly patients Pacing Clin Electrophysiol 1991;14:174-180.[CrossRef][Medline] 14. Shaw DB, Holman RR, Gowers JI. Survival in sinoatrial disorder (sick-sinus syndrome) Br Med J 1980;280:139-141.[Abstract/Free Full Text] 15. Dreifus LS, Michelson EL, Kaplinsky E. Bradyarrhythmias: clinical significance and management J Am Coll Cardiol 1983;1:327-338.[Abstract] 16. Rubenstein JJ, Schulman CL, Yurchak PM, DeSanctis RW. Clinical spectrum of the sick sinus syndrome Circulation 1972;46:5-13.[Abstract/Free Full Text] 17. Fisher JD. Role of electrophysiologic testing in the diagnosis and treatment of patients with known and suspected bradycardias and tachycardias Prog Cardiovasc Dis 1981;24:25-90.[CrossRef][Web of Science][Medline] 18. Reiffel JA, Kuehnert MJ. Electrophysiological testing of sinus node function: diagnostic and prognostic application-including updated information from sinus node electrograms Pacing Clin Electrophysiol 1994;17:349-365.[CrossRef][Medline] 19. Friedberg CK, Donoso E, Stein WG. Nonsurgical acquired heart block Ann N Y Acad Sci 1964;111:835-847.[Web of Science][Medline] 20. Recommendations for pacemaker prescription for symptomatic bradycardia. Report of a working party of the British Pacing and Electrophysiology Group. Br Heart J 1991;66:185-191.[Free Full Text] 21. Kastor JA. Atrioventricular block (first of two parts) N Engl J Med 1975;292:462-465.[Abstract] 22. Ector H, Rolies L, De Geest H. Dynamic electrocardiography and ventricular pauses of 3 seconds and more: etiology and therapeutic implications Pacing Clin Electrophysiol 1983;6:548-551.[CrossRef][Medline] 23. Gallagher JJ, Svenson RH, Kasell JH, et al. Catheter technique for closed-chest ablation of the atrioventricular conduction system N Engl J Med 1982;306:194-200.[Abstract] 24. Langberg JJ, Chin MC, Rosenqvist M, et al. Catheter ablation of the atrioventricular junction with radiofrequency energy Circulation 1989;80:1527-1535.[Abstract/Free Full Text] 25. Glikson M, Dearani JA, Hyberger LK, Schaff HV, Hammill SC, Hayes DL. Indications, effectiveness, and long-term dependency in permanent pacing after cardiac surgery Am J Cardiol 1997;80:1309-1313.[CrossRef][Web of Science][Medline] 26. Kim MH, Deeb GM, Eagle KA, et al. Complete atrioventricular block after valvular heart surgery and the timing of pacemaker implantation Am J Cardiol 2001;87:649-651.[CrossRef][Web of Science][Medline] 27. Koplan BA, Stevenson WG, Epstein LM, Aranki SF, Maisel WH. Development and validation of a simple risk score to predict the need for permanent pacing after cardiac valve surgery J Am Coll Cardiol 2003;41:795-801.[Abstract/Free Full Text] 28. Perloff JK, Stevenson WG, Roberts NK, Cabeen W, Weiss J. Cardiac involvement in myotonic muscular dystrophy (Steinert's disease): a prospective study of 25 patients Am J Cardiol 1984;54:1074-1081.[CrossRef][Web of Science][Medline] 29. Hiromasa S, Ikeda T, Kubota K, et al. Myotonic dystrophy: ambulatory electrocardiogram, electrophysiologic study, and echocardiographic evaluation Am Heart J 1987;113:1482-1488.[CrossRef][Web of Science][Medline] 30. Stevenson WG, Perloff JK, Weiss JN, Anderson TL. Facioscapulohumeral muscular dystrophy: evidence for selective, genetic electrophysiologic cardiac involvement J Am Coll Cardiol 1990;15:292-299.[Abstract] 31. James TN, Fisch C. Observations on the cardiovascular involvement in Freidreich's ataxia Am Heart J 1963;66:164-175.[CrossRef][Web of Science][Medline] 32. Roberts NK, Perloff JK, Kark RA. Cardiac conduction in the Kearns-Sayre syndrome (a neuromuscular disorder associated with progressive external ophthalmoplegia and pigmentary retinopathy). Report of 2 cases and review of 17 published cases. Am J Cardiol 1979;44:1396-1400.[CrossRef][Web of Science][Medline] 33. Charles R, Holt S, Kay JM, Epstein EJ, Rees JR. Myocardial ultrastructure and the development of atrioventricular block in Kearns-Sayre syndrome Circulation 1981;63:214-219.[Abstract/Free Full Text] 34. James TN. Observations on the cardiovascular involvement, including the cardiac conduction system, in progressive muscular dystrophy Am Heart J 1962;63:48-56.[CrossRef][Web of Science][Medline] 35. Strasberg B, Amat-Y-Leon F, Dhingra RC, et al. Natural history of chronic second-degree atrioventricular nodal block Circulation 1981;63:1043-1049.[Abstract/Free Full Text] 36. Shaw DB, Kekwick CA, Veale D, Gowers J, Whistance T. Survival in second degree atrioventricular block Br Heart J 1985;53:587-593.[Abstract/Free Full Text] 37. Chokshi SK, Sarmiento J, Nazari J, Mattioni T, Zheutlin T, Kehoe R. Exercise-provoked distal atrioventricular block Am J Cardiol 1990;66:114-116.[CrossRef][Web of Science][Medline] 38. Barold SS, Mugica J. New Perspectives in Cardiac PacingMount Kisco, NY: Futura Publishing Co; 1991. pp. 23. 39. Gadboys HL, Wisoff G, Litwak RS. Surgical treatment of complete heart block. An analysis of 36 cases. JAMA 1964;189:97-102.[Abstract/Free Full Text] 40. Barold SS. Indications for permanent cardiac pacing in first-degree AV block: Class I, II, or III? Pacing Clin Electrophysiol 1996;19:747-751.[CrossRef][Medline] 41. Kim YH, O'Nunain S, Trouton T, et al. Pseudo-pacemaker syndrome following inadvertent fast pathway ablation for atrioventricular nodal reentrant tachycardia J Cardiovasc Electrophysiol 1993;4:178-182.[Web of Science][Medline] 42. Zipes DP. Second-degree atrioventricular block Circulation 1979;60:465-472.[Abstract/Free Full Text] 43. Zeltser D, Justo D, Halkin A, et al. Drug-induced atrioventricular block: prognosis after discontinuation of the culprit drug J Am Coll Cardiol 2004;44:105-108.[Abstract/Free Full Text] 44. Shohat-Zabarski R, Iakobishvili Z, Kusniec J, Mazur A, Strasberg B. Paroxysmal atrioventricular block: clinical experience with 20 patients Int J Cardiol 2004;97:399-405.[CrossRef][Web of Science][Medline] 45. Mymin D, Mathewson FA, Tate RB, Manfreda J. The natural history of primary first-degree atrioventricular heart block N Engl J Med 1986;315:1183-1187.[Abstract] 46. McAlister HF, Klementowicz PT, Andrews C, Fisher JD, Feld M, Furman S. Lyme carditis: an important cause of reversible heart block Ann Intern Med 1989;110:339-345.[Abstract/Free Full Text] 47. Johansson BW. Complete heart block. A clinical, hemodynamic and pharmacological study in patients with and without an artificial pacemaker. Acta Med Scand Suppl 1966;451:1-127.[Medline] 48. Hindman MC, Wagner GS, JaRo M, et al. The clinical significance of bundle branch block complicating acute myocardial infarction. 2. Indications for temporary and permanent pacemaker insertion. Circulation 1978;58:689-699.[Abstract/Free Full Text] 49. Donmoyer TL, DeSanctis RW, Austen WG. Experience with implantable pacemakers using myocardial electrodes in the management of heart block Ann Thorac Surg 1967;3:218-227.[Medline] 50. Edhag O, Swahn A. Prognosis of patients with complete heart block or arrhythmic syncope who were not treated with artificial pacemakers. A long-term follow-up study of 101 patients. Acta Med Scand 1976;200:457-463.[Web of Science][Medline] 51. Levine SA, Miller H, Penton GB. Some clinical features of complete heart block Circulation 1956;13:801-824.[Web of Science][Medline] 52. Dhingra RC, Denes P, Wu D, Chuquimia R, Rosen KM. The significance of second degree atrioventricular block and bundle branch block. Observations regarding site and type of block. Circulation 1974;49:638-646.[Abstract/Free Full Text] 53. Donoso E, Adler LN, Friedberg CK. Unusual forms of second-degree atrioventricular block, including mobitz type-II block, associated with the Morgagni-Adams-Stokes Syndrome Am Heart J 1964;67:150-157.[CrossRef][Web of Science][Medline] 54. Ranganathan N, Dhurandhar R, Phillips JH, Wigle ED. His Bundle electrogram in bundle-branch block Circulation 1972;45:282-294.[Abstract/Free Full Text] 55. Dhingra RC, Denes P, Wu D, et al. Syncope in patients with chronic bifascicular block. Significance, causative mechanisms, and clinical implications. Ann Intern Med 1974;81:302-306.[CrossRef][Web of Science][Medline] 56. Josephson M. Clinical Cardiac Electrophysiology: Techniques and Interpretations2nd edition. Philadelphia, PA: Lea & Febiger; 1993. pp. 145. 57. Kulbertus H, Collignon P. Association of right bundle-branch block with left superior or inferior intraventricular block. Its relation to complete heart block and Adams-Stokes syndrome. Br Heart J 1969;31:435-440.[Free Full Text] 58. DePasquale NP, Bruno MS. Natural history of combined right bundle branch block and left anterior hemiblock (bilateral bundle branch block) Am J Med 1973;54:297-303.[CrossRef][Web of Science][Medline] 59. Scheinman MM, Peters RW, Modin G, Brennan M, Mies C, O'Young J. Prognostic value of infranodal conduction time in patients with chronic bundle branch block Circulation 1977;56:240-244.[Abstract/Free Full Text] 60. Denes P, Dhingra RC, Wu D, Wyndham CR, Leon F, Rosen KM. Sudden death in patients with chronic bifascicular block Arch Intern Med 1977;137:1005-1010.[Abstract/Free Full Text] 61. McAnulty JH, Kauffman S, Murphy E, Kassebaum DG, Rahimtoola SH. Survival in patients with intraventricular conduction defects Arch Intern Med 1978;138:30-35.[Abstract/Free Full Text] 62. Peters RW, Scheinman MM, Modin C, O'Young J, Somelofski CA, Mies C. Prophylactic permanent pacemakers for patients with chronic bundle branch block Am J Med 1979;66:978-985.[CrossRef][Web of Science][Medline] 63. Fisch GR, Zipes DP, Fisch C. Bundle branch block and sudden death Prog Cardiovasc Dis 1980;23:187-224.[CrossRef][Web of Science][Medline] 64. McAnulty JH, Rahimtoola SH, Murphy E, et al. Natural history of "high-risk" bundle-branch block: final report of a prospective study N Engl J Med 1982;307:137-143.[Abstract] 65. Scheinman MM, Peters RW, Suave MJ, et al. Value of the H-Q interval in patients with bundle branch block and the role of prophylactic permanent pacing Am J Cardiol 1982;50:1316-1322.[CrossRef][Web of Science][Medline] 66. Morady F, Higgins J, Peters RW, et al. Electrophysiologic testing in bundle branch block and unexplained syncope Am J Cardiol 1984;54:587-591.[CrossRef][Web of Science][Medline] 67. Click RL, Gersh BJ, Sugrue DD, et al. Role of invasive electrophysiologic testing in patients with symptomatic bundle branch block Am J Cardiol 1987;59:817-823.[CrossRef][Web of Science][Medline] 68. Ezri M, Lerman BB, Marchlinski FE, Buxton AE, Josephson ME. Electrophysiologic evaluation of syncope in patients with bifascicular block Am Heart J 1983;106:693-697.[CrossRef][Web of Science][Medline] 69. Twidale N, Heddle WF, Ayres BF, Tonkin AM. Clinical implications of electrophysiology study findings in patients with chronic bifascicular block and syncope Aust N Z J Med 1988;18:841-847.[Web of Science][Medline] 70. Englund A, Bergfeldt L, Rehnqvist N, Astrom H, Rosenqvist M. Diagnostic value of programmed ventricular stimulation in patients with bifascicular block: a prospective study of patients with and without syncope J Am Coll Cardiol 1995;26:1508-1515.[Abstract] 71. Probst P, Pachinger O, Akbar MA, Leisch F, Kaindl F. The HQ time in congestive cardiomyopathies Am Heart J 1979;97:436-441.[CrossRef][Web of Science][Medline] 72. Dhingra RC, Wyndham C, Bauernfeind R, et al. Significance of block distal to the His bundle induced by atrial pacing in patients with chronic bifascicular block Circulation 1979;60:1455-1464.[Abstract/Free Full Text] 73. Cheng TO. Atrial pacing: its diagnostic and therapeutic applications Prog Cardiovasc Dis 1971;14:230-247.[CrossRef][Medline] 74. Brignole M, Menozzi C, Moya A, et al. Mechanism of syncope in patients with bundle branch block and negative electrophysiological test Circulation 2001;104:2045-2050.[Abstract/Free Full Text] 75. Col JJ, Weinberg SL. The incidence and mortality of intraventricular conduction defects in acute myocardial infarction Am J Cardiol 1972;29:344-350.[CrossRef][Web of Science][Medline] 76. Ritter WS, Atkins JM, Blomqvist CG, Mullins CB. Permanent pacing in patients with transient trifascicular block during acute myocardial infarction Am J Cardiol 1976;38:205-208.[CrossRef][Web of Science][Medline] 77. Ginks WR, Sutton R, Oh W, Leatham A. Long-term prognosis after acute anterior infarction with atrioventricular block Br Heart J 1977;39:186-189.[Abstract/Free Full Text] 78. Domenighetti G, Perret C. Intraventricular conduction disturbances in acute myocardial infarction: short- and long-term prognosis Eur J Cardiol 1980;11:51-59.[Web of Science][Medline] 79. Lamas GA, Muller JE, Turi ZG, et al. A simplified method to predict occurrence of complete heart block during acute myocardial infarction Am J Cardiol 1986;57:1213-1219.[CrossRef][Web of Science][Medline] 80. Brignole M, Menozzi C, Lolli G, Bottoni N, Gaggioli G. Long-term outcome of paced and nonpaced patients with severe carotid sinus syndrome Am J Cardiol 1992;69:1039-1043.[CrossRef][Web of Science][Medline] 81. Brignole M, Menozzi C, Gianfranchi L, Oddone D, Lolli G, Bertulla A. Neurally mediated syncope detected by carotid sinus massage and head-up tilt test in sick sinus syndrome Am J Cardiol 1991;68:1032-1036.[CrossRef][Web of Science][Medline] 82. Connolly SJ, Sheldon R, Thorpe KE, et al. Pacemaker therapy for prevention of syncope in patients with recurrent severe vasovagal syncope: Second Vasovagal Pacemaker Study (VPS II): a randomized trial JAMA 2003;289:2224-2229.[Abstract/Free Full Text] 83. Sutton R, Brignole M, Menozzi C, et al. Dual-chamber pacing in the treatment of neurally mediated tilt-positive cardioinhibitory syncope: pacemaker versus no therapy: a multicenter randomized study. The Vasovagal Syncope International Study (VASIS) Investigators. Circulation 2000;102:294-299.[Abstract/Free Full Text] 84. Ammirati F, Colivicchi F, Santini M. Permanent cardiac pacing versus medical treatment for the prevention of recurrent vasovagal syncope: a multicenter, randomized, controlled trial Circulation 2001;104:52-57.[Abstract/Free Full Text] 85. Sheldon R, Koshman ML, Wilson W, Kieser T, Rose S. Effect of dual-chamber pacing with automatic rate-drop sensing on recurrent neurally mediated syncope Am J Cardiol 1998;81:158-162.[CrossRef][Web of Science][Medline] 86. Peters RW, Scheinman MM, Morady F, Jacobson L. Long-term management of recurrent paroxysmal tachycardia by cardiac burst pacing Pacing Clin Electrophysiol 1985;8:35-44.[CrossRef][Medline] 87. Fisher JD, Johnston DR, Furman S, Mercando AD, Kim SG. Long-term efficacy of antitachycardia pacing for supraventricular and ventricular tachycardias Am J Cardiol 1987;60:1311-1316.[CrossRef][Web of Science][Medline] 88. Den DK, Bertholet M, Brugada P, et al. Clinical experience with implantable devices for control of tachyarrhythmias Pacing Clin Electrophysiol 1984;7:548-556.[CrossRef][Medline] 89. Saksena S, Pantopoulos D, Parsonnet V, Rothbart ST, Hussain SM, Gielchinsky I. Usefulness of an implantable antitachycardia pacemaker system for supraventricular or ventricular tachycardia Am J Cardiol 1986;58:70-74.[CrossRef][Web of Science][Medline] 90. Barold SS, Wyndham CR, Kappenberger LL, Abinader EG, Griffin JC, Falkoff, MD. Implanted atrial pacemakers for paroxysmal atrial flutter. Long-term efficacy. Ann Intern Med 1987;107:144-149.[Abstract/Free Full Text] 91. Eldar M, Griffin JC, Abbott JA, et al. Permanent cardiac pacing in patients with the long QT syndrome J Am Coll Cardiol 1987;10:600-607.[Abstract] 92. Eldar M, Griffin JC, Van Hare GF, et al. Combined use of beta-adrenergic blocking agents and long-term cardiac pacing for patients with the long QT syndrome J Am Coll Cardiol 1992;20:830-837.[Abstract] 93. Saksena S, Prakash A, Hill M, et al. Prevention of recurrent atrial fibrillation with chronic dual-site right atrial pacing J Am Coll Cardiol 1996;28:687-694.[Abstract] 94. Saksena S, Delfaut P, Prakash A, Kaushik RR, Krol RB. Multisite electrode pacing for prevention of atrial fibrillation J Cardiovasc Electrophysiol 1998;9:S155-S162.[Web of Science][Medline] 95. Lamas GA, Lee K, Sweeney M, et al. The mode selection trial (MOST) in sinus node dysfunction: design, rationale, and baseline characteristics of the first 1000 patients Am Heart J 2000;140:541-551.[CrossRef][Web of Science][Medline] 96. Deleted in proof. 97. Fisher JD, Teichman SL, Ferrick A, Kim SG, Waspe LE, Martinez MR. Antiarrhythmic effects of VVI pacing at physiologic rates: a crossover controlled evaluation Pacing Clin Electrophysiol 1987;10:822-830.[CrossRef][Medline] 98. Moss AJ, Robinson J. Clinical features of the idiopathic long QT syndrome Circulation 1992;85:I140-I144.[Medline] 99. Viskin S, Alla SR, Barron HV, et al. Mode of onset of torsade de pointes in congenital long QT syndrome J Am Coll Cardiol 1996;28:1262-1268.[Abstract] 100. Knight BP, Gersh BJ, Carlson, MD, et al. Role of permanent pacing to prevent atrial fibrillation: science advisory from the American Heart Association Council on Clinical Cardiology (Subcommittee on Electrocardiography and Arrhythmias) and the Quality of Care and Outcomes Research Interdisciplinary Working Group, in collaboration with the Heart Rhythm Society Circulation 2005;111:240-243.[Abstract/Free Full Text] 101. Hunt SA. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure) J Am Coll Cardiol 2005;46:e1-e82.[Free Full Text] 101a. Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure N Engl J Med 2002;346:1845-1853.[Abstract/Free Full Text] 101b. Bristow MR, Saxon LA, Boehmer J, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure N Engl J Med 2004;350:2140-2150.[Abstract/Free Full Text] 101c. Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure N Engl J Med 2005;352:1539-1549.[Abstract/Free Full Text] 102. Cazeau S, Leclercq C, Lavergne T, et al. Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay N Engl J Med 2001;344:873-880.[Abstract/Free Full Text] 103. Fananapazir L, Epstein ND, Curiel RV, Panza JA, Tripodi D, McAreavey D. Long-term results of dual-chamber (DDD) pacing in obstructive hypertrophic cardiomyopathy. Evidence for progressive symptomatic and hemodynamic improvement and reduction of left ventricular hypertrophy. Circulation 1994;90:2731-2742.[Abstract/Free Full Text] 104. Nishimura RA, Hayes DL, Ilstrup DM, Holmes Jr. DR, Tajik AJ. Effect of dual-chamber pacing on systolic and diastolic function in patients with hypertrophic cardiomyopathy. Acute Doppler echocardiographic and catheterization hemodynamic study. J Am Coll Cardiol 1996;27:421-430.[Abstract] 105. Nishimura RA, Symanski JD, Hurrell DG, Trusty JM, Hayes DL, Tajik AJ. Dual-chamber pacing for cardiomyopathies: a 1996 clinical perspective Mayo Clin Proc 1996;71:1077-1087.[Abstract] 106. Kappenberger L, Linde C, Daubert C, et al. Pacing in hypertrophic obstructive cardiomyopathy. A randomized crossover study. PIC Study Group. Eur Heart J 1997;18:1249-1256.[Abstract/Free Full Text] 107. Nishimura RA, Trusty JM, Hayes DL, et al. Dual-chamber pacing for hypertrophic cardiomyopathy: a randomized, double-blind, crossover trial J Am Coll Cardiol 1997;29:435-441.[Abstract] 108. Maron BJ, Nishimura RA, McKenna WJ, Rakowski H, Josephson ME, Kieval RS. Assessment of permanent dual-chamber pacing as a treatment for drug-refractory symptomatic patients with obstructive hypertrophic cardiomyopathy. A randomized, double-blind, crossover study (M-PATHY). Circulation 1999;99:2927-2933.[Abstract/Free Full Text] 109. Kelly AM, Porter CJ, McGoon, MD, Espinosa RE, Osborn MJ, Hayes DL. Breath-holding spells associated with significant bradycardia: successful treatment with permanent pacemaker implantation Pediatrics 2001;108:698-702.[Abstract/Free Full Text] 110. Beder SD, Gillette PC, Garson Jr. A, Porter CB, McNamara DG. Symptomatic sick sinus syndrome in children and adolescents as the only manifestation of cardiac abnormality or associated with unoperated congenital heart disease Am J Cardiol 1983;51:1133-1136.[CrossRef][Web of Science][Medline] 111. Lillehei CW, Sellers RD, Bonnabeau RC, Eliot RS. Chronic postsurgical complete heart block with particular reference to prognosis, management, and a new P-wave pacemaker J Thorac Cardiovasc Surg 1963;46:436-456.[Web of Science][Medline] 112. Deleted in proof. 113. Michaelsson M, Jonzon A, Riesenfeld T. Isolated congenital complete atrioventricular block in adult life. A prospective study. Circulation 1995;92:442-449.[Abstract/Free Full Text] 114. Moak JP, Barron KS, Hougen TJ, et al. Congenital heart block: development of late-onset cardiomyopathy, a previously underappreciated sequela J Am Coll Cardiol 2001;37:238-242.[Abstract/Free Full Text] 115. Villain E, Coastedoat-Chalumeau N, Marijon E, Boudjemline Y, Piette JC, Bonnet D. Presentation and prognosis of complete atrioventricular block in childhood, according to maternal antibody status J Am Coll Cardiol 2006;48:1682-1687.[Abstract/Free Full Text] 116. Jaeggi ET, Hamilton RM, Silverman ED, Zamora SA, Hornberger LK. Outcome of children with fetal, neonatal or childhood diagnosis of isolated congenital atrioventricular block. A single institution's experience of 30 years. J Am Coll Cardiol 2002;39:130-137.[Abstract/Free Full Text] 117. Pinsky WW, Gillette PC, Garson Jr. A, McNamara DG. Diagnosis, management, and long-term results of patients with congenital complete atrioventricular block Pediatrics 1982;69:728-733.[Abstract/Free Full Text] 118. Silka MJ, Manwill JR, Kron J, McAnulty JH. Bradycardia-mediated tachyarrhythmias in congenital heart disease and responses to chronic pacing at physiologic rates Am J Cardiol 1990;65:488-493.[CrossRef][Web of Science][Medline] 119. Stephenson EA, Casavant D, Tuzi J, et al. Efficacy of atrial antitachycardia pacing using the Medtronic AT500 pacemaker in patients with congenital heart disease Am J Cardiol 2003;92:871-876.[CrossRef][Web of Science][Medline] 120. Pfammatter JP, Paul T, Lehmann C, Kallfelz HC. Efficacy and proarrhythmia of oral sotalol in pediatric patients J Am Coll Cardiol 1995;26:1002-1007.[Abstract] 121. Dewey RC, Capeless MA, Levy AM. Use of ambulatory electrocardiographic monitoring to identify high-risk patients with congenital complete heart block N Engl J Med 1987;316:835-839.[Abstract] 122. Sholler GF, Walsh EP. Congenital complete heart block in patients without anatomic cardiac defects Am Heart J 1989;118:1193-1198.[CrossRef][Web of Science][Medline] 123. Cohen MI, Rhodes LA, Wernovsky G, Gaynor JW, Spray TL, Rychik J. Atrial pacing: an alternative treatment for protein-losing enteropathy after the Fontan operation J Thorac Cardiovasc Surg 2001;121:582-583.[Free Full Text] 124. Villain E, Ouarda F, Beyler C, Sidi D, Abid F. Predictive factors for late complete atrio-ventricular block after surgical treatment for congenital cardiopathy Arch Mal Coeur Vaiss 2003;96:495-498.[Web of Science][Medline] 125. Gross GJ, Chiu CC, Hamilton RM, Kirsh JA, Stephenson EA. Natural history of postoperative heart block in congenital heart disease: implications for pacing intervention Heart Rhythm 2006;3:601-604.[CrossRef][Web of Science][Medline] 126. Banks MA, Jenson J, Kugler JD. Late development of atrioventricular block after congenital heart surgery in down syndrome Am J Cardiol 2001;88:86-89.[Web of Science] 127. Krongrad E. Prognosis for patients with congenital heart disease and postoperative intraventricular conduction defects Circulation 1978;57:867-870.[Abstract/Free Full Text] 127a. Weindling SN, Saul JP, Gamble WJ, Mayer JE, Wessel D, Walsh EP. Duration of complete atrioventricular block after congenital heart disease surgery Am J Cardiol 1998;82:525-527.[CrossRef][Web of Science][Medline] 128. Levy WC, Mozaffarian D, Linker DT, et al. The Seattle Heart Failure Model: prediction of survival in heart failure Circulation 2006;113:1424-1433.[Abstract/Free Full Text] 129. Mozaffarian D, Anker SD, Anand I, et al. Prediction of mode of death in heart failure: the Seattle Heart Failure Model Circulation 2007;116:392-398.[Abstract/Free Full Text] 130. The Seattle Heart Failure Model. Available at: http://www.seattleheartfailuremodel.org. Accessed January 2008. 131. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G. A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med 1999;341:1882-1890.[Abstract/Free Full Text] 132. Moss AJ, Zareba W, Hall WJ, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction N Engl J Med 2002;346:877-883.[Abstract/Free Full Text] 133. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias N Engl J Med 1997;337:1576-1583.[Abstract/Free Full Text] 134. Wever EF, Hauer RN, van Capelle FL, et al. Randomized study of implantable defibrillator as first-choice therapy versus conventional strategy in postinfarct sudden death survivors Circulation 1995;91:2195-2203.[Abstract/Free Full Text] 135. Siebels J, Kuck KH. Implantable cardioverter defibrillator compared with antiarrhythmic drug treatment in cardiac arrest survivors (the Cardiac Arrest Study Hamburg) Am Heart J 1994;127:1139-1144.[CrossRef][Web of Science][Medline] 136. Connolly SJ, Gent M, Roberts RS, et al. Canadian implantable defibrillator study (CIDS): a randomized trial of the implantable cardioverter defibrillator against amiodarone Circulation 2000;101:1297-1302.[Abstract/Free Full Text] 137. Kuck KH, Cappato R, Siebels J, Ruppel R. Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest: the Cardiac Arrest Study Hamburg (CASH) Circulation 2000;102:748-754.[Abstract/Free Full Text] 138. Connolly SJ, Hallstrom AP, Cappato R, et al. Meta-analysis of the implantable cardioverter defibrillator secondary prevention trials. AVID, CASH and CIDS studies. Antiarrhythmics vs Implantable Defibrillator study. Cardiac Arrest Study Hamburg. Canadian Implantable Defibrillator Study. Eur Heart J 2000;21:2071-2078.[Abstract/Free Full Text] 139. Bardy GH, Lee KL, Mark DB, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure N Engl J Med 2005;352:225-237.[Abstract/Free Full Text] 140. Kadish A, Dyer A, Daubert JP, et al. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy N Engl J Med 2004;350:2151-2158.[Abstract/Free Full Text] 141. Desai AS, Fang JC, Maisel WH, Baughman KL. Implantable defibrillators for the prevention of mortality in patients with nonischemic cardiomyopathy: a meta-analysis of randomized controlled trials JAMA 2004;292:2874-2879.[Abstract/Free Full Text] 142. Moss AJ, Hall WJ, Cannom DS, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med 1996;335:1933-1940.[Abstract/Free Full Text] 143. Zareba W, Moss AJ, Daubert JP, Hall WJ, Robinson JL, Andrews M. Implantable cardioverter defibrillator in high-risk long QT syndrome patients J Cardiovasc Electrophysiol 2003;14:337-341.[CrossRef][Web of Science][Medline] 144. Viskin S. Implantable cardioverter defibrillator in high-risk long QT syndrome patients J Cardiovasc Electrophysiol 2003;14:1130-1131.[CrossRef][Web of Science][Medline] 145. Goel AK, Berger S, Pelech A, Dhala A. Implantable cardioverter defibrillator therapy in children with long QT syndrome Pediatr Cardiol 2004;25:370-378.[Web of Science][Medline] 146. Monnig G, Kobe J, Loher A, et al. Implantable cardioverter-defibrillator therapy in patients with congenital long-QT syndrome: a long-term follow-up Heart Rhythm 2005;2:497-504.[CrossRef][Web of Science][Medline] 147. Goldenberg I, Mathew J, Moss AJ, et al. Corrected QT variability in serial electrocardiograms in long QT syndrome: the importance of the maximum corrected QT for risk stratification J Am Coll Cardiol 2006;48:1047-1052.[Abstract/Free Full Text] 148. Hobbs JB, Peterson DR, Moss AJ, et al. Risk of aborted cardiac arrest or sudden cardiac death during adolescence in the long-QT syndrome JAMA 2006;296:1249-1254.[Abstract/Free Full Text] 149. Silka MJ, Kron J, Dunnigan A, Dick M. Sudden cardiac death and the use of implantable cardioverter-defibrillators in pediatric patients. The Pediatric Electrophysiology Society. Circulation 1993;87:800-807.[Abstract/Free Full Text] 150. Hamilton RM, Dorian P, Gow RM, Williams WG. Five-year experience with implantable defibrillators in children Am J Cardiol 1996;77:524-526.[CrossRef][Web of Science][Medline] 151. Alexander ME, Cecchin F, Walsh EP, Triedman JK, Bevilacqua LM, Berul CI. Implications of implantable cardioverter defibrillator therapy in congenital heart disease and pediatrics J Cardiovasc Electrophysiol 2004;15:72-76.[Web of Science][Medline] 152. Choi GR, Porter CB, Ackerman MJ. Sudden cardiac death and channelopathies: a review of implantable defibrillator therapy Pediatr Clin North Am 2004;51:1289-1303.[CrossRef][Web of Science][Medline] 153. Karamlou T, Silber I, Lao R, et al. Outcomes after late reoperation in patients with repaired tetralogy of Fallot: the impact of arrhythmia and arrhythmia surgery Ann Thorac Surg 2006;81:1786-1793.[Abstract/Free Full Text] 154. Khairy P, Landzberg MJ, Gatzoulis MA, et al. Value of programmed ventricular stimulation after tetralogy of Fallot repair: a multicenter study Circulation 2004;109:1994-2000.[Abstract/Free Full Text] 155. Kammeraad JA, van Deurzen CH, Sreeram N, et al. Predictors of sudden cardiac death after Mustard or Senning repair for transposition of the great arteries J Am Coll Cardiol 2004;44:1095-1102.[Abstract/Free Full Text] 156. Dubin AM, Berul CI, Bevilacqua LM, et al. The use of implantable cardioverter-defibrillators in pediatric patients awaiting heart transplantation J Card Fail 2003;9:375-379.[CrossRef][Web of Science][Medline]
This article has been cited by other articles:
|
|
|
|
 
S.W. Parry, T. Chadwick, J.C. Gray, R.S. Bexton, M. Tynan, J.P. Bourke, and S. Nath
The intravenous adenosine test: a new test for the identification of bradycardia pacing indications? A pilot study in subjects with bradycardia pacing indications, vasovagal syncope and controls
QJM,
July 1, 2009;
102(7):
461 - 468.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Proclemer, M. Ghidina, D. Gregori, D. Facchin, L. Rebellato, P. Fioretti, and M. Brignole
Impact of the main implantable cardioverter-defibrillator trials in clinical practice: data from the Italian ICD Registry for the years 2005-07
Europace,
April 1, 2009;
11(4):
465 - 475.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. E. Epstein
Reply.
J. Am. Coll. Cardiol.,
March 31, 2009;
53(13):
1163 - 1163.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. E. Stone and A. Apinis
Current Perioperative Management of the Patient With a Cardiac Rhythm Management Device
Seminars in Cardiothoracic and Vascular Anesthesia,
March 1, 2009;
13(1):
31 - 43.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S W Parry, P Reeve, J Lawson, F E Shaw, J Davison, M Norton, R Frearson, S Kerr, and J L Newton
The Newcastle protocols 2008: an update on head-up tilt table testing and the management of vasovagal syncope and related disorders
Heart,
March 1, 2009;
95(5):
416 - 420.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Gheorghiade and P. S. Pang
Acute heart failure syndromes.
J. Am. Coll. Cardiol.,
February 17, 2009;
53(7):
557 - 573.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Tomaske, R. Pretre, M. Rahn, and U. Bauersfeld
Epicardial and pleural lead ICD systems in children and adolescents maintain functionality over 5 years
Europace,
October 1, 2008;
10(10):
1152 - 1156.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Tung, P. Zimetbaum, and M. E. Josephson
A Critical Appraisal of Implantable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death
J. Am. Coll. Cardiol.,
September 30, 2008;
52(14):
1111 - 1121.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. E. Poole, G. W. Johnson, A. S. Hellkamp, J. Anderson, D. J. Callans, M. H. Raitt, R. K. Reddy, F. E. Marchlinski, R. Yee, T. Guarnieri, et al.
Prognostic Importance of Defibrillator Shocks in Patients with Heart Failure
N. Engl. J. Med.,
September 4, 2008;
359(10):
1009 - 1017.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Guidelines: Implanted Devices for Treatment of Cardiac Arrhythmias
Journal Watch Cardiology,
June 11, 2008;
2008(611):
1 - 1.
[Full Text]
|
|
|
|
Top
ACC/AHA Task Force Members
Table of Contents