ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities

В Slide Set выделены наиболее значимые изменения и дополнения

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Notable Changes in 2008 ACC/AHA/HRS Guidelines

1. ICD recommendations are combined into a single list because of overlap between primary and secondary indications.
2. Primary prevention ICD indications in nonischemic cardiomyopathy are clarified using data from SCD-HeFT (i.e., ischemic and nonischemic cardiomyopathies and LVEF ≤35%, NYHA II-III) for support.
3. Indications for ICD therapy in inherited arrhythmia syndromes and selected nonischemic cardiomyopathies are listed.
4. MADIT II indication (i.e., ischemic cardiomypathy and LVEF ≤30%, NYHA I) is now Class I, elevated from Class IIa.
5. EF criteria for primary prevention ICD indications are based on entry criteria for trials on which the recommendations are based.
6. Emphasized primary SCD prevention ICD recommendations apply only to patients
receiving optimal medical therapy and reasonable expectation of survival with good functional capacity for >1 year.
7. Independent risk assessment preceding ICD implantation is emphasized, including consideration of patient preference.
8. Optimization of pacemaker programming to minimize unneeded RV pacing is encouraged.
9. Pacemaker insertion is discouraged for asymptomatic bradycardia, particularly at night.
10. A section has been added that addresses ICD and pacemaker programming at end of life.