Cardiac Pacing and Cardiac Resynchronisation Therapy

Topics: Arrhythmias

Summary

Authors

Table of contents: Full Text (ESC Clinical Practice Guidelines)

Introduction

• Pacing in bradyarrhythmia, syncope, and other specific conditions, Cardiac resynchronization therapy

Pacing in arrhythmias

• Sinus node disease: Indications for pacing in sinus node disease, Choice of the pacing mode for patients with sinus node disease
• Atrioventricular and intraventricular conduction disturbances: Indications for pacing, Acquired atrioventricular block in special cases, Pacing for chronic bifascicular and trifascicular block, Indications for pacing, Choice of pacing mode for patients with atrioventricular block
• Recent myocardial infarction: Pacing in conduction disturbances related to acute myocardial infarction
• Reflex syncope: Carotid sinus syndrome, Vasovagal syncope, Adenosine-sensitive syncope
• Paediatrics and congenital heart diseases: Sinus node dysfunction and bradycardia–tachycardia syndrome at young ages, Congenital atrioventricular block, Atrioventricular block and cardiac surgery, Long QT syndrome, Adults with congenital heart disease, Device and mode selection
• Cardiac transplantation

Pacing for specific conditions

• Hypertrophic cardiomyopathy, The rationale for short atrioventricular delay DDD pacing in hypertrophic obstructive cardiomyopathy, Therapy delivery and programming, Indications for pacing in hypertrophic obstructive cardiomyopathy, Sleep apnoea

Cardiac resynchronization therapy in patients with heart failure

• Introduction: Rationale of cardiac resynchronization, Evidence-based clinical effects of cardiac resynchronization therapy, Cost-effectiveness issues, Unresolved issues, Programming recommendations
• Recommendations:
  • Recommendations for the use of cardiac resynchronization therapy by biventricular pacemaker (CRT-P) or biventricular pacemaker combined with an implantable cardioverter, defibrillator (CRT-D) in heart failure patients
  • Recommendations for the use of biventricular pacing in heart failure patients with a concomitant indication for permanent pacing
  • Recommendations for the use of an implantable cardioverter defibrillator combined with biventricular pacemaker (CRT-D) in heart failure patients with an indication for an implantable cardioverter defibrillator,
  • Recommendations for the use of biventricular pacing in heart failure patients with permanent atrial fibrillation 

Appendix A: pacemaker follow-up

• The main objectives, structure, and function of the pacemaker clinic Pre-discharge assessment and long-term follow-up methodology, Complications, failures, and side effects of pacemaker treatment, Special issues related to the paced patient’s life

Appendix B: technical considerations and requirements for implanting cardiac resynchronization therapy devices

• Technical and personnel requirements for centres intending to implant cardiac resynchronization therapy devices, Scheduling patient for cardiac resynchronization therapy, Characterization of coronary sinus anatomy, Requirements for the operating theatre, Personnel requirements during cardiac resynchronization therapy implantation, Clinical competence for implanting cardiac resynchronization therapy devices, Minimum training for competence, Maintenance of competence, Further practical cardiac resynchronization therapy implant recommendations, Follow-up, Long-term follow-up