The guidelines cover two main areas: the first includes permanent pacing in bradyarrhythmias, syncope and other conditions such as hypertrophic obstructive cardiomyopathy, while the second refers to ventricular resynchronisation as an adjunct therapy in heart failure. Together with the guidelines for the management of ventricular arrhythmias and for the prevention of sudden cardiac death published last year, these guidelines provide a well structured approach to the use of devices for rhythm management.The section on the indications for resynchronisation is far more detailed than the key indication provided in the guidelines for the management of patients with heart failure, as it addresses several groups of patients that represent a specific problem for the electrophysiologist, such as those with atrial fibrillation.
Professor Panos Vardas, chairperson of the ESC Guidelines Task Force, notes: “Thanks to important developments in technology, not only patients with sinus node dysfunction and atrial ventricular conduction defects can benefit from pacing therapy; today, electrical stimulation has advanced to provide ventricular resynchronisation as an adjunctive therapy for selected patients with heart failure.”