Pocket Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy

Publication Date: August 2021
Chairperson: Michael Glikson and Jens Cosedis Nielsen

Table of Contents

• Introduction
• Background
• Evaluation of the patient with suspected or documented bradycardia or conduction-system disease
  • History and physical examination
  • Electrocardiogram
  • Non-invasive evaluation
  • Implantable monitors
  • Electrophysiology study
• Cardiac pacing for bradycardia and conduction system disease
  • Pacing for sinus node dysfunction
  • Pacing for atrioventricular block
  • Pacing for conduction disorders without atrioventricular block
  • Pacing for reflex syncope
  • Pacing for suspected (undocumented) bradycardia
• Cardiac Resynchronization Therapy
  • Epidemiology, prognosis, and pathophysiology of heart failure suitable for cardiac resynchronization therapy by biventricular pacing
  • Indication for cardiac resynchronization therapy: patients in sinus rhythm
  • Patients in atrial fibrillation
  • Patients with conventional pacemaker or implantable cardioverter defibrillator who need upgrade to cardiac resynchronization therapy
  • Pacing in patients with reduced left ventricular ejection fraction and a conventional indication for antibradycardia pacing
  • Benefit of adding implantable cardioverter defibrillator in patients with indications for cardiac resynchronization therapy
• Alternative site pacing
  • Septal pacing
  • His bundle pacing
  • Left bundle branch area pacing
  • Leadless pacing
• Indications for pacing in specific conditions
  • Pacing in acute myocardial infarction
  • Pacing after cardiac surgery and heart transplantation
  • Pacing after transcatheter aortic valve implantation
  • Cardiac pacing and cardiac resynchronization therapy in congenital heart disease
  • Pacing in hypertrophic cardiomyopathy
  • Pacing in rare diseases
• Special considerations on device implantations and perioperative management
• Complications of cardiac pacing and cardiac resynchronization therapy
• Management considerations
  • Magnetic resonance imaging in patients with implanted cardiac devices
  • Radiation therapy in pacemaker patients
  • Temporary pacing
  • Perioperative management in patients with cardiovascular implantable electronic devices
  • Cardiovascular implantable electronic devices and sports activity
  • When pacing is no longer indicated
  • Device follow-up
• Patient-centered care and shared decision-making in cardiac pacing and cardiac resynchronization therapy