Cardiac resynchronization therapy contraindications: Difference between revisions

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==Overview==
==Overview==
CRT is contraindicated in patients who are symptomatic or who have a limited life expectancy.
CRT is contraindicated in patients who are asymptomatic or who have a limited life expectancy.
 
==Contraindications==
==Contraindications==
* Patients who are asymptomatic with a reduced [[LVEF]] who have no other indications for pacing.
* Patients who are asymptomatic with a reduced [[LVEF]] who have no other indications for pacing.
* Patients who have a limited life expectancy due to a non-cardiac condition.
* Patients who have a limited life expectancy due to a non-cardiac condition.
* Patients who have a limited [[functional capacity]] due to a chronic non-cardiac condition.
* Patients who have a limited [[functional capacity]] due to a chronic non-cardiac condition.
==2012 American College of Cardiology Foundation/American Heart Association Task Force/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities <ref name="urlAmerican College of Cardiology Foundation | Journal of the American College of Cardiology | 2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm AbnormalitiesA Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines">{{cite web |url=http://content.onlinejacc.org/article.aspx?articleid=1357576 |title=American College of Cardiology Foundation &#124; Journal of the American College of Cardiology &#124; 2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm AbnormalitiesA Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines |format= |work= |accessdate=2012-09-11}}</ref> (DONOT EDIT)==
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==='''[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]'''===
'''1)''' CRT is not recommended for patients with NYHA class I or II symptoms and non-LBBB pattern with QRS duration less than 150 ms. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])


'''2)''' CRT is not indicated for patients whose comorbidities and/or frailty limit survival with good functional capacity to less than 1 year. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])
}}
==ACC / AHA Guidelines - Recommendations for Cardiac Resynchronization Therapy in Patients with Severe Systolic Heart Failure (DO NOT EDIT)<ref name="pmid18483207">{{cite journal |author=Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, 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, Smith SC, Jacobs AK, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Faxon DP, Halperin JL, Hiratzka LF, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura RA, Ornato JP, Page RL, Riegel B, Tarkington LG, Yancy CW |title=ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: 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): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons |journal=[[Circulation]] |volume=117 |issue=21 |pages=e350–408 |year=2008 |month=May |pmid=18483207 |doi=10.1161/CIRCUALTIONAHA.108.189742 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18483207 |issn= |accessdate=2011-01-15}}</ref>==
==ACC / AHA Guidelines - Recommendations for Cardiac Resynchronization Therapy in Patients with Severe Systolic Heart Failure (DO NOT EDIT)<ref name="pmid18483207">{{cite journal |author=Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, 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, Smith SC, Jacobs AK, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Faxon DP, Halperin JL, Hiratzka LF, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura RA, Ornato JP, Page RL, Riegel B, Tarkington LG, Yancy CW |title=ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: 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): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons |journal=[[Circulation]] |volume=117 |issue=21 |pages=e350–408 |year=2008 |month=May |pmid=18483207 |doi=10.1161/CIRCUALTIONAHA.108.189742 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18483207 |issn= |accessdate=2011-01-15}}</ref>==
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Latest revision as of 12:10, 5 May 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief:: Bhaskar Purushottam, M.D. [2] Synonyms and Keywords: CRT

Overview

CRT is contraindicated in patients who are asymptomatic or who have a limited life expectancy.

Contraindications

  • Patients who are asymptomatic with a reduced LVEF who have no other indications for pacing.
  • Patients who have a limited life expectancy due to a non-cardiac condition.
  • Patients who have a limited functional capacity due to a chronic non-cardiac condition.

ACC / AHA Guidelines - Recommendations for Cardiac Resynchronization Therapy in Patients with Severe Systolic Heart Failure (DO NOT EDIT)[1]

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)

2) CRT is not indicated for patients whose functional status and life expectancy are limited predominantly by chronic noncardiac conditions.(Level of Evidence: C)


References

  1. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, 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, Smith SC, Jacobs AK, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Faxon DP, Halperin JL, Hiratzka LF, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura RA, Ornato JP, Page RL, Riegel B, Tarkington LG, Yancy CW (2008). "ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: 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): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons". Circulation. 117 (21): e350–408. doi:10.1161/CIRCUALTIONAHA.108.189742. PMID 18483207. Retrieved 2011-01-15. Unknown parameter |month= ignored (help)

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