Sick sinus syndrome surgery: Difference between revisions

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/* 2008 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: Permanent Pacing in Sinus Node Dysfunction (DO NOT EDIT){{cite journal| author=Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS et al.|...
Hardik Patel (talk | contribs)
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5,256 edits
/* 2008 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: Permanent Pacing in Sinus Node Dysfunction (DO NOT EDIT){{cite journal| author=Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS et al.|...
Line 11: Line 11:
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|-
| bgcolor="LightGreen"|
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Permanent [[pacemaker]] implantation is indicated for sinus node dysfunction (SND) with documented symptomatic [[bradycardia]], including frequent sinus pauses that produce symptoms. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
<nowiki>"</nowiki>'''1.''' Permanent pacemaker implantation is indicated for sinus node dysfunction (SND) with documented symptomatic bradycardia, including frequent sinus pauses that produce symptoms. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|-
| bgcolor="LightGreen"|
| bgcolor="LightGreen"|<nowiki>”</nowiki>'''2.''' Permanent pacemaker implantation is indicated for symptomatic chronotropic incompetence. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
<nowiki>”</nowiki>'''2.''' Permanent pacemaker implantation is indicated for symptomatic chronotropic incompetence. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|-
| bgcolor="LightGreen"|
| bgcolor="LightGreen"|<nowiki>”</nowiki>'''3.''' Permanent pacemaker implantation is indicated for symptomatic sinus bradycardia that results from required drug therapy for medical conditions. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
<nowiki>”</nowiki>'''3.''' Permanent pacemaker implantation is indicated for symptomatic sinus bradycardia that results from required drug therapy for medical conditions. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}
|}


{|class="wikitable"
{|class="wikitable"
|-
|-
| colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]
| colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit)
|-
|-
| bgcolor="LightCoral"|
| bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Permanent pacemaker implantation is not indicated for SND in asymptomatic patients. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
<nowiki>"</nowiki>'''1.''' Permanent pacemaker implantation is not indicated for SND in asymptomatic patients. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|-
| bgcolor="LightCoral"|
| bgcolor="LightCoral"|<nowiki>”</nowiki>'''2.''' Permanent pacemaker implantation is not indicated for SND in patients for whom the symptoms suggestive of bradycardia have been clearly documented to occur in the absence of bradycardia. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
<nowiki>”</nowiki>'''2.''' Permanent pacemaker implantation is not indicated for SND in patients for whom the symptoms suggestive of
bradycardia have been clearly documented to occur in the absence of bradycardia. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|-
| bgcolor="LightCoral"|
| bgcolor="LightCoral"|<nowiki>"</nowiki>'''3.''' Permanent pacemaker implantation is not indicated for SND with symptomatic bradycardia due to nonessential drug therapy. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
<nowiki>"</nowiki>'''3.''' Permanent pacemaker implantation is not indicated for SND with symptomatic bradycardia due to nonessential drug therapy. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}
|}


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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
|-
| bgcolor="LemonChiffon"|
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Permanent pacemaker implantation is reasonable for SND with heart rate less than 40 bpm when a clear association between significant symptoms consistent with bradycardia and the actual presence of bradycardia has not been documented. ‘'([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
<nowiki>"</nowiki>'''1.''' Permanent pacemaker implantation is reasonable for SND with heart rate less than 40 bpm when a clear association between significant symptoms consistent with bradycardia and the actual presence of bradycardia has not been documented. ‘'([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|-
| bgcolor="LemonChiffon"|
| bgcolor="LemonChiffon"|<nowiki>”</nowiki>'''2.''' Permanent pacemaker implantation is reasonable for [[syncope]] of unexplained origin when clinically significant abnormalities of sinus node function are discovered or provoked in electrophysiological studies. ‘'([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
<nowiki>”</nowiki>'''2.''' Permanent pacemaker implantation is reasonable for syncope of unexplained origin when clinically significant abnormalities of sinus node function are discovered or provoked in electrophysiological studies. ‘'([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}
|}


Revision as of 15:42, 31 October 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Surgery and Device-Based Therapy

2008 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: Permanent Pacing in Sinus Node Dysfunction (DO NOT EDIT)[1]

Class I
"1. Permanent pacemaker implantation is indicated for sinus node dysfunction (SND) with documented symptomatic bradycardia, including frequent sinus pauses that produce symptoms. (Level of Evidence: C)"
”2. Permanent pacemaker implantation is indicated for symptomatic chronotropic incompetence. (Level of Evidence: C)"
”3. Permanent pacemaker implantation is indicated for symptomatic sinus bradycardia that results from required drug therapy for medical conditions. (Level of Evidence: C)"
Class III (No Benefit)
"1. Permanent pacemaker implantation is not indicated for SND in asymptomatic patients. (Level of Evidence: C)"
”2. Permanent pacemaker implantation is not indicated for SND in patients for whom the symptoms suggestive of bradycardia have been clearly documented to occur in the absence of bradycardia. (Level of Evidence: C)"
"3. Permanent pacemaker implantation is not indicated for SND with symptomatic bradycardia due to nonessential drug therapy. (Level of Evidence: C)"
Class IIa
"1. Permanent pacemaker implantation is reasonable for SND with heart rate less than 40 bpm when a clear association between significant symptoms consistent with bradycardia and the actual presence of bradycardia has not been documented. ‘'(Level of Evidence: C)"
”2. Permanent pacemaker implantation is reasonable for syncope of unexplained origin when clinically significant abnormalities of sinus node function are discovered or provoked in electrophysiological studies. ‘'(Level of Evidence: C)"
Class IIb

"1. Permanent pacemaker implantation may be considered in minimally symptomatic patients with chronic heart rate less than 40 bpm while awake. ‘'(Level of Evidence: C)"

References

  1. ↑ Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS; et al. (2008). "ACC/AHA/HRS 2008 guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: executive summary". Heart Rhythm. 5 (6): 934–55. doi:10.1016/j.hrthm.2008.04.015. PMID 18534377.

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