Cardiac resynchronization therapy indications: Difference between revisions
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❑ [[Patients]] with an [[LVEF]] <_35% who have received a conventional [[pacemaker]] or an [[ICD]] and subsequently develop worsening [[HF]] despite [[optimal medical therapy]] and who have a significant proportion of [[RV pacing]] should be considered for upgrade to [[CRT]]<br> | ❑ [[Patients]] with an [[LVEF]] <_35% who have received a conventional [[pacemaker]] or an [[ICD]] and subsequently develop worsening [[HF]] despite [[optimal medical therapy]] and who have a significant proportion of [[RV pacing]] should be considered for upgrade to [[CRT]]<br> | ||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |''' | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''([[ESC guidelines classification scheme|Class IIb, Level of Evidence B]]) :''' | ||
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❑ [[CRT]] may be considered for [[symptomatic]] [[patients]] with [[HF]] in [[sinus rhythm]] with a [[QRS]] duration of 130-149 ms and non-[[LBBB]] [[QRS]] morphology and with [[LVEF]] <_35% despite [[optimal medical therapy]] in order to improve symptoms and reduce [[morbidity]] and [[mortality]]<br> | ❑ [[CRT]] may be considered for [[symptomatic]] [[patients]] with [[HF]] in [[sinus rhythm]] with a [[QRS]] duration of 130-149 ms and non-[[LBBB]] [[QRS]] morphology and with [[LVEF]] <_35% despite [[optimal medical therapy]] in order to improve symptoms and reduce [[morbidity]] and [[mortality]]<br> | ||
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Revision as of 06:22, 25 February 2022
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Cardiac resynchronization therapy Microchapters |
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Treatment |
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Cardiac resynchronization therapy indications On the Web |
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American Roentgen Ray Society Images of Cardiac resynchronization therapy indications |
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Directions to Hospitals Administering Cardiac resynchronization therapy |
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Risk calculators and risk factors for Cardiac resynchronization therapy indications |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Bhaskar Purushottam, M.D. [2], Hardik Patel, M.D.
Overview
Cardiac resynchronization therapy (CRT) with or without an implantable cardiac defibrillator (ICD) is indicated in patients who have an LVEF less than or equal to 35%, left bundle branch block (LBBB) with a QRS duration greater than or equal to 0.15 seconds, and normal sinus rhythm, for the treatment of NYHA functional Class III or ambulatory Class IV heart failure symptoms in patients whose medical therapy has been optimized.
Indications
2021 ESC Guideline for management of acute heart failure
Abbreviations:
AHF: Acute heart failure;
LMWH: Low-molecular-weight heparin;
PaO2: Partial pressure of oxygen ;
SBP: Systolic blood pressure;
SpO2: Transcutaneous oxygen saturation;
| Recommendations for cardiac resynchronization therapy implantation in patients with heart failure |
| (Class I, Level of Evidence A): |
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❑ CRT is recommended for symptomatic patients with HF in sinus rhythm with a QRS duration >_150 ms and LBBB QRS morphology and with LVEF <_35%
despite optimal medical therapy in order to improve symptoms and reduce morbidity and mortality. |
| (Class IIa, Level of Evidence B): |
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❑ CRT should be considered for symptomatic patients with HF in sinus rhythm with a QRS duration >_150 ms and non-LBBB QRS morphology and
with LVEF <_35% despite OMT in order to improve symptoms and reduce morbidity and mortality |
| (Class IIb, Level of Evidence B) : |
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❑ CRT may be considered for symptomatic patients with HF in sinus rhythm with a QRS duration of 130-149 ms and non-LBBB QRS morphology and with LVEF <_35% despite optimal medical therapy in order to improve symptoms and reduce morbidity and mortality |
| The above table adopted from 2021 ESC Guideline |
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References
- ↑ McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano G, Ruschitzka F, Kathrine Skibelund A (September 2021). "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure". Eur Heart J. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368. PMID 34447992 Check
|pmid=value (help). Vancouver style error: initials (help)