Sick sinus syndrome guidelines: Difference between revisions
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==Overview== | ==Overview== | ||
==Guidelines== | ==ACC / AHA Guidelines- Recommendations for Permanent Pacing in Sinus Node Dysfunction (DO NOT EDIT) <ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, 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. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: 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). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>== | ||
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===Class I=== | |||
1. Permanent [[pacemaker]] implantation is indicated for [[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 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)'' | |||
===Class III=== | |||
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)''}} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 04:04, 28 August 2012
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Sick sinus syndrome Microchapters |
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Sick sinus syndrome guidelines On the Web |
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Risk calculators and risk factors for Sick sinus syndrome guidelines |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
ACC / AHA Guidelines- Recommendations for Permanent Pacing in Sinus Node Dysfunction (DO NOT EDIT) [1]
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Class I1. Permanent pacemaker implantation is indicated for 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 IIa1. 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 IIb1. Permanent pacemaker implantation may be considered in minimally symptomatic patients with chronic heart rate less than 40 bpm while awake. (Level of Evidence: C) Class III1. 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) |
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References
- ↑ Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, 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. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: 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). Circulation. 2008; 117: 2820–2840. PMID 18483207