Cardiac resynchronization therapy indications
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Cardiac resynchronization therapy Microchapters |
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Treatment |
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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
Indications
The ACC / AHA guidelines indicate that CRT is recommended for those patients with all of the following: [1]
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1. Patients with an left ventricular ejection fraction less than or equal to 35%, QRS duration greater than or equal to 0.12 seconds, sinus rhythm and NYHA class 3 or 4 heart failure symptoms on optimal medical therapy (considered a class 1 indication with level A evidence) 2. Patients with an left ventricular ejection fraction less than or equal to 35%, QRS duration greater than or equal to 0.12 seconds, atrial fibrillation and NYHA class 3 or 4 heart failure symptoms on optimal medical therapy (considered a class 2a indication with level B evidence) 3. Patients with an left ventricular ejection fraction less than or equal to 35%, NYHA class 3 or 4 heart failure symptoms on optimal medical therapy and who have frequent dependence on ventricular pacing (considered a class 2a indication with level B evidence) 4. Patients with an left ventricular ejection fraction less than or equal to 35%, NYHA class 1 or 2 heart failure symptoms on optimal medical therapy and who are undergoing implantation of a permanent pacemaker and or ICD with anticipated frequent ventricular pacing (considered a class 2b indication with level C evidence) |
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References
- ↑ 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
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