Class III recommendations in guidelines for cardiovascular medicine organized by year of guideline publication
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| Class III Recommendations in Guidelines for Cardiovascular Medicine |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Aparna Vuppala, M.B.B.S. [2]
Overview
There are 584 class III recommendations in guidelines published by American cardiology societies. Class III recommendations may be classified either by guideline name/year of publication or by recommendation level of evidence.
Organized by Year of Guideline Publication
The table shown below is a list of class III recommendations obtained from American guidelines for cardiovascular medicine. The list is organized by year of publication (from newest to oldest). Alternatively, to view the same list organized by guideline name/keyword, click here.
| Number | Year of Guideline Publication | Guideline Keywords | Title of Guideline | Class III Recommendation | Level of Evidence | Effect |
| 1 | 2015 | Secondary prevention after CABG | Secondary Prevention After Coronary Artery Bypass Graft Surgery | Among patients with LV dysfunction (EF <35%), ICD therapy is not recommended for the prevention of sudden cardiac death after CABG until 3 months of postoperative goal-directed medical therapy has been provided and persistent LV dysfunction has been confirmed. | A | N/A |
| 2 | 2015 | Secondary prevention after CABG | Secondary Prevention After Coronary Artery Bypass Graft Surgery | Warfarin should not be routinely prescribed after CABG for graft patency unless patients have other indications for long-term antithrombotic therapy (such as AF, venous thromboembolism, or a mechanical prosthetic valve). | A | N/A |
| 3 | 2015 | Hypertension in CAD | Treatment of Hypertension in Patients with Coronary Artery Disease | Drugs to avoid in patients with hypertension and HF with reduced ejection fraction are nondihydropyridine CCBs (such as verapamil and diltiazem), clonidine, moxonidine, and hydralazine without a nitrate. | B | Harm |
| 4 | 2015 | Secondary prevention after CABG | Secondary Prevention After Coronary Artery Bypass Graft Surgery | Discontinuation of statin therapy is not recommended before or after CABG unless patients have adverse reactions to therapy. | B | N/A |
| 5 | 2015 | Secondary prevention after CABG | Secondary Prevention After Coronary Artery Bypass Graft Surgery | Routine ACE inhibitor therapy is not recommended early after CABG among patients who do not have a history of recent MI, LV dysfunction, diabetes mellitus, or chronic kidney disease because it may lead to more harm than benefit and an unpredictable BP response. | B | N/A |
| 6 | 2015 | Secondary prevention after CABG | Secondary Prevention After Coronary Artery Bypass Graft Surgery | Antithrombotic alternatives to warfarin (dabigatran, apixaban, rivaroxaban) should not be routinely administered early after CABG until additional safety data have accrued. | C | N/A |
| 7 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Routine use of pulmonary artery catheterization in patients, even those with elevated risk, is not recommended. | A | No benefit |
| 8 | 2014 | Fetal cardiac disease | Diagnosis and Treatment of Fetal Cardiac Disease | Fetal medical therapy is of no benefit for fetuses with sinus bradycardia, irregular rhythms caused by extrasystolic beats. | A | N/A |
| 9 | 2014 | Fetal cardiac disease | Diagnosis and Treatment of Fetal Cardiac Disease | Referral for fetal cardiac evaluation is not indicated for maternal medications including SSRIs (other than paroxetine). | A | N/A |
| 10 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Antioxidant vitamin supplements (eg, vitamins E, C, or beta carotene) should not be used for secondary prevention in patients with NSTE-ACS. | A | No benefit |
| 11 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Folic acid, with or without vitamins B6 and B12, should not be used for secondary prevention in patients with NSTE-ACS. | A | No benefit |
| 12 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Hormone therapy with estrogen plus progestin, or estrogen alone, should not be given as new drugs for secondary prevention of coronary events to postmenopausal women after NSTE-ACS and should not be continued in previous users unless the benefits outweigh the estimated risks. | A | Harm |
| 13 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | In patients with NSTE-ACS (ie, without ST-elevation, true posterior MI, or left bundle-branch block not known to be old), intravenous fibrinolytic therapy should not be used. | A | Harm |
| 14 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | With contemporary troponin assays, creatine kinase myocardial isoenzyme (CK-MB) and myoglobin are not useful for diagnosis of ACS. | A | No benefit |
| 15 | 2014 | Postthrombotic syndrome | The Postthrombotic Syndrome - Evidence-Based Prevention, Diagnosis, and Treatment Strategies | Recommendations for Thrombolysis and Endovascular Approaches to Acute DVT for the Prevention of PTS Systemic thrombolysis is not recommended for the treatment of DVT. | A | N/A |
| 16 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | For patients with a cryptogenic ischemic stroke or TIA and a PFO without evidence for DVT, available data do not support a benefit for PFO closure. | A | N/A |
| 17 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | For patients with a recent (within 6 months) TIA or ischemic stroke ipsilateral to a stenosis or occlusion of the middle cerebral or carotid artery, EC/IC bypass surgery is not recommended. | A | N/A |
| 18 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | Routine supplementation with a single vitamin or combination of vitamins is not recommended. | A | N/A |
| 19 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | The combination of aspirin and clopidogrel, when initiated days to years after a minor stroke or TIA and continued for 2 to 3 years, increases the risk of hemorrhage relative to either agent alone and is not recommended for routine long-term secondary prevention after ischemic stroke or TIA. | A | N/A |
| 20 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | When the degree of stenosis is <50%, CEA and CAS are not recommended. | A | N/A |
| 21 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | Statin therapy is not indicated for prevention of hemodynamic progression of AS in patients with mild-to-moderate calcific valve disease (stages B to D). | A | No benefit |
| 22 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Administration of intravenous amiodarone, adenosine, digoxin (oral or intravenous), or nondihydropyridine calcium channel antagonists (oral or intravenous) in patients with Wolff-Parkinson-White syndrome who have pre-excited AF is potentially harmful because these drugs accelerate the ventricular rate. | B | Harm |
| 23 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Dofetilide therapy should not be initiated out of hospital because of the risk of excessive QT prolongation that can cause torsades de pointes. | B | Harm |
| 24 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Dronedarone should not be used for treatment of AF in patients with New York Heart Association class III and IV HF or patients who have had an episode of decompensated HF in the past 4 weeks. | B | Harm |
| 25 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Dronedarone should not be used to control the ventricular rate in patients with permanent AF as it increases the risk of the combined endpoint of stroke, myocardial infarction, systemic embolism, or cardiovascular death. | B | Harm |
| 26 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Dronedarone, in specific, for rhythm control should not be continued when AF becomes permanent. | B | Harm |
| 27 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | In patients with pre-excitation and AF, digoxin, nondihydropyridine calcium channel antagonists, or intravenous amiodarone should not be administered as they may increase the ventricular response and may result in ventricular fibrillation. | B | Harm |
| 28 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | The direct thrombin inhibitor dabigatran should not be used in patients with AF and a mechanical heart valve. | B | Harm |
| 29 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Therapy with an ACE inhibitor, ARB, or statin is not beneficial for primary prevention of AF in patients without cardiovascular disease. | B | No benefit |
| 30 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Alpha-2 agonists for prevention of cardiac events are not recommended in patients who are undergoing noncardiac surgery. | B | No benefit |
| 31 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Beta-blocker therapy should not be started on the day of surgery. | B | Harm |
| 32 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Elective noncardiac surgery should not be performed within 30 days after BMS implantation or within 12 months after DES implantation in patients in whom dual antiplatelet therapy will need to be discontinued perioperatively. | B | Harm |
| 33 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | For patients with a low risk of perioperative MACE, further testing is not recommended before the planned operation. | B | No benefit |
| 34 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | It is not recommended that routine coronary revascularization be performed before noncardiac surgery exclusively to reduce perioperative cardiac events. | B | No benefit |
| 35 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Prophylactic intravenous nitroglycerin is not effective in reducing myocardial ischemia in patients undergoing noncardiac surgery. | B | No benefit |
| 36 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Routine postoperative screening with troponin levels in unselected patients without signs or symptoms suggestive of myocardial ischemia or MI is not useful for guiding perioperative management. | B | No benefit |
| 37 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Routine preoperative evaluation of LV function is not recommended. | B | No benefit |
| 38 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Routine preoperative resting 12-lead ECG is not useful for asymptomatic patients undergoing low-risk surgical procedures. | B | No benefit |
| 39 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Routine screening with noninvasive stress testing is not useful for patients undergoing low-risk noncardiac surgery. | B | No benefit |
| 40 | 2014 | Cardiovascular risk assessment | ACC/AHA Guideline on the Assessment of Cardiovascular Risk | The contribution of ApoB, chronic kidney disease, albuminuria, and cardiorespiratory fitness to risk assessment for a first ASCVD event is uncertain at present. | B | No benefit |
| 41 | 2014 | Fetal cardiac disease | Diagnosis and Treatment of Fetal Cardiac Disease | Referral for fetal cardiac evaluation is not indicated for isolated CHD in a relative other than first or second degree. | B | N/A |
| 42 | 2014 | Fetal cardiac disease | Diagnosis and Treatment of Fetal Cardiac Disease | Referral for fetal cardiac evaluation is not indicated for maternal gestational DM with HbA1c <6% or isolated CHD in a relative other than first or second degree. | B | N/A |
| 43 | 2014 | Fetal cardiac disease | Diagnosis and Treatment of Fetal Cardiac Disease | Referral for fetal cardiac evaluation is not indicated for vitamin K agonists (although fetal survey is recommended). | B | N/A |
| 44 | 2014 | Fetal cardiac disease | Diagnosis and Treatment of Fetal Cardiac Disease | Fetal medical therapy is of no benefit for fetuses with intermittent SVT without fetal compromise or hydrops, or intermittent VT < 200 bpm (accelerated ventricular rhythm) without fetal compromise or hydrops fetalis. | B | N/A |
| 45 | 2014 | Fetal cardiac disease | Diagnosis and Treatment of Fetal Cardiac Disease | Specialized delivery room care is not needed for fetuses with shunt lesions, most ductal-dependent lesions, or controlled arrhythmias. | B | N/A |
| 46 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | A strategy of routine blood transfusion in hemodynamically stable patients with NSTE-ACS and hemoglobin levels greater than 8 g/dL is not recommended. | B | No benefit |
| 47 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Administration of intravenous beta blockers is potentially harmful in patients with NSTE-ACS who have risk factors for shock. | B | Harm |
| 48 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | An early invasive strategy (ie, diagnostic angiography with intent to perform revascularization) is not recommended especially in women with acute chest pain and a low likelihood of ACS who are troponin-negative. | B | No benefit |
| 49 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Fondaparinux should not be used as the sole anticoagulant to support PCI in patients with NSTE-ACS due to an increased risk of catheter thrombosis. | B | Harm |
| 50 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Immediate-release nifedipine should not be administered to patients with NSTE-ACS in the absence of beta-blocker therapy. | B | Harm |
| 51 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Nitrates should not be administered to patients with NSTE-ACS who recently received a phosphodiesterase inhibitor, especially within 24 hours of sildenafil or vardenafil, or within 48 hours of tadalafil. | B | Harm |
| 52 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Nonsteroidal anti-inflammatory drugs (NSAIDs) (except aspirin) should not be initiated and should be discontinued during hospitalization for NSTE-ACS because of the increased risk of MACE associated with their use. | B | Harm |
| 53 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | NSAIDs with increasing degrees of relative COX-2 selectivity should not be administered to patients with NSTE-ACS and chronic musculoskeletal discomfort when therapy with acetaminophen, nonacetylated salicylates, tramadol, small doses of narcotics, or nonselective NSAIDs provide acceptable pain relief. | B | Harm |
| 54 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Prasugrel should not be administered to patients with a prior history of stroke or transient ischemic attack. | B | Harm |
| 55 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Women with NSTE-ACS and low-risk features should not undergo early invasive treatment because of the lack of benefit and the possibility of harm. | B | No benefit |
| 56 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | For patients with a stroke or TIA attributable to moderate stenosis (50%–69%) of a major intracranial artery, angioplasty or stenting is not recommended given the low rate of stroke on medical management and the inherent periprocedural risk of endovascular treatment. | B | N/A |
| 57 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | For patients with stroke or TIA attributable to 50% to 99% stenosis of a major intracranial artery, EC/IC bypass surgery is not recommended. | B | N/A |
| 58 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | For patients with stroke or TIA attributable to severe stenosis (70%–99%) of a major intracranial artery, stenting with the Wingspan stent system is not recommended as an initial treatment, even for patients who were taking an antithrombotic agent at the time of the stroke or TIA. | B | N/A |
| 59 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | In adults with a recent ischemic stroke or TIA who are known to have mild to moderate hyperhomocysteinemia, supplementation with folate, vitamin B6, and vitamin B12 safely reduces levels of homocysteine but has not been shown to prevent stroke. | B | N/A |
| 60 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | Routine, long term follow-up imaging of the extracranial carotid circulation with carotid duplex ultrasonography is not recommended. | B | N/A |
| 61 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | ACE inhibitors and ARBs should not be given to pregnant patients with valve regurgitation. | B | Harm |
| 62 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | ACE inhibitors and ARBs should not be given to pregnant patients with valve stenosis. | B | Harm |
| 63 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | Anticoagulant therapy with oral direct thrombin inhibitors or anti-Xa agents should not be used in patients with mechanical valve prostheses. | B | Harm |
| 64 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | Catheter ablation for AF should not be performed in patients with severe MR when mitral repair or replacement is anticipated, with preference for the combined maze procedure plus mitral valve repair. | B | No benefit |
| 65 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | Exercise testing should not be performed in symptomatic patients with AS when the aortic velocity is 4.0 m per second or greater or mean pressure gradient is 40 mm Hg or higher (stage D). | B | Harm |
| 66 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | LMWH should not be administered to pregnant patients with mechanical prostheses unless antiXa levels are monitored 4 to 6 hours after administration. | B | Harm |
| 67 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | MVR should not be performed for the treatment of isolated severe primary MR limited to less than one half of the posterior leaflet unless mitral valve repair has been attempted and was unsuccessful. | B | Harm |
| 68 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | Prophylaxis against IE is not recommended in patients with VHD who are at risk of IE for nondental procedures (e.g., TEE, esophagogastroduodenoscopy, colonoscopy, or cystoscopy) in the absence of active infection. | B | No benefit |
| 69 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | TAVR is not recommended in patients in whom existing comorbidities would preclude the expected benefit from correction of AS. | B | No benefit |
| 70 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | Vasodilator therapy is not indicated for normotensive asymptomatic patients with chronic primary MR (stages B and C1) and normal systolic LV function. | B | No benefit |
| 71 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Antiarrhythmic drugs for rhythm control should not be continued when AF becomes permanent. | C | Harm |
| 72 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Antiarrhythmic drugs in for rhythm control should not be continued when AF becomes permanent. | C | Harm |
| 73 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | AV nodal ablation with permanent ventricular pacing should not be performed to improve rate control without prior attempts to achieve rate control with medications. | C | Harm |
| 74 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | Nondihydropyridine calcium channel antagonists should not be used in patients with decompensated HF as these may lead to further hemodynamic compromise. | C | Harm |
| 75 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | The direct thrombin inhibitor dabigatran and the factor Xa inhibitor rivaroxaban are not recommended in patients with AF and end-stage CKD or on dialysis because of the lack of evidence from clinical trials regarding the balance of risks and benefits. | C | No benefit |
| 76 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Elective noncardiac surgery should not be performed within 14 days of balloon angioplasty in patients in whom aspirin will need to be discontinued perioperatively. | C | Harm |
| 77 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Initiation or continuation of aspirin is not beneficial in patients undergoing elective noncardiac noncarotid surgery who have not had previous coronary stenting (Level of Evidence B), unless the risk of ischemic events outweighs the risk of surgical bleeding. | C | No benefit |
| 78 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | Routine preoperative coronary angiography is not recommended. | C | No benefit |
| 79 | 2014 | Cardiac evaluation for noncardiac surgery | ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery | The routine use of intraoperative transesophageal echocardiogram during noncardiac surgery to screen for cardiac abnormalities or to monitor for myocardial ischemia is not recommended in patients without risk factors or procedural risks for significant hemodynamic, pulmonary, or neurological compromise. | C | No benefit |
| 80 | 2014 | ECG screening test | Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardiovascular Disease in Healthy General Populations of Young People (12–25 Years of Age) | Mandatory and universal mass screening with 12-lead ECGs in large general populations of young healthy people 12 to 25 years of age (including on a national basis in the United States) to identify genetic/congenital and other cardiovascular abnormalities is not recommended for athletes and nonathletes alike. | C | No benefit |
| 81 | 2014 | Fetal cardiac disease | Diagnosis and Treatment of Fetal Cardiac Disease | Referral for fetal cardiac evaluation is not indicated for maternal infection other than rubella with seroconversion only. | C | N/A |
| 82 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | An early invasive strategy (ie, diagnostic angiography with intent to perform revascularization) is not recommended in patients (both men and women) with acute chest pain and a low likelihood of ACS who are troponin-negative. | C | No benefit |
| 83 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | An early invasive strategy (ie, diagnostic angiography with intent to perform revascularization) is not recommended in patients with extensive comorbidities (eg, hepatic, renal, pulmonary failure; cancer), in whom the risks of revascularization and comorbid conditions are likely to outweigh the benefits of revascularization. | C | No benefit |
| 84 | 2014 | NSTE ACS (NSTEMI and unstable angina) | AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes | Beta blockers should not be administered to patients with ACS with a recent history of cocaine or methamphetamine use who demonstrate signs of acute intoxication due to the risk of potentiating coronary spasm. | C | Harm |
| 85 | 2014 | PCI without on-site surgical back-up | SCAI/ACC/AHA Update on Percutaneous Coronary Intervention Without On-Site Surgical Backup | It is not recommended to perform a primary or elective PCI in hospitals without on-site cardiac surgery without a proven plan for rapid transport to a cardiac surgery operating room in a nearby hospital and without appropriate hemodynamic support capability for transfers. | C | N/A |
| 86 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | For patients with rheumatic mitral valve disease who are prescribed VKA therapy after an ischemic stroke or TIA, antiplatelet therapy should not be routinely added. | C | N/A |
| 87 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | Routine screening for hyperhomocysteinemia among patients with a recent ischemic stroke or TIA is not indicated. | C | N/A |
| 88 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | Routine testing for antiphospholipid antibodies is not recommended for patients with ischemic stroke or TIA who have no other manifestations of the antiphospholipid antibody syndrome and who have an alternative explanation for their ischemic event, such as atherosclerosis, carotid stenosis, or AF. | C | N/A |
| 89 | 2014 | Secondary prevention of stroke | Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | Surgical endarterectomy of aortic arch plaque for the purposes of secondary stroke prevention is not recommended. | C | N/A |
| 90 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | Patients with known VHD should not receive antibiotics before blood cultures are obtained for unexplained fever. | C | Harm |
| 91 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | Valve operation should not be performed in pregnant patients with valve stenosis in the absence of severe HF symptoms. | C | Harm |
| 92 | 2014 | Valvular heart disease | AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease | Valve operations should not be performed in pregnant patients with valve regurgitation in the absence of severe intractable HF symptoms. | C | Harm |
| 93 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | AF catheter ablation should not be performed in patients who cannot be treated with anticoagulant therapy during and after the procedure. | C | Harm |
| 94 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | AF catheter ablation to restore sinus rhythm should not be performed with the sole intent of obviating the need for anticoagulation. | C | Harm |
| 95 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | AV node ablation should not be performed without a pharmacological trial to achieve ventricular rate control. | C | Harm |
| 96 | 2014 | Atrial fibrillation | AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation | For rate control, intravenous nondihydropyridine calcium channel antagonists, intravenous beta blockers, and dronedarone should not be administered to patients with decompensated HF. | C | Harm |
| 97 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | At present, no pharmacological agents with putative neuroprotective actions have demonstrated efficacy in improving outcomes after ischemic stroke, and therefore, other neuroprotective agents are not recommended. | A | N/A |
| 98 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Because of lack of evidence of efficacy and the potential to increase the risk of infectious complications, corticosteroids (in conventional or large doses) are not recommended for treatment of cerebral edema and increased ICP complicating ischemic stroke. | A | N/A |
| 99 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Frank hypodensity on NECT may increase the risk of hemorrhage with fibrinolysis and should be considered in treatment decisions. If frank hypodensity involves more than one third of the MCA territory, intravenous rtPA treatment should be withheld. | A | N/A |
| 100 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Hemodilution by volume expansion is not recommended for treatment of patients with acute ischemic stroke. | A | N/A |
| 101 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | The administration of vasodilatory agents, such as pentoxifylline, is not recommended for treatment of patients with acute ischemic stroke. | A | N/A |
| 102 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | The intravenous administration of streptokinase for treatment of stroke is not recommended. | A | N/A |
| 103 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Urgent anticoagulation for the management of noncerebrovascular conditions is not recommended for patients with moderate-to-severe strokes because of an increased risk of serious intracranial hemorrhagic complications. | A | Harm |
| 104 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Urgent anticoagulation, with the goal of preventing early recurrent stroke, halting neurological worsening, or improving outcomes after acute ischemic stroke, is not recommended for treatment of patients with acute ischemic stroke. | A | N/A |
| 105 | 2013 | Dyslipidemia | ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults | CK should not be routinely measured in individuals receiving statin therapy. | A | No benefit |
| 106 | 2013 | Dyslipidemia | ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults | It may be harmful to initiate simvastatin at 80 mg daily or increase the dose of simvastatin to 80 mg daily. | A | Harm |
| 107 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Calcium channel–blocking drugs are not recommended as routine treatment for patients with HFrEF. | A | No benefit |
| 108 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Statins are not beneficial as adjunctive therapy when prescribed solely for the diagnosis of HF in the absence of other indications for their use. | A | No benefit |
| 109 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Aspirin is not recommended as a substitute for other acute interventions for treatment of stroke, including intravenous rtPA. | B | N/A |
| 110 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Data on the utility of hyperbaric oxygen are inconclusive, and some data imply that the intervention may be harmful. Thus, with the exception of stroke secondary to air embolization, this intervention is not recommended for treatment of patients with acute ischemic stroke. | B | N/A |
| 111 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Initiation of anticoagulant therapy within 24 hours of treatment with intravenous rtPA is not recommended. | B | N/A |
| 112 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Routine use of nutritional supplements has not been shown to be beneficial. | B | N/A |
| 113 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Routine use of prophylactic antibiotics has not been shown to be beneficial. | B | N/A |
| 114 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Supplemental oxygen is not recommended in nonhypoxic patients with acute ischemic stroke. | B | N/A |
| 115 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | The administration of other intravenous antiplatelet agents that inhibit the glycoprotein IIb/IIIa receptor is not recommended. | B | N/A |
| 116 | 2013 | Dyslipidemia | ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults | BAS should not be used in individuals with baseline fasting triglyceride levels ≥300 mg/dL or type III hyperlipoproteinemia, because severe triglyceride elevations might occur. (A fasting lipid panel should be obtained before BAS is initiated, 3 months after initiation, and every 6 to 12 months thereafter.) | B | Harm |
| 117 | 2013 | Dyslipidemia | ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults | Fenofibrate should not be used if moderate or severe renal impairment, defined as eGFR <30 mL/min per 1.73 m2, is present. If eGFR is between 30 and 59 mL/min per 1.73 m2, the dose of fenofibrate should not exceed 54 mg/day. If, during follow-up, the eGFR decreases persistently to ≤30 mL/min per 1.73 m2, fenofibrate should be discontinued. | B | Harm |
| 118 | 2013 | Dyslipidemia | ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults | Gemfibrozil should not be initiated in patients on statin therapy because of an increased risk for muscle symptoms and rhabdomyolysis. | B | Harm |
| 119 | 2013 | Dyslipidemia | ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults | Niacin should not be used if patients develop either hepatic transaminase elevations higher than 2 to 3 times ULN, persistent severe cutaneous symptoms, persistent hyperglycemia, acute gout or unexplained abdominal pain or gastrointestinal symptoms, or new-onset atrial fibrillation or weight loss. | B | Harm |
| 120 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Anticoagulation is not recommended in patients with chronic HFrEF without AF, a prior thromboembolic event, or a cardioembolic source. | B | No benefit |
| 121 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | CRT is not recommended for patients with NYHA class I or II symptoms and non-LBBB pattern with a QRS duration of less than 150 ms. | B | No benefit |
| 122 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Drugs known to adversely affect the clinical status of patients with current or prior symptoms of HFrEF are potentially harmful and should be avoided or withdrawn whenever possible (eg, most antiarrhythmic drugs, most calcium channel–blocking drugs [except amlodipine], nonsteroidal anti-inflammatory drugs, or thiazolidinediones). | B | Harm |
| 123 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Inappropriate use of aldosterone receptor antagonists is potentially harmful because of life-threatening hyperkalemia or renal insufficiency when serum creatinine is greater than 2.5 mg/dL in men or greater than 2.0 mg/dL in women (or estimated glomerular filtration rate <30 mL/min/1.73 m2), and/or potassium greater than 5.0 mEq/L. | B | Harm |
| 124 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Long-term use of either continuous or intermittent, intravenous parenteral positive inotropic agents, in the absence of specific indications or for reasons other than palliative care, is potentially harmful in the patient with HF. | B | Harm |
| 125 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Nutritional supplements as treatment for HF are not recommended in patients with current or prior symptoms of HFrEF. | B | No benefit |
| 126 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Routine repeat measurement of LV function assessment in the absence of clinical status change or treatment interventions should not be performed. | B | No benefit |
| 127 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Routine use of invasive hemodynamic monitoring is not recommended in normotensive patients with acute decompensated HF and congestion with symptomatic response to diuretics and vasodilators. | B | No benefit |
| 128 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Use of parenteral inotropes in normotensive patients with acute decompensated HF without evidence of decreased organ perfusion is not recommended. | B | Harm |
| 129 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Use of parenteral inotropic agents in hospitalized patients without documented severe systolic dysfunction, low blood pressure, or impaired perfusion and evidence of significantly depressed cardiac output, with or without congestion, is potentially harmful. | B | Harm |
| 130 | 2013 | STEMI | ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction | Delayed PCI of a totally occluded infarct artery greater than 24 hours after STEMI should not be performed in asymptomatic patients with 1- or 2-vessel disease if they are hemodynamically and electrically stable and do not have evidence of severe ischemia | B | No benefit |
| 131 | 2013 | STEMI | ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction | DES should not be used in primary PCI for patients with STEMI who are unable to tolerate or comply with a prolonged course of DAPT because of the increased risk of stent thrombosis with premature discontinuation of one or both agents. | B | Harm |
| 132 | 2013 | STEMI | ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction | Fibrinolytic therapy should not be administered to patients with ST depression except when a true posterior (inferobasal) MI is suspected or when associated with ST elevation in lead aVR. | B | Harm |
| 133 | 2013 | STEMI | ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction | Fondaparinux should not be used as the sole anticoagulant to support primary PCI because of the risk of catheter thrombosis. | B | Harm |
| 134 | 2013 | STEMI | ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction | Glucocorticoids and nonsteroidal anti-inflammatory drugs are potentially harmful for treatment of pericarditis after STEMI | B | Harm |
| 135 | 2013 | STEMI | ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction | PCI should not be performed in a noninfarct artery at the time of primary PCI in patients with STEMI who are hemodynamically stable. | B | Harm |
| 136 | 2013 | STEMI | ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction | Prasugrel should not be administered to patients with a history of prior stroke or transient ischemic attack. | B | Harm |
| 137 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Prophylactic use of anticonvulsants is not recommended. | C | N/A |
| 138 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | Routine placement of indwelling bladder catheters is not recommended because of the associated risk of catheter-associated UTIs. | C | N/A |
| 139 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | The administration of aspirin (or other antiplatelet agents) as an adjunctive therapy within 24 hours of intravenous fibrinolysis is not recommended. | C | N/A |
| 140 | 2013 | Acute ischemic stroke | Guidelines for the Early Management of Patients With Acute Ischemic Stroke | The use of intravenous rtPA in patients taking direct thrombin inhibitors or direct factor Xa inhibitors may be harmful and is not recommended unless sensitive laboratory tests such as aPTT, INR, platelet count, and ECT, TT, or appropriate direct factor Xa activity assays are normal, or the patient has not received a dose of these agents for >2 days (assuming normal renal metabolizing function). Similar consideration should be given to patients being considered for intra-arterial rtPA. | C | Harm |
| 141 | 2013 | Cardiovascular toxicity in cancer therapy | Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy | The routine use of signal-averaged electrocardiography is not recommended for the evaluation of patients presenting with heart failure. | C | N/A |
| 142 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | CRT is not indicated for patients whose comorbidities and/or frailty limit survival with good functional capacity to less than 1 year. | C | No benefit |
| 143 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Endomyocardial biopsy should not be performed in the routine evaluation of patients with HF. | C | Harm |
| 144 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Hormonal therapies other than to correct deficiencies are not recommended for patients with current or prior symptoms of HFrEF. | C | No benefit |
| 145 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Long-term use of infused positive inotropic drugs is potentially harmful for patients with HFrEF, except as palliation for patients with end-stage disease who cannot be stabilized with standard medical treatment. | C | Harm |
| 146 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Nondihydropyridine calcium channel blockers with negative inotropic effects may be harmful in asymptomatic patients with low LVEF and no symptoms of HF after MI. | C | Harm |
| 147 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Routine combined use of an ACE inhibitor, ARB, and aldosterone antagonist is potentially harmful for patients with HFrEF. | C | Harm |
| 148 | 2013 | Heart failure | ACCF/AHA Guideline for the Management of Heart Failure | Routine use of nutritional supplements is not recommended for patients with HFpEF. | C | No benefit |
| 149 | 2013 | Site competence to PCI | ACCF/AHA/SCAI Update of the Clinical Competence Statement on Coronary Artery Interventional Procedures | Primary or elective PCI should not be performed in hospitals without onsite cardiac surgery capabilities without a proven plan for rapid transport to a cardiac surgery operating room in a nearby hospital or without hemodynamic support capability for transfer. | N/A | N/A |
| 150 | 2012 | Evaluation for kidney and liver transplantation | Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates | Initiating beta-blocker therapy in beta-blocker–naïve patients the night before and/or the morning of noncardiac surgery is not recommended. | A | N/A |
| 151 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Estrogen therapy is not recommended in postmenopausal women with SIHD with the intent of reducing cardiovascular risk or improving clinical outcomes. | A | No benefit |
| 152 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Treatment of elevated homocysteine with folate or vitamins B6 and B12 is not recommended with the intent of reducing cardiovascular risk or improving clinical outcomes in patients with SIHD. | A | No benefit |
| 153 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Vitamin C, vitamin E, and beta-carotene supplementation are not recommended with the intent of reducing cardiovascular risk or improving clinical outcomes in patients with SIHD. | A | No benefit |
| 154 | 2012 | Device-based therapy (Update) | ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | CRT is not recommended for patients with NYHA class I or II symptoms and non-LBBB pattern with QRS duration less than 150 ms. | B | N/A |
| 155 | 2012 | Evaluation for kidney and liver transplantation | Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates | Consistent with NKF/KDOQI guidelines, given the risks of pharmacological therapy to raise HDL (in the absence of high LDL or high triglycerides), it is not recommended to initiate such therapy in patients with kidney disease. | B | N/A |
| 156 | 2012 | Evaluation for kidney and liver transplantation | Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates | It is not recommended that routine prophylactic coronary revascularization be performed in patients with stable CAD, absent symptomatic or survival indications, before transplantation surgery. | B | N/A |
| 157 | 2012 | Evaluation for kidney and liver transplantation | Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates | Lipid-lowering therapy specifically for the goals of preventing acute rejection or preserving allograft function is not recommended. | B | N/A |
| 158 | 2012 | Evaluation for kidney and liver transplantation | Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates | Transplantation surgery is not recommended within 4 weeks of coronary revascularization with balloon angioplasty. | B | N/A |
| 159 | 2012 | Evaluation for kidney and liver transplantation | Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates | Transplantation surgery within 3 months of BMS placement and within 12 months of DES placement is not recommended, particularly if the anticipated time of poststent dual antiplatelet therapy will be shortened. | B | N/A |
| 160 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Nitrates should not be administered to patients within 24 hours of sildenafil or vardenafil administration or within 48 hours of tadalafil administration. | B | N/A |
| 161 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | PDE5 inhibitors should not be used in patients receiving nitrate therapy. | B | N/A |
| 162 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | CABG or PCI should not be performed with the primary or sole intent to improve survival in patients with SIHD with 1 or more coronary stenoses that are not anatomically or functionally significant (eg, <70% diameter non–left main coronary artery stenosis, FFR >0.80, no or only mild ischemia on noninvasive testing), involve only the left circumflex or right coronary artery, or subtend only a small area of viable myocardium. | B | Harm |
| 163 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | CCTA should not be performed for assessment of native coronary arteries with known moderate or severe calcification or with coronary stents less than 3 mm in diameter in patients with known SIHD who have new or worsening symptoms not consistent with UA, irrespective of ability to exercise. | B | No benefit |
| 164 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Coronary angiography for risk assessment is not recommended in patients with SIHD who elect not to undergo revascularization or who are not candidates for revascularization because of comorbidities or individual preferences. | B | No benefit |
| 165 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Coronary angiography is not recommended to further assess risk in patients with SIHD who have preserved LV function (EF >50%) and low-risk criteria on noninvasive testing. | B | No benefit |
| 166 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Dipyridamole is not recommended as antiplatelet therapy for patients with SIHD. | B | No benefit |
| 167 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | PCI to improve survival should not be performed in stable patients with significant (≥50% diameter stenosis) unprotected left main CAD who have unfavorable anatomy for PCI and who are good candidates for CABG. | B | Harm |
| 168 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | PCI with coronary stenting (bare-metal stent or drug-eluting stent) should not be performed if the patient is not likely to be able to tolerate and comply with dual antiplatelet therapy for the appropriate duration of treatment based on the type of stent implanted. | B | Harm |
| 169 | 2012 | Ankle-brachial index | Measurement and Interpretation of the Ankle-Brachial Index | The use of the cuff over a distal bypass should be avoided (risk of bypass thrombosis). | C | Harm |
| 170 | 2012 | Ankle-brachial index | Measurement and Interpretation of the Ankle-Brachial Index | During follow-up, the ABI should not be used alone to follow revascularized patients. | C | No benefit |
| 171 | 2012 | Device-based therapy (Update) | ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | CRT is not indicated for patients whose comorbidities and/or frailty limit survival with good functional capacity to less than 1 year. | C | N/A |
| 172 | 2012 | Evaluation for kidney and liver transplantation | Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates | Administration of dopamine to the kidney transplant recipient is not beneficial for renal allograft function, and administration may be harmful. | C | N/A |
| 173 | 2012 | Mechanical circulatory support | Recommendations for the Use of Mechanical Circulatory Support Device Strategies and Patient Selection | Long-term mechanical circulatory support is not recommended in patients with advanced kidney disease in whom renal function is unlikely to recover despite improved hemodynamics and who are therefore at high risk for progression to renal replacement therapy. | C | N/A |
| 174 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Cardiovascular drugs that can improve symptoms and survival should not be withheld because of concerns about the potential impact on sexual function. | C | N/A |
| 175 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Patients with CVD who experience cardiovascular symptoms precipitated by sexual activity should defer sexual activity until their condition is stabilized and optimally managed. | C | N/A |
| 176 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Patients with unstable, decompensated, and/or severe symptomatic CVD should defer sexual activity until their condition is stabilized and optimally managed. | C | N/A |
| 177 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Sexual activity is not advised for patients with decompensated or advanced (NYHA class III or IV) heart failure until their condition is stabilized and optimally managed. | C | N/A |
| 178 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Sexual activity is not advised for patients with severe or significantly symptomatic valvular disease until their condition is stabilized and optimally managed. | C | N/A |
| 179 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Sexual activity should be deferred for patients with atrial fibrillation and poorly controlled ventricular rate, uncontrolled or symptomatic supraventricular arrhythmias, and spontaneous or exercise-induced ventricular tachycardia until the condition is optimally managed. | C | N/A |
| 180 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Sexual activity should be deferred for patients with HCM who are severely symptomatic until their condition is stabilized. | C | N/A |
| 181 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Sexual activity should be deferred for patients with unstable or refractory angina until their condition is stabilized and optimally managed. | C | N/A |
| 182 | 2012 | Sexual activity and cardiovascular disease | Sexual Activity and Cardiovascular Disease | Sexual activity should be deferred in patients with an ICD who have received multiple shocks until the causative arrhythmia is stabilized and optimally controlled. | C | N/A |
| 183 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | A request to perform either more than 1 stress imaging study or a stress imaging study and a CCTA at the same time is not recommended for risk assessment in patients with SIHD. | C | No benefit |
| 184 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Acupuncture should not be used for the purpose of improving symptoms or reducing cardiovascular risk in patients with SIHD. | C | No benefit |
| 185 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | CABG or PCI to improve symptoms should not be performed in patients who do not meet anatomic (≥50% diameter left main or ≥70% non–left main stenosis diameter) or physiological (eg, abnormal FFR) criteria for revascularization. | C | Harm |
| 186 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Chelation therapy is not recommended with the intent of improving symptoms or reducing cardiovascular risk in patients with SIHD. | C | No benefit |
| 187 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Coronary angiography is not recommended to assess risk in asymptomatic patients with no evidence of ischemia on noninvasive testing. | C | No benefit |
| 188 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Coronary angiography is not recommended to assess risk in patients who are at low risk according to clinical criteria and who have not undergone noninvasive risk testing. | C | No benefit |
| 189 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Echocardiography, radionuclide imaging, CMR, and cardiac CT are not recommended for routine assessment of LV function in patients with a normal ECG, no history of MI, no symptoms or signs suggestive of heart failure, and no complex ventricular arrhythmias. | C | No benefit |
| 190 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Exercise stress with nuclear MPI is not recommended as an initial test in low-risk patients who have an interpretable ECG and at least moderate physical functioning or no disabling comorbidity. | C | No benefit |
| 191 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Measurement of LV function with a technology such as echocardiography or radionuclide imaging is not recommended for routine periodic reassessment of patients who have not had a change in clinical status or who are at low risk of adverse cardiovascular events. | C | No benefit |
| 192 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Nuclear MPI, echocardiography, or CMR, with either exercise or pharmacological stress or CCTA, is not recommended for follow-up assessment in patients with SIHD, if performed more frequently than at a) 5-year intervals after CABG or b) 2-year intervals after PCI. | C | No benefit |
| 193 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Pharmacological stress imaging (nuclear MPI, echocardiography, or CMR) or CCTA is not recommended for risk assessment in patients with SIHD who are able to exercise to an adequate workload and have an interpretable ECG. | C | No benefit |
| 194 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Pharmacological stress imaging with nuclear MPI, echocardiography, or CMR is not recommended in patients with known SIHD who have new or worsening symptoms not consistent with UA and who are capable of at least moderate physical functioning or have no disabling comorbidity. | C | No benefit |
| 195 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Standard exercise ECG testing is not recommended for patients who have an uninterpretable ECG or are incapable of at least moderate physical functioning or have disabling comorbidity. | C | No benefit |
| 196 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Standard exercise ECG testing should not be performed in patients with known SIHD who have new or worsening symptoms not consistent with UA and who are either incapable of at least moderate physical functioning/have disabling comorbidity or have an uninterpretable ECG. | C | No benefit |
| 197 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Therapy with rosiglitazone should not be initiated in patients with SIHD. | C | Harm |
| 198 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Treatment with garlic, coenzyme Q10, selenium, or chromium is not recommended with the intent of reducing cardiovascular risk or improving clinical outcomes in patients with SIHD. | C | No benefit |
| 199 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Pharmacological stress with nuclear MPI, echocardiography, or CMR is not recommended for patients who have an interpretable ECG and at least moderate physical functioning or no disabling comorbidity. | C | No benefit |
| 200 | 2012 | Stable ischemic heart disease | ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease | Routine reassessment (<1 year) of LV function with technologies such as echocardiography radionuclide imaging, CMR, or cardiac computed tomography is not recommended in patients with no change in clinical status and for whom no change in therapy is contemplated. | C | No benefit |
| 201 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Except in extraordinary circumstances, carotid revascularization by either CEA or CAS is not recommended when atherosclerosis narrows the lumen by less than 50%. | A | No benefit |
| 202 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Administration of N-acetyl-L-cysteine is not useful for the prevention of contrast-induced acute kidney injury. | A | No benefit |
| 203 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Cutting balloon angioplasty should not be performed routinely during PCI. | A | No benefit |
| 204 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Laser angioplasty should not be used routinely during PCI. | A | No benefit |
| 205 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Rotational atherectomy should not be performed routinely for de novo lesions or in-stent restenosis. | A | No benefit |
| 206 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Aspirin is not useful for preventing a first stroke in persons at low risk. | A | N/A |
| 207 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Hormone therapy (CEE with or without MPA) should not be used for primary prevention of stroke in postmenopausal women. | A | N/A |
| 208 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Screening for cardiac conditions such as PFO in the absence of neurological conditions or a specific cardiac cause is not recommended | A | N/A |
| 209 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | SERMs, such as raloxifene, tamoxifen, or tibolone, should not be used for primary prevention of stroke. | A | N/A |
| 210 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Treatment with antibiotics for chronic infections as a means to prevent stroke is not recommended. | A | N/A |
| 211 | 2011 | VTE | Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension | Systemic fibrinolysis should not be given routinely to patients with IFDVT. | A | N/A |
| 212 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | CABG or PCI should not be performed with the primary or sole intent to improve survival in patients with SIHD with 1 or more coronary stenoses that are not anatomically or functionally significant (eg, <70% diameter non–left main coronary artery stenosis, fractional flow reserve >0.80, no or only mild ischemia on noninvasive testing), involve only the left circumflex or right coronary artery, or subtend only a small area of viable myocardium. | B | Harm |
| 213 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | Cyclooxygenase-2 inhibitors are not recommended for pain relief in the postoperative period after CABG. | B | Harm |
| 214 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | Discontinuation of statin or other dyslipidemic therapy is not recommended before or after CABG in patients without adverse reactions to therapy. | B | Harm |
| 215 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | PCI to improve survival should not be performed in stable patients with significant (>50% diameter stenosis) unprotected left main CAD who have unfavorable anatomy for PCI and who are good candidates for CABG. | B | Harm |
| 216 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | PCI with coronary stenting (bare-metal stent or drug-eluting stent) should not be performed if the patient is not likely to be able to tolerate and comply with dual antiplatelet therapy for the appropriate duration of treatment based on the type of stent implanted. | B | Harm |
| 217 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | Postmenopausal hormonal therapy (estrogen/prosgesterone) should not be administered to women undergoing CABG. | B | Harm |
| 218 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter secundum ASD closure is not indicated in patients with a small secundum ASD of no hemodynamic significance and with no other risk factors. | B | N/A |
| 219 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Neonates, infants, and children with a small to moderate-sized MVSD (without symptoms or evidence of pulmonary hypertension) in whom there is a reasonable expectation that the defect will become smaller over time should be followed up expectantly and do not need closure of the VSD. | B | N/A |
| 220 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Neonates, infants, and children with hemodynamically significant (left ventricular or left atrial volume overload or pulmonary-to-systemic blood flow ratio >2 1) inlet MVSDs with inadequate space between the defect and the atrioventricular or semilunar valves should not undergo device closure (hybrid or percutaneous). | B | N/A |
| 221 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Pulmonary valvuloplasty should not be performed in patients with pulmonary atresia and RV-dependent coronary circulation. | B | N/A |
| 222 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter balloon valvuloplasty is not indicated for patients with congenital mitral valve stenosis due to supramitral valve ring or associated with hypoplastic left ventricle. | B | N/A |
| 223 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Administration of clopidogrel in combination with aspirin is not recommended within 3 months after stroke or TIA. | B | No benefit |
| 224 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Full-intensity parenteral anticoagulation with unfractionated heparin or low-molecular-weight heparinoids is not recommended for patients with atherosclerotic ECVD who develop TIA or acute ischemic stroke. | B | No benefit |
| 225 | 2011 | Hypertophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Genetic testing is not indicated in relatives when the index patient does not have a definitive pathogenic mutation. | B | No benefit |
| 226 | 2011 | Hypertophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Ongoing clinical screening is not indicated in genotype-negative relatives in families with HCM. | B | No benefit |
| 227 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Digitalis is potentially harmful in the treatment of dyspnea in patients with HCM and in the absence of AF. | B | Harm |
| 228 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Dopamine, dobutamine, norepinephrine, and other intravenous positive inotropic drugs are potentially harmful for the treatment of acute hypotension in patients with obstructive HCM. | B | Harm |
| 229 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Permanent pacemaker implantation should not be performed as a first-line therapy to relieve symptoms in medically refractory symptomatic patients with HCM and LVOT obstruction who are candidates for septal reduction. | B | No benefit |
| 230 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | The use of disopyramide alone without beta blockers or verapamil is potentially harmful in the treatment of symptoms (angina or dyspnea) in patients with HCM with AF because disopyramide may enhance atrioventricular conduction and increase the ventricular rate during episodes of AF. | B | Harm |
| 231 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | DES should not be implanted if the patient is not likely to be able to tolerate and comply with prolonged DAPT or this cannot be determined before stent implantation. | B | Harm |
| 232 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Elective noncardiac surgery should not be performed in the 4 to 6 weeks after balloon angioplasty or BMS implantation or the 12 months after DES implantation in patients in whom the P2Y12 inhibitor will need to be discontinued perioperatively. | B | Harm |
| 233 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | PCI of a totally occluded infarct artery greater than 24 hours after STEMI should not be performed in asymptomatic patients with 1- or 2-vessel disease if patients are hemodynamically and electrically stable and do not have evidence of severe ischemia. | B | No benefit |
| 234 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | PCI should not be performed in a noninfarct artery at the time of primary PCI in patients with STEMI without hemodynamic compromise. | B | Harm |
| 235 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | PCI to improve survival should not be performed in stable patients with significant (≥50% diameter stenosis) unprotected left main CAD who have unfavorable anatomy for PCI and who are good candidates for CABG. | B | Harm |
| 236 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | PCI with coronary stenting should not be performed if the patient is not likely to be able to tolerate and comply with DAPT. | B | Harm |
| 237 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Routine precatheterization laboratory (eg, ambulance or emergency room) administration of GP IIb/IIIa inhibitors as part of an upstream strategy for patients with STEMI undergoing PCI is not beneficial. | B | No benefit |
| 238 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Routine prophylactic coronary revascularization should not be performed in patients with stable CAD before noncardiac surgery. | B | Harm |
| 239 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | The routine use of vascular closure devices is not recommended for the purpose of decreasing vascular complications, including bleeding. | B | No benefit |
| 240 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | UFH should not be given to patients already receiving therapeutic subcutaneous enoxaparin. | B | Harm |
| 241 | 2011 | Peripheral arterial disease (Update) | ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease | Anticoagulation therapy should not be used with antiplatelet therapy for prevention of cardiovascular events among patients with PAD. | B | N/A |
| 242 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Aspirin is not useful for preventing a first stroke in persons with diabetes or diabetes plus asymptomatic peripheral artery disease (defined as an ankle brachial pressure index <0.99) in the absence of other established CVD. | B | N/A |
| 243 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Low-dose aspirin (81 mg/d) is not indicated for primary stroke prevention in persons who are persistently aPL positive. | B | N/A |
| 244 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | MRI and MRA criteria for selection of children for primary stroke prevention using transfusion have not been established, and these tests are not recommended in place of TCD for this purpose. | B | N/A |
| 245 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Population screening for asymptomatic carotid artery stenosis is not recommended. | B | N/A |
| 246 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | The addition of a fibrate to a statin in persons with diabetes is not useful for decreasing stroke risk. | B | N/A |
| 247 | 2011 | VTE | Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension | An IVC filter should not be used routinely in the treatment of IFDVT. | B | N/A |
| 248 | 2011 | VTE | Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension | CDT or PCDT should not be given to most patients with chronic DVT symptoms (>21 days) or patients who are at high risk for bleeding complications. | B | N/A |
| 249 | 2011 | VTE | Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension | Fibrinolysis is not recommended for patients with low-risk PE or submassive acute PE with minor RV dysfunction, minor myocardial necrosis, and no clinical worsening. | B | N/A |
| 250 | 2011 | VTE | Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension | Fibrinolysis is not recommended for undifferentiated cardiac arrest. | B | N/A |
| 251 | 2011 | VTE | Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension | PAH (WHO Group I)-specific medical therapy should not be used in lieu of pulmonary endarterectomy or delay evaluation for pulmonary endarterectomy for patients with objectively proven CTEPH who are or may be surgical candidates at an experienced center. | B | N/A |
| 252 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | An arterial graft should not be used to bypass the right coronary artery with less than a critical stenosis (<90%). | C | Harm |
| 253 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | CABG or PCI to improve symptoms should not be performed in patients who do not meet anatomic (>50% left main or >70% non–left main stenosis) or physiological (eg, abnormal fractional flow reserve) criteria for revascularization. | C | Harm |
| 254 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | CABG should not be performed in patients with end-stage renal disease whose life expectancy is limited by noncardiac issues. | C | Harm |
| 255 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | CABG should not be performed in patients with ventricular tachycardia with scar and no evidence of ischemia. | C | Harm |
| 256 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | Emergency CABG should not be performed after failed PCI if revascularization is impossible because of target anatomy or a no-reflow state. | C | Harm |
| 257 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | Emergency CABG should not be performed after failed PCI in the absence of ischemia or threatened occlusion. | C | Harm |
| 258 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | Emergency CABG should not be performed in patients with noreflow (successful epicardial reperfusion with unsuccessful microvascular reperfusion). | C | Harm |
| 259 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | Emergency CABG should not be performed in patients with persistent angina and a small area of viable myocardium who are stable hemodynamically. | C | Harm |
| 260 | 2011 | CABG | ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery | Routine use of early extubation strategies in facilities with limited backup for airway emergencies or advanced respiratory support is potentially harmful. | C | Harm |
| 261 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Aortic valve balloon dilation is not indicated in children with isolated valvar AS who also have a degree of aortic regurgitation that warrants surgical aortic valve replacement or repair. | C | N/A |
| 262 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Aortic valvuloplasty is not indicated in children with isolated valvar AS who have a resting peak systolic valve gradient (by catheter) of <40 mm Hg† and who have no symptoms or ST-T-wave changes on electrocardiography. | C | N/A |
| 263 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Ductal stenting should not be performed in an infant with cyanotic CHD who has obvious proximal pulmonary artery stenosis in the vicinity of the ductal insertion. | C | N/A |
| 264 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Pulmonary venous angioplasty and stenting should not be considered in the management of pulmonary vein stenosis associated with other CHD that requires surgical intervention. | C | N/A |
| 265 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter ASD closure is contraindicated in the management of patients with a secundum ASD and advanced pulmonary vascular obstructive disease. | C | N/A |
| 266 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter ASD closure should not be performed with currently available devices in patients with ASDs other than those of the secundum variety. This would include defects of septum primum, sinus venosus defects, and unroofed coronary sinus defects. | C | N/A |
| 267 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter coil or device occlusion of a BTS (or Potts or Waterston shunt) is not recommended before the cardiac defect has been corrected if the patient develops unsatisfactory hypoxemia with balloon occlusion of the shunt. | C | N/A |
| 268 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter device occlusion is not indicated for patients with clinically insignificant coronary arteriovenous fistulae (eg, normal-sized cardiac chambers). | C | N/A |
| 269 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter device occlusion of a PVL is contraindicated when it is determined that there is inadequate space in which to seat the device without impairing valvar function. | C | N/A |
| 270 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter device occlusion of PVLs is not recommended for a small (hemodynamically insignificant) PVL or when hemolysis is mild or nonexistent. | C | N/A |
| 271 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter occlusion is not recommended for patients with pulmonary atresia with aortopulmonary collaterals that can be unifocalized into native pulmonary arteries. | C | N/A |
| 272 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter occlusion is not recommended for the presence of aortopulmonary collaterals of any size in biventricle or single-ventricle patients who have significant cyanosis due to decreased pulmonary flow. | C | N/A |
| 273 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Transcatheter PDA occlusion should not be attempted in a patient with a PDA with severe pulmonary hypertension associated with bidirectional or right-to-left shunting that is unresponsive to pulmonary vasodilator therapy. | C | N/A |
| 274 | 2011 | Cardiac catheterization and intervention in pediatric cardiac disease | Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease | Venovenous collaterals that drain below the diaphragm in a patient scheduled to undergo Fontan completion need not be embolized. | C | N/A |
| 275 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Revascularization is not recommended for patients with asymptomatic FMD of a carotid artery, regardless of the severity of stenosis. | C | No benefit |
| 276 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Asymptomatic patients with asymmetrical upper limb BP, periclavicular bruit, or flow reversal in a vertebral artery caused by subclavian artery stenosis should not undergo revascularization unless the internal mammary artery is required for myocardial revascularization. | C | No benefit |
| 277 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Carotid duplex ultrasonography is not recommended for patients without risk factors for atherosclerotic carotid disease and no disease on initial vascular testing. | C | No benefit |
| 278 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Carotid duplex ultrasonography is not recommended for routine evaluation of patients with neurological or psychiatric disorders unrelated to focal cerebral ischemia. | C | No benefit |
| 279 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Carotid duplex ultrasonography is not recommended for routine screening of asymptomatic patients who have no risk factors for atherosclerosis. | C | No benefit |
| 280 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Except in extraordinary circumstances, carotid revascularization by either CEA or CAS is not recommended for patients with severe disability caused by cerebral infarction that precludes preservation of useful function. | C | No benefit |
| 281 | 2011 | Extracranial carotid and vertebral artery disease | Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease | Reoperative CEA or CAS should not be performed in asymptomatic patients with less than 70% carotid stenosis that has remained stable. | C | Harm |
| 282 | 2011 | Hypertophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | For women with advanced heart failure symptoms and HCM, pregnancy is associated with excess morbidity/mortality. | C | Harm |
| 283 | 2011 | Hypertophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Heart transplantation should not be performed in mildly symptomatic patients of any age with HCM. | C | Harm |
| 284 | 2011 | Hypertophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Invasive electrophysiologic testing as routine SCD risk stratification for patients with HCM should not be performed. | C | Harm |
| 285 | 2011 | Hypertophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Patients with HCM should not participate in intense competitive sports regardless of age, sex, race, presence or absence of LVOT obstruction, prior septal reduction therapy, or implantation of a cardioverter-defibrillator for high-risk status. | C | Harm |
| 286 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Alcohol septal ablation should not be done in patients with HCM who are less than 21 years of age and is discouraged in adults less than 40 years of age if myectomy is a viable option. | C | Harm |
| 287 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Alcohol septal ablation should not be done in patients with HCM with concomitant disease that independently warrants surgical correction (eg, coronary artery bypass grafting for CAD, mitral valve repair for ruptured chordae) in whom surgical myectomy can be performed as part of the operation. | C | Harm |
| 288 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | ICD placement as a routine strategy in patients with HCM without an indication of increased risk is potentially harmful. | C | Harm |
| 289 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | ICD placement as a strategy to permit patients with HCM to participate in competitive athletics is potentially harmful. | C | Harm |
| 290 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | ICD placement in patients who have an identified HCM genotype in the absence of clinical manifestations of HCM is potentially harmful. | C | Harm |
| 291 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Mitral valve replacement for relief of LVOT obstruction should not be performed in patients with HCM in whom septal reduction therapy is an option. | C | Harm |
| 292 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Nifedipine or other dihydropyridine calcium channel-blocking drugs are potentially harmful for treatment of symptoms (angina or dyspnea) in patients with HCM who have resting or provocable LVOT obstruction. | C | Harm |
| 293 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Permanent pacemaker implantation for the purpose of reducing gradient should not be performed in patients with HCM who are asymptomatic or whose symptoms are medically controlled. | C | No benefit |
| 294 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Septal reduction therapy should not be done for adult patients with HCM who are asymptomatic with normal exercise tolerance or whose symptoms are controlled or minimized on optimal medical therapy. | C | Harm |
| 295 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Septal reduction therapy should not be done unless performed as part of a program dedicated to the longitudinal and multidisciplinary care of patients with HCM. | C | Harm |
| 296 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Verapamil is potentially harmful in patients with obstructive HCM in the setting of systemic hypotension or severe dyspnea at rest. | C | Harm |
| 297 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | A strategy of coronary angiography with intent to perform PCI is not recommended in patients with STEMI in whom the risks of revascularization are likely to outweigh the benefits or when the patient or designee does not want invasive care. | C | No benefit |
| 298 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | An early invasive strategy (ie, diagnostic angiography with intent to perform revascularization) is not recommended in patients with extensive comorbidities (eg, liver or pulmonary failure, cancer) in whom the risks of revascularization and comorbid conditions are likely to outweigh the benefits of revascularization, there is a low likelihood of ACS despite acute chest pain, or consent to revascularization will not be granted regardless of the findings. | C | No benefit |
| 299 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | CABG or PCI to improve symptoms should not be performed in patients who do not meet anatomic (≥50% left main or ≥70% non–left main stenosis) or physiological (eg, abnormal fractional flow reserve) criteria for revascularization. | C | Harm |
| 300 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Fondaparinux should not be used as the sole anticoagulant to support PCI. An additional anticoagulant with anti-IIa activity should be administered because of the risk of catheter thrombosis. | C | Harm |
| 301 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | In patients with a prior history of allergic reactions to shellfish or seafood, anaphylactoid prophylaxis for contrast reaction is not beneficial. | C | No benefit |
| 302 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | It is not recommended that elective/urgent PCI be performed by low-volume operators (<75 procedures per year) at low-volume centers (200 to 400 procedures per year) with or without on-site cardiac surgery. An institution with a volume of fewer than 200 procedures per year, unless in a region that is underserved because of geography, should carefully consider whether it should continue to offer this service. | C | No benefit |
| 303 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | IVUS for routine lesion assessment is not recommended when revascularization with PCI or CABG is not being contemplated. | C | No benefit |
| 304 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | PCI is not recommended for chronic saphenous vein graft occlusions. | C | Harm |
| 305 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Primary or elective PCI should not be performed in hospitals without on-site cardiac surgery capabilities without a proven plan for rapid transport to a cardiac surgery operating room in a nearby hospital or without appropriate hemodynamic support capability for transfer. | C | Harm |
| 306 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Routine periodic stress testing of asymptomatic patients after PCI without specific clinical indications should not be performed. | C | No benefit |
| 307 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | Routine use of a proton pump inhibitor is not recommended for patients at low risk of gastrointestinal bleeding, who have much less potential to benefit from prophylactic therapy. | C | No benefit |
| 308 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | The routine clinical use of genetic testing to screen patients treated with clopidogrel who are undergoing PCI is not recommended. | C | No benefit |
| 309 | 2011 | PCI | ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention | The routine clinical use of platelet function testing to screen patients treated with clopidogrel who are undergoing PCI is not recommended. | C | No benefit |
| 310 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Dosing with vitamin K antagonists on the basis of pharmacogenetics is not recommended at this time. | C | N/A |
| 311 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Genetic screening of the general population for prevention of a first stroke is not recommended. | C | N/A |
| 312 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Noninvasive screening for unruptured intracranial aneurysms in patients with 1 relative with SAH or intracranial aneurysms is not recommended. | C | N/A |
| 313 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | OCs may be harmful in women with additional risk factors (eg, cigarette smoking, prior thromboembolic events). | C | N/A |
| 314 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Screening of patients at risk for myopathy in the setting of statin use is not recommended when considering initiation of statin therapy at this time. | C | N/A |
| 315 | 2011 | Primary prevention of stroke | Guidelines for the Primary Prevention of Stroke | Universal screening for intracranial aneurysms in carriers of mutations for Mendelian disorders associated with aneurysm is not recommended. | C | N/A |
| 316 | 2011 | VTE | Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension | An IVC filter should not be used routinely as an adjuvant to anticoagulation and systemic fibrinolysis in the treatment of acute PE. | C | N/A |
| 317 | 2011 | VTE | Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension | Catheter embolectomy and surgical thrombectomy are not recommended for patients with low-risk PE or submassive acute PE with minor RV dysfunction, minor myocardial necrosis, and no clinical worsening. | C | N/A |
| 318 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Assessment for the presence of blunted flow reserve (microvascular ischemia) using quantitative myocardial blood flow measurements by PET is not indicated for the assessment of prognosis in patients with HCM. | C | No benefit |
| 319 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | In patients with HCM with resting or provocable outflow tract obstruction, regardless of symptom status, pure vasodilators and high-dose diuretics are potentially harmful. | C | Harm |
| 320 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Routine SPECT MPI or stress echocardiography is not indicated for detection of “silent” CAD-related ischemia in patients with HCM who are asymptomatic. | C | No benefit |
| 321 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Routine TEE and/or contrast echocardiography is not recommended when TTE images are diagnostic of HCM and/or there is no suspicion of fixed obstruction or intrinsic mitral valve pathology. | C | No benefit |
| 322 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | Septal reduction therapy should not be performed for asymptomatic adult and pediatric patients with HCM with normal effort tolerance regardless of the severity of obstruction. | C | Harm |
| 323 | 2011 | Hypertrophic cardiomyopathy | ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy | TTE studies should not be performed more frequently than every 12 months in patients with HCM when it is unlikely that any changes have occurred that would have an impact on clinical decision making. | C | No benefit |
| 324 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | Prophylactic administration of lidocaine is not recommended for the management of arrhythmias / ventricular rhythm disorders. | A | N/A |
| 325 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | Prophylactic antiarrhythmics are not recommended for patients with suspected ACS or myocardial infarction in the prehospital or ED. | A | N/A |
| 326 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | Routine administration of magnesium sulfate in cardiac arrest is not recommended unless torsades de pointes is present. | A | N/A |
| 327 | 2010 | CPR - Cardiac arrest | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Cardiac Arrest | In patients with cardiac arrest and without known PE, routine fibrinolytic treatment given during CPR shows no benefit and is not recommended. | A | No benefit |
| 328 | 2010 | Arteriotomy closure devices | Arteriotomy Closure Devices for Cardiovascular Procedures | ACDs should not be used routinely for the specific purpose of reducing vascular complications in patients undergoing invasive cardiovascular procedures via the femoral artery approach. | B | N/A |
| 329 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | Fibrinolytic therapy should not be administered to patients who present greater than 24 hours after the onset of symptoms. | B | N/A |
| 330 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | Following STEMI, routine consultation with a cardiologist or another physician is not recommended except in equivocal or uncertain cases. Consultation delays therapy and is associated with increased hospital mortality rates. | B | N/A |
| 331 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | Electric pacing is not recommended for routine use in cardiac arrest. | B | N/A |
| 332 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | Fibrinolytic therapy should not be routinely used in cardiac arrest. | B | N/A |
| 333 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | Procainamide and sotalol should be avoided in patients with wide-complex tachycardia and prolonged QT. If one of these antiarrhythmic agents is given, a second agent should not be given without expert consultation. | B | N/A |
| 334 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | Routine administration of calcium for treatment of in-hospital and out-of-hospital cardiac arrest is not recommended. | B | N/A |
| 335 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | Routine use of sodium bicarbonate is not recommended for patients in cardiac arrest. | B | N/A |
| 336 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | Verapamil is contraindicated for wide-complex tachycardias unless known to be of supraventricular origin. | B | N/A |
| 337 | 2010 | CPR - Adult BLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Basic Life Support | Cricoid pressure might be used in a few special circumstances (eg, to aid in viewing the vocal cords during tracheal intubation). However, the routine use of cricoid pressure in adult cardiac arrest is not recommended. | B | N/A |
| 338 | 2010 | CPR - Adult BLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Basic Life Support | Excessive ventilation can be harmful in rescue breathing because it increases intrathoracic pressure, decreases venous return to the heart, and diminishes cardiac output and survival. Rescuers should avoid excessive ventilation (too many breaths or too large a volume) during CPR. | B | N/A |
| 339 | 2010 | CPR - Adult BLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Basic Life Support | Excessive ventilation in rescue breathing is unnecessary and can cause gastric inflation and its resultant complications, such as regurgitation and aspiration. | B | N/A |
| 340 | 2010 | CPR - Cardiac arrest | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Cardiac Arrest | The administration of flumazenil to patients with undifferentiated coma confers risk and is not recommended. | B | N/A |
| 341 | 2010 | CPR - Cardiac arrest | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Cardiac Arrest | Unnecessary cervical spine immobilization can impede adequate opening of the airway and delay delivery of rescue breaths. Routine stabilization of the cervical spine in the absence of circumstances that suggest a spinal injury is not recommended. | B | N/A |
| 342 | 2010 | CPR - Electrical therapies | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Electrical Therapies Automated External Defibrillators, Defibrillation, Cardioversion, and Pacing | It is not useful to shock asystole. | B | N/A |
| 343 | 2010 | CPR - Electrical therapies | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Electrical Therapies Automated External Defibrillators, Defibrillation, Cardioversion, and Pacing | Pacing is not effective for asystolic cardiac arrest and may delay or interrupt the delivery of chest compressions. Pacing for patients in asystole is not recommended. | B | N/A |
| 344 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | Avoid excessive cricoid pressure so as not to obstruct the trachea. | B | N/A |
| 345 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | Calcium Calcium administration is not recommended for pediatric cardiopulmonary arrest in the absence of documented hypocalcemia, calcium channel blocker overdose, hypermagnesemia, or hyperkalemia. | B | N/A |
| 346 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | In septic shock, etomidate has been shown to facilitate endotracheal intubation in infants and children with minimal hemodynamic effect, but do not use it routinely in pediatric patients with evidence of septic shock. | B | N/A |
| 347 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | Routine use of sodium bicarbonate is not recommended for patients in cardiac arrest. | B | N/A |
| 348 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | There is no survival benefit from high-dose epinephrine in asystole/PEA, and it may be harmful, particularly in asphyxia. | B | N/A |
| 349 | 2010 | CPR - Post-cardiac arrest care | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Post–Cardiac Arrest Care | Attempts to control glucose concentration within a lower range (80 to 110 mg/dL [4.4 to 6.1 mmol/L]) should not be implemented after cardiac arrest due to the increased risk of hypoglycemia. | B | N/A |
| 350 | 2010 | CPR - Post-cardiac arrest care | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Post–Cardiac Arrest Care | The routine use of any serum or CSF biomarker as a sole predictor of poor outcome in comatose patients after cardiac arrest is not recommended. | B | N/A |
| 351 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | Do not administer syrup of ipecac for ingestions of toxins. | B | N/A |
| 352 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | During thermal burns, do not apply ice directly to a burn; it can produce tissue ischemia | B | N/A |
| 353 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Genotype testing for CHD risk assessment in asymptomatic adults is not recommended. | B | No benefit |
| 354 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | In asymptomatic high-risk adults, measurement of CRP is not recommended for cardiovascular risk assessment. | B | No benefit |
| 355 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | In low-risk men younger than 50 years of age or women 60 years of age or younger, measurement of CRP is not recommended for cardiovascular risk assessment. | B | No benefit |
| 356 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Measurement of natriuretic peptides is not recommended for CHD risk assessment in asymptomatic adults. | B | No benefit |
| 357 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Peripheral arterial flow-mediated dilation studies are not recommended for cardiovascular risk assessment in asymptomatic adults. | B | No benefit |
| 358 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Persons at low risk (<6% 10-year risk) should not undergo CAC measurement for cardiovascular risk assessment. | B | No benefit |
| 359 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Furosemide, mannitol, or dopamine should not be given solely for the purpose of renal protection in descending aortic repairs. | B | N/A |
| 360 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Perioperative brain hyperthermia is not recommended in repairs of the ascending aortic and transverse aortic arch as it is probably injurious to the brain. | B | N/A |
| 361 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Furosemide, mannitol, or dopamine should not be given solely for the purpose of renal protection in descending aortic repairs. | B | N/A |
| 362 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Perioperative brain hyperthermia is not recommended in repairs of the ascending aortic and transverse aortic arch as it is probably injurious to the brain. | B | N/A |
| 363 | 2010 | Aspirin for primary prevention in people with diabetes | ADA/AHA/ACCF Aspirin for Primary Prevention of Cardiovascular Events in People With Diabetes | Aspirin should not be recommended for CVD prevention for adults with diabetes at low CVD risk (men under age 50 years and women under 60 years with no major additional CVD risk factors; 10-year CVD risk under 5%) as the potential adverse effects from bleeding offset the potential benefits. | C | Harm |
| 364 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | ACE Inhibitors and ARBs in the Hospital IV administration of ACE inhibitors is contraindicated in the first 24 hours because of risk of hypotension. | C | N/A |
| 365 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | NSAIDs (except for aspirin), both nonselective as well as COX-2 selective agents, should not be administered during hospitalization for STEMI because of the increased risk of mortality, reinfarction, hypertension, heart failure, and myocardial rupture associated with their use. | C | N/A |
| 366 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | Patients initially treated with enoxaparin should not be switched to UFH and vice versa because of increased risk of bleeding. | C | N/A |
| 367 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | Statins should not be discontinued during the index hospitalization unless contraindicated. | C | N/A |
| 368 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | The use of inpatient-derived risk scoring systems are not recommended to identify patients who may be safely discharged from the ED. | C | N/A |
| 369 | 2010 | CPR - ACS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Acute Coronary Syndromes | The use of nitrates in patients with hypotension (SBP <90 mm Hg or ≥30 mm Hg below baseline), extreme bradycardia (<50 bpm), or tachycardia in the absence of heart failure (>100 bpm) and in patients with right ventricular infarction is contraindicated. | C | N/A |
| 370 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | Adenosine should not be given for unstable or for irregular or polymorphic wide-complex tachycardias, as it may cause degeneration of the arrhythmia to VF. | C | N/A |
| 371 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | AV nodal blocking drugs (e.g. CCB or BB) should not be used for pre-excited atrial fibrillation or flutter. | C | N/A |
| 372 | 2010 | CPR - Adult ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Advanced Cardiovascular Life Support | The routine use of cricoid pressure in cardiac arrest is not recommended. | C | N/A |
| 373 | 2010 | CPR - Adult stroke | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Adult Stroke | Following stroke, unless the patient is hypotensive (systolic blood pressure <90 mm Hg), prehospital intervention for blood pressure is not recommended. | C | N/A |
| 374 | 2010 | CPR - Cardiac arrest | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Cardiac Arrest | During rescue breathing, attempts to remove water from the breathing passages by any means other than suction (eg, abdominal thrusts or the Heimlich maneuver) are unnecessary and potentially dangerous. The routine use of abdominal thrusts or the Heimlich maneuver for drowning victims is not recommended. | C | N/A |
| 375 | 2010 | CPR - Cardiac arrest | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Cardiac Arrest | The effect of bolus administration of potassium for cardiac arrest suspected to be secondary to hypokalemia is unknown and ill advised. | C | N/A |
| 376 | 2010 | CPR - CPR techniques and devices | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - CPR Techniques and Devices | Precordial thump should not be used for unwitnessed out-of-hospital cardiac arrest. | C | N/A |
| 377 | 2010 | CPR - CPR techniques and devices | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - CPR Techniques and Devices | Rescuers should avoid using the automatic mode of the oxygen-powered, flow-limited resuscitator during CPR because it may generate high positive end-expiratory pressure (PEEP) that may impede venous return during chest compressions and compromise forward blood flow. | C | N/A |
| 378 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | Among children with cocain toxicity do not give β-adrenergic blockers. | C | N/A |
| 379 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | Among children with TCA or other sodium channel blocker toxicity, do not administer Class IA (quinidine, procainamide), Class IC (flecainide, propafenone), or Class III (amiodarone and sotalol) antiarrhythmics, which may exacerbate cardiac toxicity. | C | N/A |
| 380 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | An IV/IO dose of Verapamil, 0.1 to 0.3 mg/kg is effective in terminating SVT in older children, but it should not be used in infants without expert consultation because it may cause potential myocardial depression, hypotension, and cardiac arrest. | C | N/A |
| 381 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | Avoid delivering excessive ventilation during cardiac arrest. | C | N/A |
| 382 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | In cases of trauma, do not routinely hyperventilate even in case of head injury (Class III, LOE C).338,339 Intentional brief hyperventilation may be used as a temporizing rescue therapy if there are signs of impending brain herniation (eg, sudden rise in measured intracranial pressure, dilation of one or both pupils with decreased response to light, bradycardia, and hypertension). | C | N/A |
| 383 | 2010 | CPR - Pediatric ACLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Advanced Life Support | There is insufficient evidence to recommend routine cricoid pressure application to prevent aspiration during endotracheal intubation in children. Do not continue cricoid pressure if it interferes with ventilation or the speed or ease of intubation. | C | N/A |
| 384 | 2010 | CPR - Pediatric BLS | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Pediatric Basic Life Support | During bag-mask ventilation, avoid excessive ventilation. | C | N/A |
| 385 | 2010 | CPR - Post-cardiac arrest care | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Post–Cardiac Arrest Care | Active rewarming should be avoided in comatose patients who spontaneously develop a mild degree of hypothermia (>32°C [89.6°F]) after resuscitation from cardiac arrest during the first 48 hours after ROSC. | C | N/A |
| 386 | 2010 | CPR - Post-cardiac arrest care | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Post–Cardiac Arrest Care | Routine hyperventilation with hypocapnia should be avoided after ROSC because it may worsen global brain ischemia by excessive cerebral vasoconstriction | C | N/A |
| 387 | 2010 | CPR - Post-cardiac arrest care | AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science - Post–Cardiac Arrest Care | The absence of vestibulo-ocular reflexes at ≥24 hours (FPR 0%, 95% CI 0% to 14%) or Glasgow Coma Scale (GCS) score <5 at ≥72 hours (FPR 0%, 95% CI 0% to 6%) are less reliable for predicting poor outcome or were studied only in limited numbers of patients. Other clinical signs, including myoclonus, are not recommended for predicting poor outcome | C | N/A |
| 388 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | Do not administer anything by mouth for any poison ingestion unless advised to do so by a poison control center or emergency medical personnel because it may be harmful | C | N/A |
| 389 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | During electric injuries, do not place yourself in danger by touching an electrocuted victim while the power is on. Turn off the power at its source; at home the switch is usually near the fuse box. | C | N/A |
| 390 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | During injury emergencies, elevation and use of pressure points are not recommended to control bleeding. These unproven procedures may compromise the proven intervention of direct pressure, so they could be harmful. | C | N/A |
| 391 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | First aid providers should not use immobilization devices because their benefit in first aid has not been proven and they may be harmful. Immobilization devices may be needed in special circumstances when immediate extrication (eg, rescue of drowning victim) is required, but first aid providers should not use these devices unless they have been properly trained in their use. | C | N/A |
| 392 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | Following trauma, assume that any injury to an extremity includes a bone fracture. Cover open wounds with a dressing. Do not move or try to straighten an injured extremity. There is no evidence that straightening an angulated suspected long bone fracture shortens healing time or reduces pain prior to permanent fixation. | C | N/A |
| 393 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | In cases of frostbite, chemical warmers should not be placed directly on frostbitten tissue because they can reach temperatures that can cause burns | C | N/A |
| 394 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | In cases of frostbite, transport the victim to an advanced medical facility as rapidly as possible. Do not try to rewarm the frostbite if there is any chance that it might refreeze or if you are close to a medical facility. | C | N/A |
| 395 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | In jellyfish stings, ressure immobilization bandages are not recommended because animal studies show that pressure with an immobilization bandage causes further release of venom, even from already fired nematocysts. | C | N/A |
| 396 | 2010 | First aid | AHA and American Red Cross Guidelines for First Aid | In snakebites, do not apply suction as first aid. Suction does remove some venom, but the amount is very small. Suction has no clinical benefit and it may aggravate the injury. | C | N/A |
| 397 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Coronary computed tomography angiography is not recommended for cardiovascular risk assessment in asymptomatic adults. | C | No benefit |
| 398 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Echocardiography is not recommended for cardiovascular risk assessment of CHD in asymptomatic adults without hypertension. | C | No benefit |
| 399 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Magnetic resonance imaging for detection of vascular plaque is not recommended for cardiovascular risk assessment in asymptomatic adults. | C | No benefit |
| 400 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Measures of arterial stiffness outside of research settings are not recommended for cardiovascular risk assessment in asymptomatic adults. | C | No benefit |
| 401 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Stress MPI is not indicated for cardiovascular risk assessment in low- or intermediate-risk asymptomatic adults. (Exercise or pharmacologic stress MPI is primarily used and studied for its role in advanced cardiac evaluation of symptoms suspected of representing CHD and/or estimation of prognosis in patients with known coronary artery disease. | C | No benefit |
| 402 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Measurement of lipid parameters, including lipoproteins, apolipoproteins, particle size, and density, beyond a standard fasting lipid profile is not recommended for cardiovascular risk assessment in asymptomatic adults. | C | No benefit |
| 403 | 2010 | Risk assessment in asymptomatic adults | ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults | Stress echocardiography is not indicated for cardiovascular risk assessment in low- or intermediate-risk asymptomatic adults. (Exercise or pharmacologic stress echocardiography is primarily used for its role in advanced cardiac evaluation of symptoms suspected of representing CHD and/or estimation of prognosis in patients with known coronary artery disease or the assessment of patients with known or suspected valvular heart disease.) | C | No benefit |
| 404 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | A negative chest x-ray should not delay definitive aortic imaging in patients determined to be high risk for aortic dissection by initial screening. | C | N/A |
| 405 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Regional anesthetic techniques are not recommended in patients at risk of neuraxial hematoma formation due to thienopyridine antiplatelet therapy, low-molecular-weight heparins, or clinically significant anticoagulation. | C | N/A |
| 406 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Routinely changing double-lumen endotracheal (endobronchial) tubes to single-lumen tubes at the end of surgical procedures complicated by significant upper airway edema or hemorrhage is not recommended. | C | N/A |
| 407 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Vasodilator therapy should not be initiated prior to rate control so as to avoid associated reflex tachycardia that may increase aortic wall stress, leading to propagation or expansion of a thoracic aortic dissection. | C | N/A |
| 408 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | A negative chest x-ray should not delay definitive aortic imaging in patients determined to be high risk for aortic dissection by initial screening. | C | N/A |
| 409 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Vasodilator therapy should not be initiated prior to rate control so as to avoid associated reflex tachycardia that may increase aortic wall stress, leading to propagation or expansion of a thoracic aortic dissection. | C | N/A |
| 410 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Regional anesthetic techniques are not recommended in patients at risk of neuraxial hematoma formation due to thienopyridine antiplatelet therapy, low-molecular-weight heparins, or clinically significant anticoagulation. | C | N/A |
| 411 | 2010 | Thoracic aortic disease | ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease | Routinely changing double-lumen endotracheal (endobronchial) tubes to single-lumen tubes at the end of surgical procedures complicated by significant upper airway edema or hemorrhage is not recommended. | C | N/A |
| 412 | 2009 | Ionizing radiation in cardiac imaging | AHA Science Advisory on Ionizing Radiation in Cardiac Imaging | Longitudinal tracking of individual cumulative lifetime dose for patients is currently not practical. The modeling required to individualize dose is very complex and difficult to achieve, and the necessary tools and information systems to accomplish this for different imaging modalities are currently not available. The usefulness and societal value of such an undertaking are uncertain. | B | N/A |
| 413 | 2009 | Ionizing radiation in cardiac imaging | AHA Science Advisory on Ionizing Radiation in Cardiac Imaging | Routine surveillance radionuclide stress tests or cardiac CTs in asymptomatic patients at low risk for ischemic heart disease are not recommended. | B | N/A |
| 414 | 2009 | Rheumatic fever | Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis | Certain antimicrobials are not recommended for treatment of group A streptococcal upper respiratory tract infections. Tetracyclines should not be used because of the high prevalence of resistant strains. | B | N/A |
| 415 | 2009 | Rheumatic fever | Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis | Diagnosis of streptococcal infections using a clinical algorithm without microbiological confirmation could result in the receipt of inappropriate antimicrobial therapy by an unacceptably large number of adults with nonstreptococcal pharyngitis and is not recommended. | B | N/A |
| 416 | 2009 | Rheumatic fever | Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis | Older fluoroquinolones (eg, ciprofloxacin) have limited activity against GAS and should not be used to treat GAS pharyngitis. Newer fluoroquinolones (eg, levofloxacin, moxifloxacin) are active in vitro against GAS but are expensive and have an unnecessarily broad spectrum of activity, and therefore, they are not recommended for routine treatment of GAS pharyngitis. | B | N/A |
| 417 | 2009 | Rheumatic fever | Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis | Streptococcal Antibody Tests A commercially available slide agglutination test for the detection of antibodies to several streptococcal antigens is the Streptozyme test (Wampole Laboratories, Stamford, Conn). This test is less well standardized and less reproducible than other antibody tests, and it should not be used as a test for evidence of a preceding GAS infection. | B | N/A |
| 418 | 2009 | Rheumatic fever | Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis | Studies suggesting that β-lactamase–producing upper respiratory tract flora may interfere with penicillin in the treatment of GAS pharyngitis have not been confirmed. Antibiotic therapy directed against these organisms remains controversial and is not indicated in patients with acute pharyngitis. | B | N/A |
| 419 | 2009 | Rheumatic fever | Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis | Sulfonamides and trimethoprim-sulfamethoxazole do not eradicate GAS in patients with pharyngitis and should not be used to treat active infections. | B | N/A |
| 420 | 2009 | Rheumatic fever | Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis | Until carefully designed and well-controlled studies have established a causal relationship between Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS) and GAS infections, the committee does not recommend routine laboratory testing for GAS to diagnose, long-term antistreptococcal prophylaxis to prevent, or immunoregulatory therapy (eg, intravenous immunoglobulin, plasma exchange) to treat exacerbations of this disorder. | B | N/A |
| 421 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Pregnancy in patients with atrial septal defect (ASD) and severe PAH (Eisenmenger syndrome) is not recommended owing to excessive maternal and fetal mortality and should be strongly discouraged. | A | Harm |
| 422 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Pregnancy in patients with ventricular septal defect (VSD) and severe PAH (Eisenmenger syndrome) is not recommended owing to excessive maternal and fetal mortality and should be strongly discouraged. | A | Harm |
| 423 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacing is not indicated for torsade de pointes VT due to reversible causes. | A | N/A |
| 424 | 2008 | Spontaneous intracerebral hemorrhage | Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults | Delayed evacuation by craniotomy appears to offer little if any benefit with a fairly high degree of certainty. In those patients presenting in coma with deep hemorrhages, removal of ICH by craniotomy may actually worsen outcome and is not recommended. | A | Harm |
| 425 | 2008 | Spontaneous intracerebral hemorrhage | Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults | With a few exceptions, the routine evacuation of supratentorial ICH by standard craniotomy within 96 hours of ictus is generally not recommended. | A | N/A |
| 426 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | AVR is not indicated in asymptomatic patients with AR who have normal LV size and function. | B | N/A |
| 427 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | AVR is not useful for prevention of sudden death in asymptomatic adults with AS who have none of the findings listed under the Class IIa/IIb indications. | B | N/A |
| 428 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Diagnostic cardiac catheterization is not indicated for uncomplicated PDA with adequate noninvasive imaging. | B | N/A |
| 429 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Endocardial pacing is not recommended in patients with CHD-PAH with persistent intravascular shunting, and alternative access for pacing leads should be sought (the risks should be individualized). | B | N/A |
| 430 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | In asymptomatic adolescents and young adults, aortic balloon valvotomy should not be performed with a peak-to-peak gradient less than 40 mm Hg without symptoms or ECG changes. | B | N/A |
| 431 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | In older adults, aortic balloon valvotomy is not recommended as an alternative to AVR, although certain younger patients may be an exception and should be referred to a center with experience in aortic balloon valvuloplasties. | B | N/A |
| 432 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | In younger patients with uncomplicated ASD for whom noninvasive imaging results are adequate, diagnostic cardiac catheterization is not indicated. | B | N/A |
| 433 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Maximal exercise testing is not recommended in ASD with severe PAH. | B | N/A |
| 434 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Maximal exercise testing is not recommended in PDA with significant PAH. | B | N/A |
| 435 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Patients with severe irreversible PAH and no evidence of a left-to-right shunt should not undergo ASD closure. | B | N/A |
| 436 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Pregnancy in women with CHD-PAH, especially those with Eisenmenger physiology, is not recommended and should be absolutely avoided in view of the high risk of maternal mortality. | B | N/A |
| 437 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Vasodilator therapy is not indicated for long-term therapy in AR for asymptomatic patients with LV systolic dysfunction who is otherwise a candidate for aortic valve replacement (AVR). | B | N/A |
| 438 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Vasodilator therapy is not indicated for long-term therapy in AR for asymptomatic patients with only mild to moderate AR and normal LV function. | B | N/A |
| 439 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | VSD closure is not recommended in patients with severe irreversible PAH. | B | N/A |
| 440 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | CRT is not indicated for asymptomatic patients with reduced LVEF in the absence of other indications for pacing. | B | N/A |
| 441 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | ICD therapy is not indicated for patients with ventricular tachyarrhythmias due to a completely reversible disorder in the absence of structural heart disease (e.g., electrolyte imbalance, drugs, or trauma). | B | N/A |
| 442 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for asymptomatic first-degree AV block. | B | N/A |
| 443 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for AV block that is expected to resolve and is unlikely to recur (e.g., drug toxicity, Lyme disease, or transient increases in vagal tone or during hypoxia in sleep apnea syndrome in the absence of symptoms). | B | N/A |
| 444 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for fascicular block with first-degree AV block without symptoms | B | N/A |
| 445 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for fascicular block without AV block or symptoms | B | N/A |
| 446 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for transient postoperative AV block with return of normal AV conduction in the otherwise asymptomatic patient. | B | N/A |
| 447 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacing is not indicated for the prevention of AF in patients without any other indication for pacemaker implantation. | B | N/A |
| 448 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent ventricular pacing is not indicated for new bundle-branch block or fascicular block in the absence of AV block. | B | N/A |
| 449 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent ventricular pacing is not indicated for persistent asymptomatic first-degree AV block in the presence of bundle-branch or fascicular block. | B | N/A |
| 450 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent ventricular pacing is not indicated for transient AV block in the absence of intraventricular conduction defects. | B | N/A |
| 451 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent ventricular pacing is not indicated for transient AV block in the presence of isolated left anterior fascicular block. | B | N/A |
| 452 | 2008 | Infective endocarditis (Update) | ACC/AHA Guideline Update on Valvular Heart Disease Focused Update on Infective Endocarditis | Prophylaxis against infective endocarditis is not recommended for nondental procedures (such as transesophageal echocardiogram, esophagogastroduodenoscopy, or colonoscopy) in the absence of active infection. | B | N/A |
| 453 | 2008 | Prevention of infective endocarditis | AHA Guideline for the Prevention of Infective Endocarditis | The administration of prophylactic antibiotics solely to prevent endocarditis is not recommended for patients who undergo GU or GI tract procedures, including diagnostic esophagogastroduodenoscopy or colonoscopy. | B | N/A |
| 454 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Prophylaxis against infective endocarditis (IE) is not recommended for nondental procedures (such as esophagogastroduodenoscopy or colonoscopy) in the absence of active infection. | ||
| 455 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Balloon valvotomy is not recommended for asymptomatic patients with a peak instantaneous gradient by Doppler less than 50 mm Hg in the presence of normal cardiac output. | C | N/A |
| 456 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Balloon valvotomy is not recommended for symptomatic patients with a peak instantaneous gradient by Doppler less than 30 mm Hg. | C | N/A |
| 457 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Balloon valvotomy is not recommended for symptomatic patients with PS and severe pulmonary regurgitation. | C | N/A |
| 458 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Cardiac catheterization is unnecessary for diagnosis of valvular PS and should be used only when percutaneous catheter intervention is contemplated. | C | N/A |
| 459 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Endocarditis prophylaxis is not recommended for those with a repaired PDA without residual shunt. | C | N/A |
| 460 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Estrogen-containing contraceptives should be avoided. | C | N/A |
| 461 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Exercise stress testing should not be performed in symptomatic patients with AS or those with repolarization abnormality on ECG or systolic dysfunction on echocardiography. | C | N/A |
| 462 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Patients with small, asymptomatic CAVF should not undergo closure of CAVF. | C | N/A |
| 463 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | PDA closure is not indicated for patients with PAH and net right-to-left shunt. | C | N/A |
| 464 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Pregnancy should not be planned without consultation and evaluation at a comprehensive ACHD center with experience and expertise in maternal and prenatal management of complex CHD. | C | N/A |
| 465 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Repeated routine phlebotomies are not recommended because of the risk of iron depletion, decreased oxygen carrying capacity, and stroke. | C | N/A |
| 466 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Surgical intervention is not recommended to prevent AR for patients with SubAS if the patient has trivial LVOT obstruction or trivial to mild AR. | C | N/A |
| 467 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | The estrogen-containing oral contraceptive pill is not recommended in ACHD patients at risk of thromboembolism, such as those with cyanosis related to an intracardiac shunt, severe PAH, or Fontan repair. | C | N/A |
| 468 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | The use of single-barrier contraception alone in women with CHD-PAH is not recommended owing to the frequency of failure. | C | N/A |
| 469 | 2008 | Congenital heart disease | ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease | Vasodilator therapy is not indicated for long-term therapy in AR for asymptomatic patients with either LV systolic function or mild to moderate LV diastolic dysfunction who is otherwise a candidate for AVR. | C | N/A |
| 470 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | CRT is not indicated for patients whose functional status and life expectancy are limited predominantly by chronic noncardiac conditions. | C | N/A |
| 471 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | ICD implantation is not indicated in pediatric patients and patients with congenital heart disease. | C | N/A |
| 472 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | ICD therapy is not indicated for NYHA Class IV patients with drug-refractory congestive heart failure who are not candidates for cardiac transplantation or CRT-D. | C | N/A |
| 473 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | ICD therapy is not indicated for patients who do not have a reasonable expectation of survival with an acceptable functional status for at least 1 year, even if they meet ICD implantation criteria specified in the Class I, IIa, and IIb recommendations. | C | N/A |
| 474 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | ICD therapy is not indicated for patients with incessant VT or VF. | C | N/A |
| 475 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | ICD therapy is not indicated for syncope of undetermined cause in a patient without inducible ventricular tachyarrhythmias and without structural heart disease. | C | N/A |
| 476 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | ICD therapy is not indicated in patients with significant psychiatric illnesses that may be aggravated by device implantation or that may preclude systematic follow-up. | C | N/A |
| 477 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | ICD therapy is not indicated when VF or VT is amenable to surgical or catheter ablation (e.g., atrial arrhythmias associated with the Wolff-Parkinson-White syndrome, RV or LV outflow tract VT, idiopathic VT, or fascicular VT in the absence of structural heart disease). | C | N/A |
| 478 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for asymptomatic bifascicular block with or without first-degree AV block after surgery for congenital heart disease in the absence of prior transient complete AV block. | C | N/A |
| 479 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for asymptomatic sinus bradycardia with the longest relative risk interval less than 3 seconds and a minimum heart rate more than 40 bpm. | C | N/A |
| 480 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for asymptomatic type I second-degree AV block at the supra-His (AV node) level or that which is not known to be intra- or infra-Hisian. | C | N/A |
| 481 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for asymptomatic type I second-degree AV block. | C | N/A |
| 482 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for patients who are asymptomatic or whose symptoms are medically controlled. | C | N/A |
| 483 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for SND in asymptomatic patients. | C | N/A |
| 484 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | 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. | C | N/A |
| 485 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for SND with symptomatic bradycardia due to nonessential drug therapy. | C | N/A |
| 486 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacemaker implantation is not indicated for symptomatic patients without evidence of LV outflow tract obstruction. | C | N/A |
| 487 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacing is not indicated for a hypersensitive cardioinhibitory response to carotid sinus stimulation without symptoms or with vague symptoms. | C | N/A |
| 488 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacing is not indicated for frequent or complex ventricular ectopic activity without sustained VT in the absence of the long-QT syndrome. | C | N/A |
| 489 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacing is not indicated for situational vasovagal syncope in which avoidance behavior is effective and preferred. | C | N/A |
| 490 | 2008 | Device-based therapy | ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities | Permanent pacing is not indicated in the presence of an accessory pathway that has the capacity for rapid anterograde conduction. | C | N/A |
| 491 | 2008 | Endomyocardial biopsy | The Role of Endomyocardial Biopsy in the Management of Cardiovascular Disease | Endomyocardial biopsy should not be performed in the setting of unexplained atrial fibrillation. | C | N/A |
| 492 | 2008 | Noninvasive coronary artery imaging | Noninvasive Coronary Artery Imaging Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography | Neither coronary CTA nor MRA should be used to screen for coronary artery disease in patients who have no signs or symptoms suggestive of coronary artery disease. | C | N/A |
| 493 | 2008 | Noninvasive coronary artery imaging | Noninvasive Coronary Artery Imaging Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography | patients with a high pretest likelihood of coronary stenoses are likely to require intervention and invasive catheter angiography for definitive evaluation; thus, CTA is not recommended for those individuals. | C | N/A |
| 494 | 2008 | Prevention of infective endocarditis | AHA Guideline for the Prevention of Infective Endocarditis | There is no evidence that coronary artery bypass graft surgery is associated with a long-term risk for infection. Therefore, antibiotic prophylaxis for dental procedures is not needed for individuals who have undergone this surgery. Antibiotic prophylaxis for dental procedures is not recommended for patients with coronary artery stents. | C | N/A |
| 495 | 2007 | Biomarkers in HF | Practice Guidelines Clinical Utilization of Cardiac Biomarker Testing in Heart Failure | Routine blood biomarker testing for the sole purpose of risk stratification in patients with heart failure is not warranted. | B | No benefit |
| 496 | 2007 | Biomarkers in HF | Practice Guidelines Clinical Utilization of Cardiac Biomarker Testing in Heart Failure | Routine blood BNP or NT-proBNP testing is not warranted for making specific therapeutic decisions for patients with acute or chronic heart failure because of the still emerging but incomplete data as well as intra- and inter-individual variations. | B | No benefit |
| 497 | 2007 | Biomarkers in HF | Practice Guidelines Clinical Utilization of Cardiac Biomarker Testing in Heart Failure | Routine blood natriuretic peptide (BNP or NT-proBNP) testing is not recommended for screening large asymptomatic patient populations for left ventricular dysfunction. | B | No benefit |
| 498 | 2007 | Heart transplant in pediatric patients | Indications for Heart Transplantation in Pediatric Heart Disease | Retransplantation is not efficacious when performed during the first 6 months after primary transplantation. | B | N/A |
| 499 | 2007 | Heart transplant in pediatric patients | Indications for Heart Transplantation in Pediatric Heart Disease | Retransplantation should not be performed during an episode of ongoing acute allograft rejection, even in the presence of graft vasculopathy. | B | N/A |
| 500 | 2007 | Heart transplant in pediatric patients | Indications for Heart Transplantation in Pediatric Heart Disease | The limited supply of pediatric donors, especially infant donors, makes heart transplantation not a feasible standard therapy for any specific congenital heart lesion. | B | N/A |
| 501 | 2007 | Biomarkers in HF | Practice Guidelines Clinical Utilization of Cardiac Biomarker Testing in Heart Failure | In diagnosing patients with heart failure, blood BNP or NT-proBNP testing should not be used to replace conventional clinical evaluation or assessment of the degree of left ventricular structural or functional abnormalities (eg, echocardiography, invasive hemodynamic assessment). | C | No benefit |
| 502 | 2007 | Biomarkers in HF | Practice Guidelines Clinical Utilization of Cardiac Biomarker Testing in Heart Failure | In diagnosing patients with heart failure, routine blood BNP or NT-proBNP testing for patients with an obvious clinical diagnosis of heart failure is not recommended. | C | No benefit |
| 503 | 2007 | Heart transplant in pediatric patients | Indications for Heart Transplantation in Pediatric Heart Disease | Heart transplantation for pediatric heart disease is not efficacious when heart disease is associated with severe, irreversible disease in other organ systems or when it is part of a severe, irreversible, multisystemic disease process. Multiorgan transplantation may be considered. | C | N/A |
| 504 | 2007 | Heart transplant in pediatric patients | Indications for Heart Transplantation in Pediatric Heart Disease | Heart transplantation is generally not indicated in adults with previously repaired or palliated congenital heart disease with a peak maximal oxygen consumption of >15 mL · kg−1 · min−1 or >50% predicted for age and sex without other indications. | C | N/A |
| 505 | 2007 | Heart transplant in pediatric patients | Indications for Heart Transplantation in Pediatric Heart Disease | Heart transplantation is not feasible in the presence of severe hypoplasia of the central branch pulmonary arteries or pulmonary veins. | C | N/A |
| 506 | 2007 | Heart transplant in pediatric patients | Indications for Heart Transplantation in Pediatric Heart Disease | Heart transplantation should not be performed in adults with previously repaired or palliated congenital heart disease in whom comorbidities exist that would otherwise preclude heart transplantation in adults. | C | N/A |
| 507 | 2007 | Heart transplant in pediatric patients | Indications for Heart Transplantation in Pediatric Heart Disease | Orthotopic heart transplantation for pediatric heart disease is not efficacious when heart disease is associated with severe, irreversible, fixed elevation of pulmonary vascular resistance. | C | N/A |
| 508 | 2007 | Standardization of biomarkers in ACS | Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines - Analytical Issues for Biochemical Markers of Acute Coronary Syndromes | Application of management guidelines for ACS should not be based solely on measurement of CRP. | C | N/A |
| 509 | 2007 | Standardization of biomarkers in ACS | Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines - Analytical Issues for Biochemical Markers of Acute Coronary Syndromes | Application of management guidelines for ACS should not be based solely on measurement of natriuretic peptides. | C | N/A |
| 510 | 2007 | Standardization of biomarkers in ACS | Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines - Analytical Issues for Biochemical Markers of Acute Coronary Syndromes | Biomarkers of necrosis should not be used for routine screening of patients with low clinical probability of ACS. | C | N/A |
| 511 | 2007 | Standardization of biomarkers in ACS | Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines - Analytical Issues for Biochemical Markers of Acute Coronary Syndromes | For patients with diagnostic ECG abnormalities on presentation (e.g., new ST-segment elevation), diagnosis and treatment should not be delayed while awaiting biomarker results. | C | N/A |
| 512 | 2007 | Standardization of biomarkers in ACS | Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines - Analytical Issues for Biochemical Markers of Acute Coronary Syndromes | Total CK, CK-MB activity, aspartate aminotransferase (AST, SGOT), β-hydroxybutyric dehydrogenase, and/or lactate dehydrogenase should not be used as biomarkers for the diagnosis of MI. | C | N/A |
| 513 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Class IC antiarrhythmic drugs in patients with a past history of MI should not be used. | A | No benefit |
| 514 | 2006 | CT for CAD | Assessment of Coronary Artery Disease by Cardiac Computed Tomography | Individuals found to be at low risk (<10% 10-year risk) or at high risk (>20% 10-year risk) do not benefit from coronary calcium assessment | B | N/A |
| 515 | 2006 | CT for CAD | Assessment of Coronary Artery Disease by Cardiac Computed Tomography | Serial imaging for assessment of progression of coronary calcification is not indicated at this time | B | N/A |
| 516 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Prophylactic antiarrhythmic drug therapy is not indicated to reduce mortality in patients with asymptomatic nonsustained ventricular arrhythmias. | B | No benefit |
| 517 | 2006 | CT for CAD | Assessment of Coronary Artery Disease by Cardiac Computed Tomography | CT coronary angiography is not recommended in asymptomatic persons for the assessment of occult CAD | C | N/A |
| 518 | 2006 | CT for CAD | Assessment of Coronary Artery Disease by Cardiac Computed Tomography | Imaging of patients to follow up stent placement cannot be recommended | C | N/A |
| 519 | 2006 | CT for CAD | Assessment of Coronary Artery Disease by Cardiac Computed Tomography | It is not recommended to use CACP measure in asymptomatic persons to establish the presence of obstructive disease for subsequent revascularization | C | N/A |
| 520 | 2006 | CT for CAD | Assessment of Coronary Artery Disease by Cardiac Computed Tomography | The incremental benefit of hybrid imaging strategies will need to be demonstrated before clinical implementation, as radiation exposure may be significant with dual nuclear/CT imaging. Therefore, hybrid nuclear/CT imaging is not recommended | C | N/A |
| 521 | 2006 | CT for CAD | Assessment of Coronary Artery Disease by Cardiac Computed Tomography | There are limited data on variability but none on the prognostic implications of CT angiography for NCP assessment or on the utility of these measures to track atherosclerosis or stenosis over time; therefore, their use for these purposes is not recommended | C | N/A |
| 522 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Ablation is not indicated in young patients with asymptomatic NSVT and normal ventricular function. | C | N/A |
| 523 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Ablation of asymptomatic relatively infrequent PVCs is not indicated. | C | N/A |
| 524 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Calcium channel blockers such as verapamil and diltiazem should not be used in patients to terminate wide-QRS-complex tachycardia of unknown origin, especially in patients with a history of myocardial dysfunction. | C | N/A |
| 525 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Digoxin or verapamil should not be used for treatment of sustained tachycardia in infants when VT has not been excluded as a potential diagnosis. | C | N/A |
| 526 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Elderly patients with projected life expectancy less than 1 y due to major comorbidities should not receive ICD therapy. | C | N/A |
| 527 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | ICD implantation is not indicated during the acute phase of myocarditis. | C | N/A |
| 528 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Pharmacological treatment of isolated PVCs in pediatric patients is not recommended. | C | N/A |
| 529 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Prolonged, unbalanced, very low calorie, semistarvation diets are not recommended; they may be harmful and provoke life-threatening ventricular arrhythmias. | C | N/A |
| 530 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Prophylactic antiarrhythmic therapy generally is not indicated for primary prevention of SCD in patients with pulmonary arterial hypertension (PAH) or other pulmonary conditions. | C | N/A |
| 531 | 2006 | Ventricular arrhythmias | ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Prophylactic antiarrhythmic therapy is not indicated for asymptomatic patients with congenital heart disease and isolated PVCs. | C | N/A |
| 532 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Oral vasodilator prostaglandins such as beraprost and iloprost are not effective medications to improve walking distance in patients with intermittent claudication. | A | N/A |
| 533 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Chelation (e.g., ethylenediaminetetraacetic acid) is not indicated for treatment of intermittent claudication and may have harmful adverse effects. | A | Harm |
| 534 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Intervention is not recommended for asymptomatic infrarenal or juxtarenal AAAs if they measure less than 5.0 cm in diameter in men or less than 4.5 cm in diameter in women. | A | N/A |
| 535 | 2005 | Diagnosis and treatment of infective endocarditis | Infective Endocarditis Diagnosis, Antimicrobial Therapy, and Management of Complications | Until further definitive data are available, the routine use of aspirin for established endocarditis is not recommended. | B | N/A |
| 536 | 2005 | Diagnosis and treatment of infective endocarditis | Infective Endocarditis Diagnosis, Antimicrobial Therapy, and Management of Complications | Administration of clindamycin to treat infective endocarditis is associated with an unacceptable rate of relapse, and clindamycin use is not routinely recommended. | B | N/A |
| 537 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Axillofemoral-femoral bypass should not be used for the surgical treatment of patients with intermittent claudication except in very limited settings. | B | N/A |
| 538 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Plasma renin activity is not recommended as a useful screening test to establish the diagnosis of RAS. | B | N/A |
| 539 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Surgical revascularization is not indicated for patients with asymptomatic intestinal arterial obstructions, except in patients undergoing aortic/renal artery surgery for other indications. | B | N/A |
| 540 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Oral iloprost is not an effective therapy to reduce the risk of amputation or death in patients with CLI. | B | N/A |
| 541 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Parenteral administration of pentoxifylline is not useful for the treatment of CLI. | B | N/A |
| 542 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Patients with acute limb ischemia and a nonviable extremity should not undergo an evaluation to define vascular anatomy or efforts to attempt revascularization. | B | N/A |
| 543 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Selective renal vein renin measurements are not recommended as a useful screening test to establish the diagnosis of RAS. | B | N/A |
| 544 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Surgical intervention is not indicated to prevent progression to limb-threatening ischemia in patients with intermittent claudication. | B | N/A |
| 545 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | The captopril test (measurement of plasma renin activity after captopril administration) is not recommended as a useful screening test to establish the diagnosis of RAS. | B | N/A |
| 546 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Oral anticoagulation therapy with warfarin is not indicated to reduce the risk of adverse cardiovascular ischemic events in individuals with atherosclerotic lower extremity PAD. | C | N/A |
| 547 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Arterial imaging is not indicated for patients with a normal postexercise ABI. This does not apply if other atherosclerotic causes (e.g., entrapment syndromes or isolated internal iliac artery occlusive disease) are suspected. | C | N/A |
| 548 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Primary stent placement is not recommended in the femoral, popliteal, or tibial arteries. | C | N/A |
| 549 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Surgical and endovascular intervention is not indicated in patients with severe decrements in limb perfusion (e.g., ABI less than 0.4) in the absence of clinical symptoms of CLI. | C | N/A |
| 550 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Vitamin E is not recommended as a treatment for patients with intermittent claudication. | C | N/A |
| 551 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Captopril renal scintigraphy is not recommended as a screening test to establish the diagnosis of RAS. | C | N/A |
| 552 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Endovascular intervention is not indicated as prophylactic therapy in an asymptomatic patient with lower extremity PAD. | C | N/A |
| 553 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Endovascular intervention is not indicated if there is no significant pressure gradient across a stenosis despite flow augmentation with vasodilators. | C | N/A |
| 554 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | Femoral-tibial artery bypasses with synthetic graft material should not be used for the treatment of claudication. | C | N/A |
| 555 | 2005 | Peripheral arterial disease | ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) | In contrast to chronic intestinal ischemia, duplex sonography of the abdomen is not an appropriate diagnostic tool for suspected acute intestinal ischemia. | C | N/A |
| 556 | 2003 | Supraventricular arrhythmias | ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias | Atenolol is not indicated as prophylactic therapy for patients with SVT during pregnancy. | B | N/A |
| 557 | 2003 | Supraventricular arrhythmias | ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias | Verapamil is not indicated among patients with wide QRS-complex tachycardia of unknown origin. | B | N/A |
| 558 | 2003 | Supraventricular arrhythmias | ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias | Amiodarone is not indicated as prophylactic therapy for patients with SVT during pregnancy. | C | N/A |
| 559 | 2003 | Supraventricular arrhythmias | ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias | Beta blockers are not indicated among patients with wide QRS-complex tachycardia of unknown origin. | C | N/A |
| 560 | 2003 | Supraventricular arrhythmias | ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias | Catheter ablation is not indicated as prophylactic therapy for patients with non-sustained and asymptomatic focal atrial tachycardia. | C | N/A |
| 561 | 2003 | Supraventricular arrhythmias | ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias | Closure of unrepaired asymptomatic ASD that is not associated with significant hemodynamic changes is not recommended to treat SVT in adults with congenital heart disease. | C | N/A |
| 562 | 2003 | Supraventricular arrhythmias | ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias | Digoxin is not indicated among patients with single or infrequent AVRT episode(s) with no pre-excitation. | C | N/A |
| 563 | 2003 | Supraventricular arrhythmias | ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias | Verapamil, diltiazem, or digoxin is not indicated among patients with AVRT that is poorly tolerated with no pre-excitation. | C | N/A |
| 564 | 2003 | Supraventricular arrhythmias | ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias | Verapamil, diltiazem, or digoxin is not indicated among patients with WPW syndrome, with pre-excitation and symptomatic arrhythmias that are well-tolerated. | C | N/A |
| 565 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG is not indicated as initial evaluation for ischemia monitoring among patients with chest pain who are able to exercise. | N/A | N/A |
| 566 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulary ECG is not indicated among pediatric patients as routine evaluation of asymptomatic individuals for athletic clearance. | N/A | N/A |
| 567 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulary ECG is not indicated among pediatric patients for the evaluation of asymptomatic Wolff-Parkinson-White syndrome. | N/A | N/A |
| 568 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulary ECG is not indicated among pediatric patients for the evaluation of chest pain without clinical evidence of heart disease. | N/A | N/A |
| 569 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulary ECG is not indicated among pediatric patients for the evaluation of syncope, near syncope, or dizziness when a noncardiac cause is present. | N/A | N/A |
| 570 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG is not indicated to assess pacemaker and ICD malfunction when device interrogation, ECG, or other available data (chest radiograph and so forth) are sufficient to establish an underlying cause/diagnosis. | N/A | N/A |
| 571 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG to assess risk for future cardiac events in patients without symptoms from arrhythmia is not indicated among patients who have sustained myocardial contusion. | N/A | N/A |
| 572 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG to assess risk for future cardiac events in patients without symptoms from arrhythmia is not indicated among patients with valvular heart disease. | N/A | N/A |
| 573 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG to assess risk for future cardiac events in patients without symptoms from arrhythmia is not indicated among post-MI patients with normal LV function. | N/A | N/A |
| 574 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG to assess symptoms possible related to rhythm disturbance is not indicated among patients with symptoms such as syncope, near syncope, episodic dizziness, or palpitation in whom other causes have been identified by history, physical examination, or laboratory tests. | N/A | N/A |
| 575 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulary ECG is not indicated among pediatric patients for the evaluation of brief palpitation in the absence of heart disease. | N/A | N/A |
| 576 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG to assess pacemaker and ICD function is not indicated for routine follow-up among asymptomatic patients. | N/A | N/A |
| 577 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG to assess risk for future cardiac events in patients without symptoms from arrhythmia is not indicated among patients with sleep apnea. | N/A | N/A |
| 578 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG to assess risk for future cardiac events in patients without symptoms from arrhythmia is not indicated among systemic hypertensive patients with LV hypertrophy. | N/A | N/A |
| 579 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG to assess risk for future cardiac events in patients without symptoms from arrhythmia is not indicated for preoperative arrhythmia evaluation of patients for noncardiac surgery. | N/A | N/A |
| 580 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Ambulatory ECG to assess symptoms possible related to rhythm disturbance is not indicated among patients with cerebrovascular accidents, without other evidence of arrhythmia. | N/A | N/A |
| 581 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Measurement of HRV to assess risk for future cardiac events and to evaluate for diabetic neuropathy is not indicated among diabetic subjects who are asymptomatic from arrhythmia. | N/A | N/A |
| 582 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Measurement of HRV to assess risk for future cardiac events is not indicated among patients with rhythm disturbances that preclude HRV analysis (ie. atrial fibrillation). | N/A | N/A |
| 583 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Measurement of HRV to assess risk for future cardiac events is not indicated among post-MI patients who are asymptomatic from arrhythmia with normal LV function. | N/A | N/A |
| 584 | 1999 | Ambulatory ECG | ACC/AHA Guidelines for Ambulatory Electrocardiography | Routine screening using ambulatory ECG is not indicated for ischemia monitoring among asymptomatic subjects. | N/A | N/A |