Congestive heart failure AHA recommendations for patients with a prior MI: Difference between revisions
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| [[File:Siren.gif|30px|link=heart failure resident survival guide]]|| <br> || <br> | | [[File:Siren.gif|30px|link= Congestive heart failure resident survival guide]]|| <br> || <br> | ||
| [[ | | [[Acute decompensated heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] | ||
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| [[File:Critical_Pathways.gif|88px|link= Congestive heart failure critical pathways]]|| <br> || <br> | |||
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{{Congestive heart failure}} | {{Congestive heart failure}} | ||
{{CMG}} | {{CMG}} ; {{AE}} {{EdzelCo}} | ||
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== 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363499">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e895-e1032 | pmid=35363499 | doi=10.1161/CIR.0000000000001063 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363499 }} </ref>== | |||
===Left Ventricular Dysfunction Due to Prior Myocardial Infarction (DO NOT EDIT) <ref name="pmid16935995">{{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.| title=ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=Circulation | year= 2006 | volume= 114 | issue= 10 | pages= e385-484 | pmid=16935995 | doi=10.1161/CIRCULATIONAHA.106.178233 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16935995}}</ref>=== | ===[[Left Ventricular]] [[Dysfunction]] Due to Prior [[Myocardial Infarction]] (DO NOT EDIT) <ref name="pmid16935995">{{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.|title=ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=Circulation |year= 2006 | volume= 114 | issue= 10 | pages= e385-484 | pmid=16935995 | doi=10.1161/CIRCULATIONAHA.106.178233 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16935995}}</ref> === | ||
{|class="wikitable" | {|class="wikitable" style="width:80%" | ||
|- | |- | ||
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]] | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Aggressive attempts should be made to treat HF that may be present in some patients with LV dysfunction due to prior MI and [[ventricular | | bgcolor="LightGreen"| <nowiki>"</nowiki> '''1.''' Aggressive attempts should be made to treat [[HF]] that may be present in some [[patients]] with [[LV dysfunction]] due to prior [[MI]] and [[ventricular tachyarrhythmia]]s. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Aggressive attempts should be made to treat [[myocardial ischemia]] that may be present in some patients with [[ventricular | | bgcolor="LightGreen"| <nowiki>"</nowiki> '''2.''' Aggressive attempts should be made to treat [[myocardial ischemia]] that may be present in some [[patients]] with [[ventricular tachyarrhythmia]]s. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' [[Coronary revascularization]] is indicated to reduce the risk of SCD in patients with VF when direct, clear evidence of acute myocardial ischemia is documented to immediately precede the onset of VF. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'' | | bgcolor="LightGreen"| <nowiki>"</nowiki> '''3.''' [[Coronary revascularization]] is indicated to reduce the risk of [[SCD]] in [[patients]] with [[VF]] when direct, clear evidence of [[acute myocardial ischemia]] is documented to immediately precede the onset of [[VF]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' If [[coronary revascularization]] cannot be carried out | | bgcolor="LightGreen"| <nowiki>"</nowiki> '''4.''' If [[coronary revascularization]] cannot be carried out and there is evidence of prior [[MI]] and significant [[LV dysfunction]], the primary [[therapy]] of [[patients]] resuscitated from [[VF]] should be the [[ICD]]] in [[patients]] who are receiving chronic optimal [[medical therapy]] and those who have reasonable expectation of [[survival]] with a good functional status for more than 1 y. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' [[ICD | | bgcolor="LightGreen"| <nowiki>"</nowiki> '''5.''' [[ICD]] therapy is recommended for [[primary prevention]] to reduce total [[mortality]] by a reduction in [[SCD]] in [[patients]] with [[LV dysfunction]] due to prior [[MI]] who are at least 40 d post-[[MI]], have an [[LVEF]] less than or equal to 30% to 40%, are [[NYHA]] functional class II or III, are receiving chronic optimal [[medical therapy]], and who have reasonable expectation of survival with a good functional status for more than 1 y. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''6.'''The [[ICD]] is effective therapy to reduce mortality by a reduction in SCD in patients with [[LV dysfunction]] due to prior [[MI]] who present with hemodynamically unstable sustained VT, | | bgcolor="LightGreen"| <nowiki>"</nowiki> '''6.''' The [[ICD]] is effective [[therapy]] to reduce [[mortality]] by a reduction in [[SCD]] in [[patients]] with [[LV dysfunction]] due to prior [[MI]] who present with [[hemodynamically]] unstable sustained [[VT]], are receiving chronic optimal [[medical therapy]], and who have reasonable expectation of [[survival]] with a good functional status for more than 1 y. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | ||
|} | |} | ||
{|class="wikitable" | {|class="wikitable" style="width:80%" | ||
|- | |- | ||
|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA | |colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class III]] | ||
|- | |- | ||
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Prophylactic antiarrhythmic drug therapy is not indicated to reduce mortality in patients with asymptomatic nonsustained ventricular arrhythmias. ''([[ACC AHA | |bgcolor="LightCoral"| <nowiki>"</nowiki> '''1.''' [[Prophylactic]] [[antiarrhythmic]] [[drug therapy]] is not indicated to reduce [[mortality]] in [[patients]] with [[asymptomatic]] nonsustained [[ventricular arrhythmias]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' [[ | |bgcolor="LightCoral"| <nowiki>"</nowiki> '''2.''' Class IC [[antiarrhythmic drug]]s in [[patients]] with a past [[history]] of [[MI]] should not be used. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | ||
|} | |} | ||
{|class="wikitable" | {|class="wikitable" style="width:80%" | ||
|- | |- | ||
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIa]] | | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIa]] | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Implantation of an [[ICD]] is reasonable in patients with [[LV dysfunction]] due to prior [[MI]] who are at least 40 d post-MI, have an [[LVEF]] of less than or equal to 30% to 35%, are NYHA functional class I on chronic optimal medical therapy, and who have reasonable expectation of survival with a good functional status for more than 1 y. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |bgcolor="LemonChiffon"| <nowiki>"</nowiki> '''1.''' Implantation of an [[ICD]] is reasonable in [[patients]] with [[LV dysfunction]] due to prior [[MI]] who are at least 40 d post-[[MI]], have an [[LVEF]] of less than or equal to 30% to 35%, are [[NYHA]] functional class I on chronic optimal [[medical therapy]], and who have reasonable expectation of [[survival]] with a good functional status for more than 1 y. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' [[Amiodarone]], often in combination with [[beta blockers]], can be useful for patients with [[LV dysfunction]] due to prior [[MI]] and symptoms due to VT unresponsive to [[beta-adrenergic blocking agents]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |bgcolor="LemonChiffon"| <nowiki>"</nowiki> '''2.''' [[Amiodarone]], often in combination with [[beta blockers]], can be useful for [[patients]] with [[LV dysfunction]] due to prior [[MI]] and [[symptoms]] due to [[VT]] unresponsive to [[beta-adrenergic blocking agents]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' [[Sotalol]] is reasonable therapy to reduce symptoms resulting from VT for patients with [[LV dysfunction]] due to prior [[MI]] unresponsive to [[beta | |bgcolor="LemonChiffon"| <nowiki>"</nowiki> '''3.''' [[Sotalol]] is reasonable [[therapy]] to reduce [[symptoms]] resulting from [[VT]] for patients with [[LV dysfunction]] due to prior [[MI]] unresponsive to [[beta blocking agents]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' Adjunctive therapies to the [[ICD]], including [[catheter ablation]] or [[surgical resection]], and pharmacological therapy with agents such as [[amiodarone]] or [[sotalol]] are reasonable to improve symptoms due to frequent episodes of | |bgcolor="LemonChiffon"| <nowiki>"</nowiki> '''4.''' [[Adjunctive therapies]] to the [[ICD]], including [[catheter ablation]] or [[surgical resection]], and [[pharmacological therapy]] with agents such as [[amiodarone]] or [[sotalol]] are reasonable to improve [[symptoms]] due to frequent episodes of [[ustained VT]] or [[VF]] in [[patients]] with [[LV dysfunction]] due to prior [[MI]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''5.''' [[Amiodarone]] is reasonable therapy to reduce symptoms due to recurrent hemodynamically stable VT for patients with [[LV dysfunction]] due to prior [[MI | |bgcolor="LemonChiffon"| <nowiki>"</nowiki> '''5.''' [[Amiodarone]] is reasonable [[therapy]] to reduce [[symptoms]] due to recurrent hemodynamically stable [[VT]] for [[patients]] with [[LV dysfunction]] due to prior [[MI\\ who cannot or refuse to have an [[ICD]] implanted. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''6.''' | |bgcolor="LemonChiffon"| <nowiki>"</nowiki> '''6.''' Implantation is reasonable for [[treatment\\ of recurrent [[ventricular tachycardia]] in [[patients]] post-[[MI]] with normal or near normal [[ventricular function]] who are receiving chronic optimal [[medical therapy]] and who have reasonable expectation of [[survival]]] with a good functional status for more than 1 y. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |} | ||
{|class="wikitable" | {|class="wikitable" style="width:80%" | ||
|- | |- | ||
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIb]] | | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIb]] | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Curative [[catheter ablation]] or [[amiodarone]] may be considered in lieu of [[ICD]] | |bgcolor="LemonChiffon"| <nowiki>"</nowiki> '''1.''' Curative [[catheter ablation]] or [[amiodarone]] may be considered in lieu of [[ICD therapy]] to improve [[symptoms]] in [[patients]] with [[LV dysfunction]] due to prior [[MI]] and recurrent hemodynamically stable [[VT]] whose [[LVEF]] is greater than 40%. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' [[Amiodarone]] may be reasonable therapy for patients with [[LV dysfunction]] due to prior [[MI]] with an [[ICD]] indication, as defined above, in patients who cannot or refuse to have an [[ICD]] implanted. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |bgcolor="LemonChiffon"| <nowiki>"</nowiki> '''2.''' [[Amiodarone]] may be reasonable [[therapy]] for [[patients]] with [[LV dysfunction]] due to prior [[MI]] with an [[ICD]] indication, as defined above, in patients who cannot or refuse to have an [[ICD]] implanted. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |} | ||
==External Link== | |||
*[https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000001063.full.pdf 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines]<ref name="pmid35363499">{{cite journal |vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW |title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines |journal=Circulation |volume=145 |issue=18 |pages=e895–e1032 |date=May 2022 |pmid=35363499 |doi=10.1161/CIR.0000000000001063 |url=}} </ref> | |||
==References== | ==References== | ||
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Latest revision as of 22:24, 22 June 2022
Resident Survival Guide |
File:Critical Pathways.gif |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Edzel Lorraine Co, DMD, MD[2]
2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [1]
Left Ventricular Dysfunction Due to Prior Myocardial Infarction (DO NOT EDIT) [2]
Class I |
" 1. Aggressive attempts should be made to treat HF that may be present in some patients with LV dysfunction due to prior MI and ventricular tachyarrhythmias. (Level of Evidence: C)" |
" 2. Aggressive attempts should be made to treat myocardial ischemia that may be present in some patients with ventricular tachyarrhythmias. (Level of Evidence: C)" |
" 3. Coronary revascularization is indicated to reduce the risk of SCD in patients with VF when direct, clear evidence of acute myocardial ischemia is documented to immediately precede the onset of VF. (Level of Evidence: B)" |
" 4. If coronary revascularization cannot be carried out and there is evidence of prior MI and significant LV dysfunction, the primary therapy of patients resuscitated from VF should be the ICD] in patients who are receiving chronic optimal medical therapy and those who have reasonable expectation of survival with a good functional status for more than 1 y. (Level of Evidence: A)" |
" 5. ICD therapy is recommended for primary prevention to reduce total mortality by a reduction in SCD in patients with LV dysfunction due to prior MI who are at least 40 d post-MI, have an LVEF less than or equal to 30% to 40%, are NYHA functional class II or III, are receiving chronic optimal medical therapy, and who have reasonable expectation of survival with a good functional status for more than 1 y. (Level of Evidence: A)" |
" 6. The ICD is effective therapy to reduce mortality by a reduction in SCD in patients with LV dysfunction due to prior MI who present with hemodynamically unstable sustained VT, are receiving chronic optimal medical therapy, and who have reasonable expectation of survival with a good functional status for more than 1 y. (Level of Evidence: A)" |
Class III |
" 1. Prophylactic antiarrhythmic drug therapy is not indicated to reduce mortality in patients with asymptomatic nonsustained ventricular arrhythmias. (Level of Evidence: B)" |
" 2. Class IC antiarrhythmic drugs in patients with a past history of MI should not be used. (Level of Evidence: A)" |
Class IIa |
" 1. Implantation of an ICD is reasonable in patients with LV dysfunction due to prior MI who are at least 40 d post-MI, have an LVEF of less than or equal to 30% to 35%, are NYHA functional class I on chronic optimal medical therapy, and who have reasonable expectation of survival with a good functional status for more than 1 y. (Level of Evidence: B) " |
" 2. Amiodarone, often in combination with beta blockers, can be useful for patients with LV dysfunction due to prior MI and symptoms due to VT unresponsive to beta-adrenergic blocking agents. (Level of Evidence: B)" |
" 3. Sotalol is reasonable therapy to reduce symptoms resulting from VT for patients with LV dysfunction due to prior MI unresponsive to beta blocking agents. (Level of Evidence: C)" |
" 4. Adjunctive therapies to the ICD, including catheter ablation or surgical resection, and pharmacological therapy with agents such as amiodarone or sotalol are reasonable to improve symptoms due to frequent episodes of ustained VT or VF in patients with LV dysfunction due to prior MI. (Level of Evidence: C)" |
" 5. Amiodarone is reasonable therapy to reduce symptoms due to recurrent hemodynamically stable VT for patients with LV dysfunction due to prior [[MI\\ who cannot or refuse to have an ICD implanted. (Level of Evidence: C)" |
" 6. Implantation is reasonable for [[treatment\\ of recurrent ventricular tachycardia in patients post-MI with normal or near normal ventricular function who are receiving chronic optimal medical therapy and who have reasonable expectation of survival] with a good functional status for more than 1 y. (Level of Evidence: C)" |
Class IIb |
" 1. Curative catheter ablation or amiodarone may be considered in lieu of ICD therapy to improve symptoms in patients with LV dysfunction due to prior MI and recurrent hemodynamically stable VT whose LVEF is greater than 40%. (Level of Evidence: B)" |
" 2. Amiodarone may be reasonable therapy for patients with LV dysfunction due to prior MI with an ICD indication, as defined above, in patients who cannot or refuse to have an ICD implanted. (Level of Evidence: C)" |
External Link
- 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[1]
References
- ↑ 1.0 1.1 Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check
|pmid=
value (help). - ↑ Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M; et al. (2006). "ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". Circulation. 114 (10): e385–484. doi:10.1161/CIRCULATIONAHA.106.178233. PMID 16935995.