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==ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (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>==


== ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (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> ==
===Recommendations for [[Heart Failure]]===


=== Recommendations for Heart Failure ===
{|class="wikitable" style="width:80%"
 
{|class="wikitable"
|-
|-
| 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.'''  [[ICD therapy]] is recommended for secondary prevention of [[Sudden cardiac death|SCD]] in patients who survived [[VF]] or hemodynamically unstable VT, or [[VT]] with [[syncope]] and who have an [[LVEF]] less than or equal to 40%, who are receiving chronic optimal medical therapy, and who have a 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>'''1.'''  [[ICD therapy]] is recommended for [[secondary prevention]] of [[Sudden cardiac death|SCD]] in [[patients]] who survived [[VF]] or hemodynamically unstable [[VT]], or [[VT]] with [[syncope]] and who have an [[LVEF]] less than or equal to 40%, who are receiving chronic optimal [[medical therapy]], and who have a reasonable expectation of [[survival]] with a good functional status for more than 1 year. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[ICD therapy]] is recommended for primary prevention to reduce total mortality by a reduction in [[Sudden cardiac death|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 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>'''2.''' [[ICD therapy]] is recommended for [[primary prevention]] to reduce total [[mortality]] by a reduction in [[Sudden cardiac death|SCD]] in patients with [[LV dysfunction]] due to prior [[MI]] who are at least 40 days post-[[MI]], have an [[LVEF]] less than or equal to 30% to 40%, are [[NYHA]] functional class II or III receiving chronic optimal [[medical therapy]], and who have reasonable expectation of survival with a good functional status for more than 1 year. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: A]])''  <nowiki>"</nowiki>
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' [[ICD therapy]] is recommended for primary prevention to reduce total mortality by a reduction in [[Sudden cardiac death|SCD]] in patients with nonischemic heart disease who have an [[LVEF]] less than or equal to 30% to 35%, 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: B]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' [[ICD therapy]] is recommended for [[primary prevention]] to reduce total [[mortality]] by a reduction in [[Sudden cardiac death|SCD]] in [[patients]] with [[nonischemic heart disease]] who have an [[LVEF]] less than or equal to 30% to 35%, 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 year. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' [[Amiodarone]], [[sotalol]], and/or other [[beta blockers]] are recommended pharmacological adjuncts to [[ICD]] therapy to suppress symptomatic [[ventricular tachyarrhythmias]] (both sustained and nonsustained) in otherwise optimally treated patients with HF. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' [[Amiodarone]], [[sotalol]], and/or other [[beta blockers]] are recommended [[pharmacological]] [[adjuncts]] to [[ICD]] [[therapy]] to suppress [[symptomatic]] [[ventricular tachyarrhythmias]] (both sustained and non-sustained) in otherwise optimally treated [[patients]] with [[HF]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' [[Amiodarone]] is indicated for the suppression of acute hemodynamically compromising [[ventricular tachyarrhythmias|ventricular]] or supraventricular tachyarrhythmias when [[cardioversion]] and/or correction of reversible causes have failed to terminate the [[arrhythmia]] or prevent its early recurrence. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' [[Amiodarone]] is indicated for the suppression of acute hemodynamically compromising [[ventricular tachyarrhythmias|ventricular]] or [[supraventricular tachyarrhythmias]] when [[cardioversion]] and/or correction of reversible causes have failed to terminate the [[arrhythmia]] or prevent its early recurrence. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<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.'''  [[ICD therapy]] combined with biventricular pacing can be effective for primary prevention to reduce total mortality by a reduction in [[Sudden cardiac death|SCD]] in patients with NYHA functional class III or IV, are receiving optimal medical therapy, in [[sinus rhythm]] with a [[QRS complex]] of at least 120 ms, 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.'''  [[ICD therapy]] combined with [[biventricular pacing]] can be effective for [[primary prevention]] to reduce total [[mortality]] by a reduction in [[Sudden cardiac death|SCD]] in [[patients]] with [[NYHA]] functional class III or IV, are receiving optimal [[medical therapy]], in [[sinus rhythm]] with a [[QRS complex]] of at least 120 ms, 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.''' [[ICD therapy]] is reasonable for primary prevention to reduce total mortality by a reduction in [[Sudden cardiac death|SCD]] 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,are receiving chronic optimal medical therapy, and 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.''' [[ICD therapy]] is reasonable for [[primary prevention]] to reduce total [[mortality]] by a reduction in [[Sudden cardiac death|SCD]] in [[patients]] with [[LV dysfunction]] due to prior [[MI]] who are at least 40 days post-[[MI]], have an [[LVEF]] of less than or equal to 30% to 35%, are [[NYHA]] functional class I, are receiving chronic optimal [[medical therapy]], and have reasonable expectation of [[survival]]with a good functional status for more than 1 year. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' [[ICD therapy]] is reasonable in patients who have recurrent stable [[VT]], a normal or near normal [[LVEF]], and optimally treated HF and who have a 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>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' [[ICD therapy]] is reasonable in [[patients]] who have recurrent stable [[VT]], a normal or near normal [[LVEF]], and optimally treated [[HF]] and who have a reasonable expectation of [[survival]] with a good functional status for more than 1 year. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' Biventricular pacing in the absence of [[ICD therapy]] is reasonable for the prevention of [[Sudden cardiac death|SCD]] in patients with NYHA functional class III or IV HF, an [[LVEF]] less than or equal to 35%, and a [[QRS complex]] equal to or wider than 160 ms (or at least 120 ms in the presence of other evidence of ventricular dyssynchrony) 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: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' [[Biventricular pacing]] in the absence of [[ICD therapy]] is reasonable for the prevention of [[Sudden cardiac death|SCD]] in [[patients]] with [[NYHA]] functional class III or IV [[HF]], an [[LVEF]] less than or equal to 35%, and a [[QRS complex]] equal to or wider than 160 ms (or at least 120 ms in the presence of other evidence of [[ventricular]] dyssynchrony) who are receiving chronic optimal [[medical therapy]] and who have reasonable expectation of [[survival]] with a good functional status for more than 1 year. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<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.''' [[Amiodarone]], [[sotalol]], and/or [[beta blockers]] may be considered as pharmacological alternatives to [[ICD therapy]] to suppress symptomatic [[ventricular tachyarrhythmias]] (both sustained and nonsustained) in optimally treated patients with HF for whom ICD therapy is not feasible. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Amiodarone]], [[sotalol]], and/or [[beta blockers]] may be considered as [[pharmacological]] alternatives to [[ICD therapy]] to suppress [[symptomatic]] [[ventricular tachyarrhythmias]] (both sustained and nonsustained) in optimally treated [[patients]] with [[HF]] for whom [[ICD]] [[therapy]] is not feasible. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' [[ICD therapy]] may be considered for primary prevention to reduce total mortality by a reduction in [[Sudden cardiac death|SCD]] in patients with nonischemic [[heart disease]] who have an [[LVEF]] of less than or equal to 30% to 35%, are NYHA functional class I receiving chronic optimal medical therapy, and who have a 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.''' [[ICD therapy]] may be considered for [[primary prevention]] to reduce total [[mortality]] by a reduction in [[Sudden cardiac death|SCD]] in [[patients]] with non[[ischemic]] [[heart disease]] who have an [[LVEF]] of less than or equal to 30% to 35%, are [[NYHA]] functional class I receiving chronic optimal [[medical therapy]], and who have a reasonable expectation of [[survival]] with a good functional status for more than 1 year. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|}
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 10:50, 21 June 2022



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ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, DMD, MD[2]

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT) [1]

Recommendations for Heart Failure

Class I
"1. ICD therapy is recommended for secondary prevention of SCD in patients who survived VF or hemodynamically unstable VT, or VT with syncope and who have an LVEF less than or equal to 40%, who are receiving chronic optimal medical therapy, and who have a reasonable expectation of survival with a good functional status for more than 1 year. (Level of Evidence: A) "
"2. 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 days post-MI, have an LVEF less than or equal to 30% to 40%, are NYHA functional class II or III receiving chronic optimal medical therapy, and who have reasonable expectation of survival with a good functional status for more than 1 year. (Level of Evidence: A) "
"3. ICD therapy is recommended for primary prevention to reduce total mortality by a reduction in SCD in patients with nonischemic heart disease who have an LVEF less than or equal to 30% to 35%, 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 year. (Level of Evidence: B) "
"4. Amiodarone, sotalol, and/or other beta blockers are recommended pharmacological adjuncts to ICD therapy to suppress symptomatic ventricular tachyarrhythmias (both sustained and non-sustained) in otherwise optimally treated patients with HF. (Level of Evidence: C)"
"5. Amiodarone is indicated for the suppression of acute hemodynamically compromising ventricular or supraventricular tachyarrhythmias when cardioversion and/or correction of reversible causes have failed to terminate the arrhythmia or prevent its early recurrence. (Level of Evidence: B)"
Class IIa
"1. ICD therapy combined with biventricular pacing can be effective for primary prevention to reduce total mortality by a reduction in SCD in patients with NYHA functional class III or IV, are receiving optimal medical therapy, in sinus rhythm with a QRS complex of at least 120 ms, and who have reasonable expectation of survival with a good functional status for more than 1 y. (Level of Evidence: B)"
"2. ICD therapy is reasonable 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 days post-MI, have an LVEF of less than or equal to 30% to 35%, are NYHA functional class I, are receiving chronic optimal medical therapy, and have reasonable expectation of survivalwith a good functional status for more than 1 year. (Level of Evidence: B) "
"3. ICD therapy is reasonable in patients who have recurrent stable VT, a normal or near normal LVEF, and optimally treated HF and who have a reasonable expectation of survival with a good functional status for more than 1 year. (Level of Evidence: C)"
"4. Biventricular pacing in the absence of ICD therapy is reasonable for the prevention of SCD in patients with NYHA functional class III or IV HF, an LVEF less than or equal to 35%, and a QRS complex equal to or wider than 160 ms (or at least 120 ms in the presence of other evidence of ventricular dyssynchrony) who are receiving chronic optimal medical therapy and who have reasonable expectation of survival with a good functional status for more than 1 year. (Level of Evidence: B)"
Class IIb
"1. Amiodarone, sotalol, and/or beta blockers may be considered as pharmacological alternatives to ICD therapy to suppress symptomatic ventricular tachyarrhythmias (both sustained and nonsustained) in optimally treated patients with HF for whom ICD therapy is not feasible. (Level of Evidence: C)"
"2. ICD therapy may be considered for primary prevention to reduce total mortality by a reduction in SCD in patients with nonischemic heart disease who have an LVEF of less than or equal to 30% to 35%, are NYHA functional class I receiving chronic optimal medical therapy, and who have a reasonable expectation of survival with a good functional status for more than 1 year. (Level of Evidence: B) "

References

  1. 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.

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