Thursday, August 30, 2007

New guidelines for cardiac pacing and cardiac resynchronization therapy

ESC publishes new guidelines for cardiac pacing and cardiac resynchronization therapy

August 30, 2007
Michael O'Riordan

Sophia Antipolis, France - On the eve of the European Society of Cardiology (ESC) 2007 Congress, which begins Sunday in Vienna, Austria, the ESC, in partnership with the European Heart Rhythm Association, has released new guidelines for cardiac pacing and cardiac resynchronization therapy (CRT) [1].

The guidelines, now published online in the European Heart Journal, aim to provide an up-to-date specialists' view of the European field and specifically address the issue of permanent pacing in bradyarrhythmias, syncope, and other conditions like hypertrophic obstructive cardiomyopathy and the use of ventricular resynchronization as an adjunct therapy in patients with heart failure.

The new guidelines, by Dr Panos Vardas (Heraklion University Hospital, Greece) and other experts, focus on the use on the appropriate use of pacemakers with various arrhythmias, including sinus node disease, atrioventricular and intraventricular conduction disturbances, pacing disturbances related to AMI, and reflex syncope, among others, and provide recommendations for clinical indications for pacing and the choice of pacing mode.
In addition, the expert panel comments on the rationale for CRT in heart-failure patients, highlights the newest evidence, and makes recommendations according to the different clinical and technical characteristics of the single patient.

"Thanks to important developments in technology and advances in the essential knowledge that we now have concerning the physiology of the paced beat, patients with sinus-node dysfunction and atrioventricular conduction system defects can now be given high-quality therapy," Vardas, chair of the new ESC guidelines, commented in an press release. "These and other developments over the past few years have advanced electrical stimulation further into the realm of ventricular resynchronization as an adjunctive therapy for patients with drug-refractory heart failure and ventricular conduction delay."

The ESC guidelines also highlight the main objectives, structure, and function of a pacemaker clinic and provide recommendations for predischarge assessment of long-term follow-up methodology. The full document, which will soon be published as a pocket-sized version and be available as a personal digital assistant download, is available at the ESC website.


Vardas PE, Auricchio A, Blanc JJ, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy. Eur Heart J 2007; DOI:10.1093/eurheart/ehm305. Available at:

Related links:

Guidelines for cardiac pacing and cardiac resynchronization therapy.
In CRT, ventricular size responds more to biventricular than to LV-only pacing [HeartWire > Heart failure; Apr 13, 2007]
Atrial fib: No reason to avoid resynchronization therapy for heart failure [HeartWire > Heart failure; Mar 20, 2007]
CRT patient-selection criteria: Studies question QRS duration, support tissue-Doppler imaging [HeartWire > Heart failure; Dec 22, 2006]
COMPANION and DEFINITE published: CRT, ICD for HF on threshold of new era [HeartWire > Heart failure; May 19, 2004]

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