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Amanda Jekowsky, American College of
Cardiology, (202) 375-6645, ajekowsk@acc.org
Ann-Marie White, Heart Rhythm Society, (202) 725-7997, awhite@HRSonline.org
Maggie Francis, American Heart Association, (214) 706-1382,
maggie.francis@heart.org
May
15, 2008
The American College of Cardiology,
American Heart Association and the Heart Rhythm Society Release
Updated Cardiac Device-Based Therapy Guidelines
New guidelines offer revised indications for the use of
pacemakers, implantable cardioverter-defibrillators (ICDs)
and cardiac resynchronization therapy (CRT) devices.
SAN FRANCISCO, May 15, 2008 – The
American College of Cardiology (ACC), American Heart Association
(AHA) and the Heart Rhythm Society (HRS) have jointly released
updated cardiac device-based therapy guidelines. The ACC/AHA/HRS
2008 Guidelines for Device-Based Therapy of Cardiac Rhythm
Abnormalities are the first guidelines that combine indications
for all cardiac implantable electronic devices and were released
today during Heart Rhythm 2008, the Heart Rhythm Society’s
29th Annual Scientific Sessions.
An estimated 180,000 pacemaker devices and 91,000 implantable
defibrillators were implanted in the U.S. in 2005 . The ability
to diagnose and treat patients, and manage their devices has
greatly improved in recent years. ACC, AHA and the HRS (formerly
NASPE) created a committee of physicians who are expert in
the areas of device therapy, cardiovascular care, internal
medicine, cardiovascular surgery, ethics and socioeconomics
to update device-based therapy guidelines, previously called
ACC/AHA/NASPE 2002 Guideline Update for Implantation of
Cardiac Pacemakers and Antiarrhythmia Devices. With the
overall goal of improving patient care, the updated guidelines
incorporate data from recent clinical trials and the most
significant advances in pacemaker and implantable cardioverter-defibrillator
(ICD) therapy.
“The updated guidelines are a product of expert analysis
of recent studies that have advanced our knowledge of cardiac
arrhythmias as well as major advances in device technology,”
said writing committee chair Andrew Epstein, M.D., professor
of medicine at the University of Alabama at Birmingham. “The
guidelines take a patient-centered approach and will help
physicians determine the most effective treatment options
available for each individual patient.”
The updated guidelines offer health care providers comprehensive
evidence-based recommendations for the appropriate use of
cardiac devices. It is the first document to comprehensively
address device-based therapy indications for life-threatening
cardiac arrhythmias and conditions including heart failure,
congenital heart disease and sudden cardiac arrest. Guidelines
also address treatment for genetic disorders such as catecholaminergic
polymorphic VT, Brugada syndrome, arrhythmogenic right ventricular
cardiomyopathy and short QT syndrome.
Revised ICD indications reflect the new developments and literature
related to the efficacy of these devices in the treatment
and prevention of sudden cardiac death and malignant ventricular
arrhythmias. Indications for cardiac resynchronization therapy
CRT to better synchronize or coordinate the rhythm of the
heart are also clarified, and the committee determined that
this therapy should only be prescribed when heart failure
patients are still exhibiting symptoms while being treated
with the optimal recommended medical therapy.
“Indications for ICDs, CRT devices, and combined ICDs
and CRT devices are continuously changing and can be expected
to change further as new trials are reported,” Epstein
added. “These guidelines extend and clarify current
best practices and will continue to evolve as technology advances.”
While the guidelines primarily focus on device indications,
the committee also addressed several device and patient management
issues. To ensure optimal patient outcomes, the committee
called for patient and family involvement in a risk assessment
prior to device implantation, including discussion of life
expectancy and quality of life issues. New guidance related
to ICD and pacemaker programming and management at the end
of life was also included.
The guidelines will be published in the Journal of the
American College of Cardiology; Circulation: Journal
of the American Heart Association; and the HeartRhythm
Journal. Full text of the guidelines will be posted on
the ACC (www.acc.org), AHA
(www.americanheart.org)
and Heart Rhythm Society (www.HRSonline.org)
Web sites.
# # #
About the American College of Cardiology (ACC):
The American College of Cardiology is leading the way to optimal
cardiovascular care and disease prevention. The College is
a 34,000-member nonprofit medical society and bestows the
credential Fellow of the American College of Cardiology upon
physicians who meet its stringent qualifications. The College
is a leader in the formulation of health policy, standards
and guidelines, and is a staunch supporter of cardiovascular
research. The ACC provides professional education and operates
national registries for the measurement and improvement of
quality care. For more information visit www.acc.org.
About the American Heart Association (AHA):
Founded in 1924, the American Heart Association is the nation’s
oldest and largest voluntary health organization dedicated
to building healthier lives, free of heart disease and stroke.
These diseases, America’s No. 1 and No. 3 killers, and
all other cardiovascular diseases claim over 870,000 lives
a year. In fiscal year 2006–07 the association invested
more than $554 million in research, professional and public
education, advocacy and community service programs to help
all Americans live longer, healthier lives. To learn more,
call 1-800-AHA-USA1 or visit americanheart.org.
About the Heart Rhythm Society
The Heart Rhythm Society is the international leader in science,
education and advocacy for cardiac arrhythmia professionals
and patients, and the primary information resource on heart
rhythm disorders. Its mission is to improve the care of patients
by promoting research, education and optimal health care policies
and standards. Incorporated in 1979 and based in Washington,
DC, it has a membership of more than 4,800 heart rhythm professionals
in more than 65 countries around the world. www.HRSonline.org.
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