GREGORATOS
ET AL., ACC/AHA/NASPE 2002 Guideline Update for Implantation
of Cardiac Pacemakers and Antiarrhythmia Devices
http://www.acc.org/clinical/guidelines/pacemaker/incorporated/index.htm;
2002
ACC/AHA/NSAPE
2002 Guideline Update for Implantation of Cardiac Pacemakers
and Antiarrythmia Devices—Full Text
A
Report of the American College of Cardiology/American Heart
Association Task Force on Practice Guidelines (ACC/AHA/NASPE
Committee on Implantation)
Preamble
It
is important that the medical profession play a significant
role in critically evaluating the use of diagnostic procedures
and therapies in the management or prevention of disease states.
Rigorous and expert analysis of the available data documenting
relative benefits and risks of those procedures and therapies
can produce helpful guidelines that improve the effectiveness
of care, optimize patient outcomes, and impact the overall
cost of care favorably by focusing resources on the most effective
strategies.
The
American College of Cardiology (ACC) and the American Heart
Association (AHA) have jointly engaged in the production of
such guidelines in the area of cardiovascular disease since
1980. This effort is directed by the ACC/AHA Task Force on
Practice Guidelines, whose charge is to develop and revise
practice guidelines for important cardiovascular diseases
and procedures. Experts in the subject under consideration
are selected from both organizations to examine subject-specific
data and write guidelines. The process includes additional
representatives from other medical practitioner and specialty
groups where appropriate. Writing groups are specifically
charged to perform a formal literature review, weigh the strength
of evidence for or against a particular treatment or procedure,
and include estimates of expected health outcomes when data
exist. Patient specific modifiers, comorbidities, and issues
of patient preference that might influence the choice of particular
tests or therapies are considered, as well as frequency of
follow-up and cost-effectiveness.
The
ACC/AHA Task Force on Practice Guidelines makes every effort
to avoid any actual or potential conflicts of interest that
might arise as a result of an outside relationship or personal
interest of a member of the writing panel. Specifically, all
members of the writing panel are asked to provide disclosure
statements of all such relationships that might be perceived
as real or potential conflicts of interest. These statements
are reviewed by the parent task force, reported orally to
all members of the writing panel at the first meeting, and
updated as changes occur. (See Appendix for conflict of interest
information for writing committee members.)
These
practice guidelines are intended to assist physicians in clinical
decision making by describing a range of generally acceptable
approaches for the diagnosis, management, or prevention of
specific diseases or conditions. These guidelines attempt
to define practices that meet the needs of most patients in
most circumstances. The ultimate judgment regarding care of
a particular patient must be made by the physician and patient
in light of all of the circumstances presented by that patient.
The
1997 Committee on Pacemaker Implantation was
chaired by Gabriel Gregoratos, MD, FACC, and included the
following members: Melvin D. Cheitlin, MD, FACC; Alicia
Conill, MD, FACP; Andrew E. Epstein, MD, FACC;
Christopher Fellows, MD, FACC; T. Bruce Ferguson, Jr.,
MD, FACC; Roger A. Freedman, MD, FACC; Mark A.
Hlatky, MD, FACC; Gerald V. Naccarelli, MD, FACC;
Sanjeev Saksena, MD, MBBS, FACC; Robert C. Schlant,
MD, FACC; and Michael J. Silka, MD, FACC. The document
update used the 1997 work as its basis. The Committee
to Update Guidelines on Cardiac Pacemaker Implantation
and Antiarrhythmic Devices was chaired by Gabriel
Gregoratos, MD, FACC, FAHA, and included the following
members: Andrew E. Epstein, MD, FACC, FAHA; Roger A.
Freedman, MD, FACC; David L. Hayes, MD, FACC,
FAHA; Mark A. Hlatky, MD, FACC, FAHA; Richard E.
Kerber, MD, FACC, FAHA; Gerald V. Naccarelli, MD,
FACC, FAHA; Mark H. Schoenfeld, MD, FACC, FAHA;
Michael J. Silka, MD, FACC; and Stephen L. Winters, MD,
FACC.
The
summary article is published in the October 15, 2002 issue
of Circulation and the November 6, 2002 issue of the
Journal of the American College of Cardiology. The
full-text guideline is posted on the ACC, AHA and NASPE Web
sites. Copies of the full-text and summary article are available
from all three organizations.
Raymond
J. Gibbons, MD, FACC, FAHA
Chair, ACC/AHA Task Force on Practice Guidelines
Elliott
M. Antman, MD, FACC, FAHA
Vice-Chair, ACC/AHA Task Force on Practice Guidelines
©
2002 by the American College of Cardiology Foundation and
the American Heart Association, Inc.
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