New Guidelines Focus on Ventricular Arrhythmias, Sudden Cardiac Death Prevention

The ACC, along with the American Heart Association and the Heart Rhythm Society, have published new guidelines for the treatment of adult patients with ventricular arrhythmias (VA) or who are at risk for sudden cardiac death. The new guidelines replace the 2006 ACC/AHA/SC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death and provide recommendations regarding general evaluation of patients with documented or suspected VA; treatments, therapies and prevention of VA; acute management of specific VA; and VA in the structurally normal heart. They also provide guidance on VA and sudden cardiac death related to special populations, including athletes, pregnancy, older patients with comorbidities, valvular heart disease, adult congenital heart disease, etc. Recommendations on the use of implantable cardiac defibrillators (ICDs) in patients with left ventricular assist devices, use of subcutaneous ICDs and the role of catheter ablation of ventricular arrhythmias are also provided. Other highlights include recommendations on genetic counseling and genetic testing to help inform clinical practice and the need for a shared decision-making approach to treatment. For the first time, these new guidelines also include a section on cost and value considerations, specifically involving strength of evidence surrounding ICDs and cost-effectiveness. Read moreView 10 Points to Remember.