2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy

Brignole, Michele; Auricchio, Angelo; Barón-Esquivias, Gonzalo; Bordachar, Pierre; Boriani, Giuseppe; Breithardt, Ole A.; Cleland, John G.F.; Deharo, Jean Claude; Delgado, Victoria; Elliott, Perry M.; Görenek, Bülent; Israel, Carsten W.; Leclercq, Christophe; Linde, Cecilia; Mont, Lluı́s; Padeletti, Luigi; Sutton, Richard; Vardas, Panos

doi:10.1016/j.rec.2013.11.003

Cited by 51 publications

(21 citation statements)

References 180 publications

(225 reference statements)

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“…The indications and implantation rates for cardiac devices have expanded dramatically in the last decade. Cardiac resynchronisation therapy is used widely for patients with advanced heart failure, and implantable (intracardiac) cardioverter defibrillators are commonly inserted for prevention of ventricular arrhythmias 45 . Similarly, in the last 15 years, transcatheter aortic valve implantation (TAVI) has gone from concept to clinical reality, and over 100,000 valves have now been implanted worldwide 46 .…”

Section: Management Of Infective Endocarditismentioning

confidence: 99%

Current controversies in infective endocarditis

Cahill

Prendergast

2015

F1000Res

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Infective endocarditis is a life-threatening disease caused by a focus of infection within the heart. For clinicians and scientists, it has been a moving target that has an evolving microbiology and a changing patient demographic. In the absence of an extensive evidence base to guide clinical practice, controversies abound. Here, we review three main areas of uncertainty: first, in prevention of infective endocarditis, including the role of antibiotic prophylaxis and strategies to reduce health care-associated bacteraemia; second, in diagnosis, specifically the use of multimodality imaging; third, we discuss the optimal timing of surgical intervention and the challenges posed by increasing rates of cardiac device infection.

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Section: Management Of Infective Endocarditismentioning

confidence: 99%

Current controversies in infective endocarditis

Cahill

Prendergast

2015

F1000Res

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“…In the choice between CRT-D and CRT-P, the 2013 ESC guideline, endorsed by our national society, the NVVC, states that no strict recommendations on device choice can be made due to insufficient evidence from randomised controlled trials. The guideline merely aims to offer guidance regarding the selection of patients for CRT-D versus CRT-P based on clinical condition, device-related complications as inappropriate ICD therapy, and costs [ 1 ]. We showed that 10 % of our CRT-D population received inappropriate ICD therapy, which is associated with healthcare costs, and CRT-D device costs are much higher than CRT-P costs.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of patients eligible for cardiac resynchronisation therapy (CRT) also have an indication for primary prophylactic implantable cardioverter defibrillator (ICD) therapy based on their depressed left ventricular ejection fraction (LVEF ≤ 35 %) [ 1 ]. Although LVEF is the strongest predictor of ventricular arrhythmias in patients without a history of ventricular arrhythmias, its value in patients eligible for CRT is questionable.…”

Section: Introductionmentioning

confidence: 99%

The risk of ventricular arrhythmias in a Dutch CRT population: CRT-defibrillator versus CRT-pacemaker

et al. 2016

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(29 %) with an LVEF ≤ 35 % (p = 0.001). LVEF post-CRT was more strongly associated to the risk of ventricular arrhythmias than volume response (LVEF > 35 %, HR 0.23, p = 0.020). Conclusion Assessing the necessity of an ICD in patients eligible for CRT remains a challenge. Six months post-CRT an LVEF > 35 % identified patients at low risk of ventricular arrhythmias. LVEF might be used at the time of generator replacement to identify patients suitable for downgrading to a CRT-pacemaker.Keywords Cardiac resynchronisation therapy · Ventricular arrhythmias · Appropriate ICD IntroductionThe majority of patients eligible for cardiac resynchronisation therapy (CRT) also have an indication for primary prophylactic implantable cardioverter defibrillator (ICD) therapy based on their depressed left ventricular ejection fraction (LVEF ≤ 35 %) [1]. Although LVEF is the strongest predictor of ventricular arrhythmias in patients without a history of ventricular arrhythmias, its value in patients eligible for CRT is questionable. CRT aims to improve LVEF and induces reverse remodelling of the left ventricle. Both reverse remodelling and overcrossing a certain threshold in LVEF post-CRT have previously been linked to a decreased risk of ventricular arrhythmias, but inconclusively [2-11]. As a CRT-defibrillator (CRT-D) device is much more expensive than a CRT-pacemaker (CRT-P) and the additional ICD induces the risk of inappropriate ICD therapy, it is clinically relevant to identify those patients at low risk of ventricular arrhythmias prior to CRT-D implant AbstractBackground Patients eligible for cardiac resynchronisation therapy (CRT) have an indication for primary prophylactic implantable cardioverter defibrillator (ICD) therapy. However, response to CRT might influence processes involved in arrhythmogenesis and therefore change the necessity of ICD therapy in certain patients. Method In 202 CRT-defibrillator patients, the association between baseline variables, 6-month echocardiographic outcome (volume response: left ventricular end-systolic volume decrease < ≥15 % and left ventricular ejection fraction (LVEF) ≤ >35 %) and the risk of first appropriate ICD therapy was analysed retrospectively. Results Fifty (25 %) patients received appropriate ICD therapy during a median follow-up of 37 (23-52) months. At baseline ischaemic cardiomyopathy (hazard ratio (HR) 2.0, p = 0.019) and a B-type natriuretic peptide level > 163 pmol/l (HR 3.8, p < 0.001) were significantly associated with the risk of appropriate ICD therapy. After 6 months, 105 (52 %) patients showed volume response and 51 (25 %) reached an LVEF > 35 %. Three (6 %) patients with an LVEF > 35 % received appropriate ICD therapy following echocardiography at ± 6 months compared with 43 patients

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“…The patient was planned for biventricular pacing therapy according to the ESC guidelines (class I indication). 6 During evaluation for additional lead placement, no signs of coronary artery disease were present on the coronary angiogram and venous levophase demonstrated a suitable coronary sinus anatomy. A total occlusion of the left brachiocephalic vein on venous angiogram prevented placement of a right-sided coronary sinus lead, owing to the high risk of vena cava superior syndrome.…”

Section: Case Reportmentioning

confidence: 93%