Evaluation and Treatment of Patients With Bradycardia and Cardiac Conduction Delay

Abstract

The 2018 American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Rhythm Society (HRS) Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay offers guidance to clinicians for the treatment of adult patients with bradycardia or symptoms thought to be associated with bradycardia or cardiac conduction system delay. 1 Recommendations for permanent pacing are reviewed in this synopsis.The ACC, the AHA, and the HRS developed this guideline. The writing committee performed an extensive review of Englishlanguage human subject literature indexed in MEDLINE (through PubMed), EMBASE, the Cochrane Library, the Agency for Health-care Research and Quality, and other selected relevant databases. The guideline underwent independent peer review and the approval process required by each professional society. 2,3 Permanent Pacing Long-term management strategies for bradycardia will depend on specific etiology and the consequences (ie, symptoms) of dysfunction, and are almost never related to an arbitrary heart rate or pause duration.Permanent pacing for sinus node dysfunction (SND) should be reserved for symptoms directly attributable to irreversible/ nonphysiologic SND (Class of Recommendation [COR] I). The