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ICD indications: Difference between revisions
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An overview of ICD and CRT(D) indications as recommended by the European Society of Cardiology. For all indications patient should be on optimal medical therapy and have a life expectancy of > 1 year. | An overview of ICD and CRT(D) indications as recommended by the ''European Society of Cardiology''. For all indications patient should be on optimal medical therapy and have a life expectancy of > 1 year. | ||
==Class I (recommendations)== | ==Class I (recommendations)== | ||
* Patients with left ventricular dysfunction due to prior myocardial infarction who are at least 40 days post MI with LVEF <30-40%, are NYHA class II or III and are receiving chronic optimal medical therapy and with life expectancy > 1 year. IA<cite>ESCSCD</cite> | * Patients with left ventricular dysfunction due to prior myocardial infarction who are at least 40 days post MI with LVEF <30-40%, are NYHA class II or III and are receiving chronic optimal medical therapy and with life expectancy > 1 year. IA<cite>ESCSCD</cite> | ||
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* CRTD is recommended in patients with sinus rhythm, LBBB, QRS > 120ms, EF<35%, NYHA III-IV. IA <cite>ESCHF</cite><cite>ESCfocusedup</cite> | * CRTD is recommended in patients with sinus rhythm, LBBB, QRS > 120ms, EF<35%, NYHA III-IV. IA <cite>ESCHF</cite><cite>ESCfocusedup</cite> | ||
* CRT in patient with an other Class I pacemaker indication who is in NYHA III/IV, LVEF ≤35%, QRS ≥120 ms. IB<cite>ESCsyncope</cite> | * CRT in patient with an other Class I pacemaker indication who is in NYHA III/IV, LVEF ≤35%, QRS ≥120 ms. IB<cite>ESCsyncope</cite> | ||
* | * Syncope, documented VT and structural heart disease. IB <cite>ESCsyncope</cite> | ||
* When monomorphic VT is induced at EP study in patients with previous myocardial infarction. IB <cite>ESCsyncope</cite> | * When monomorphic VT is induced at EP study in patients with previous myocardial infarction and syncope. IB <cite>ESCsyncope</cite> | ||
==Class IIa (should be considered)== | ==Class IIa (should be considered)== | ||
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* Unexplained syncope, significant LV dysfunction, non-ischemic DCM. Optimal medical therapy, LE>1y. IIaC<cite>ESCSCD</cite> | * Unexplained syncope, significant LV dysfunction, non-ischemic DCM. Optimal medical therapy, LE>1y. IIaC<cite>ESCSCD</cite> | ||
* Sustained VT with (near) normal LV function and non-ischemic DCM. Optimal medical therapy, LE>1y. IIaC<cite>ESCSCD</cite> | * Sustained VT with (near) normal LV function and non-ischemic DCM. Optimal medical therapy, LE>1y. IIaC<cite>ESCSCD</cite> | ||
* | * HCM with high risk (>5% in 5y): http://doc2do.com/hcm/webHCM.html <cite>ESCHCM</cite> | ||
* Arrhythmogenic right ventricular cardiomyopathy with extensive disease, including those with LV dysfunction 1 or more affected family members with SCD, or undiagnosed syncope when VT or VF has not been excluded as the cause of syncope. OMT, LE>1y.IB <cite>ESCSCD</cite> | * Arrhythmogenic right ventricular cardiomyopathy with extensive disease, including those with LV dysfunction 1 or more affected family members with SCD, or undiagnosed syncope when VT or VF has not been excluded as the cause of syncope. OMT, LE>1y.IB <cite>ESCSCD</cite> | ||
* CRTD, NYHA III/IV, SR, QRS>120ms. IIaB. <cite>ESCSCD</cite> | * CRTD, NYHA III/IV, SR, QRS>120ms. IIaB. <cite>ESCSCD</cite> | ||
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#ESCsyncope pmid=19713422 | #ESCsyncope pmid=19713422 | ||
#ESCfocusedup pmid=20801924 | #ESCfocusedup pmid=20801924 | ||
#ESCHCM pmid=25173338 | |||
</biblio> | </biblio> | ||