Document Detail


Canadian cardiovascular society guidelines on the use of cardiac resynchronization therapy: evidence and patient selection.
MedLine Citation:
PMID:  23351926     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Recent landmark trials provided the impetus to update the recommendations for cardiac resynchronization therapy (CRT). This article provides guidance on the prescription of CRT within the confines of published data. A future article will explore the implementation of these guidelines. These guidelines are intended to serve as a framework for the prescription of CRT within the Canadian health care system and beyond. They were developed through a critical evaluation of the existing literature, and expert consensus. The panel unanimously adopted each recommendation. The 8 recommendations relate to ensuring the adequacy of medical therapy before the initiation of CRT, the use of symptom severity to select candidates for CRT, differing recommendations based on the presence or absence of sinus rhythm, the presence of left bundle branch block vs other conduction patterns, and QRS duration. The use of CRT in the setting of chronic right ventricular pacing, left ventricular lead placement, and the routine assessment of dyssynchrony to guide the prescription of CRT are also included. The strength of evidence was weighed, taking full consideration of any risks of bias, as well as any imprecision, inconsistency, and indirectness of the available data. The strength of each recommendation and the quality of evidence were adjudicated. Trade-offs between desirable and undesirable consequences of alternative management strategies were considered, as were values, preferences, and resource availability. These guidelines were externally reviewed by experts, modified based on those reviews, and will be updated as new knowledge is acquired.
Authors:
Derek V Exner; David H Birnie; Gordon Moe; Bernard Thibault; François Philippon; Jeffrey S Healey; Anthony S L Tang; Eric Larose; Ratika Parkash
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  29     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  182-95     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Canadian Cardiovascular Society. All rights reserved.
Affiliation:
Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada. Electronic address: exner@ucalgary.ca.
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