2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)

Abstract

The content of these European Society of Cardiology (ESC) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC Guidelines may be translated or reproduced in any form without written permission from the ESC. Permission can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC.Disclaimer. The ESC Guidelines represent the views of the ESC and were arrived at after careful consideration of the available evidence at the time they were written. Health professionals are encouraged to take them fully into account when exercising their clinical judgement. The guidelines do not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patients, in consultation with that patient and, where appropriate and necessary, the patient's guardian or carer. It is also the health professional's responsibility to verify the rules and regulations applicable to drugs and devices at the time of prescription.

MR Imaging in Patients with Cardiac Pacemakers and Implantable Cardioverter Defibrillators

“…In light of this, the following procedure is recommended as an expansion of the ESC Guidelines on Cardiac Pacing and Cardiac Resynchronisation Therapy published in 2013 [21], including practical instructions for the collaboration between attending cardiologists and radiologists: a) In patients with absolute PM dependency (defined as intrinsic heart rhythm < 30/min) and in patients without absolute PM dependency with permanent symptomatic bradycardia (intrinsic heart rhythm < 50/min, individual deviations possible depending on symptoms and evaluation of the cardiologist), an asynchronous mode (D00 or V00) should be programmed significantly above the intrinsic heart frequency of the patient.…”

“…Abandoned PM leads are specified in the ESC guidelines from 2013 [21] as an absolute contraindication for an MR examination. From the viewpoint of the authors of this consensus paper, abandoned leads -as specified above -should be considered to significantly increase the risk profile.…”

“…Updated recommendations/guidelines regarding this topic were published in 2013 by the European Society of Cardiology (ESC) [21] and in 2015 by the German Roentgen Society [22] but relate, particularly in the ESC publication, to the own specialty and do not provide a procedure that has been coordinated and approved by both societies.…”

Interaction of Left Ventricular Size and Sex on Outcome of Cardiac Resynchronization Therapy Among Patients With a Narrow QRS Duration in the EchoCRT Trial

“…Indications reflect the greatest probability for successful therapy with QRSd >150 ms, less (or no) effect for QRSd <150 ms, and futility (or possible harm) with QRSd <130 ms 1. However, there is increasing recognition that QRSd may be prolonged not only by reduced myocardial conduction velocity (His‐Purkinje lesions) but also by increased left ventricular (LV) dimension acting to extend the “travel distance” of the propagating wavefront 2.…”

Utilization and likelihood of radiologic diagnostic imaging in patients with implantable cardiac defibrillators

“…Van der Graaf et al29 describe the status of MRI and implantable electronic devices, including ICDs, and report on four ongoing clinical trials studying MR‐conditional pacing devices. The European Society of Cardiology (ESC) on cardiac pacing and cardiac resynchronization therapy (CRT) recently published guidelines that suggest that MRI can be safely performed in patients with ICDs if strict safety conditions are met 30. These guidelines represent a major shift in the previously accepted standard that patients with a pacemaker or ICD should not undergo MRI 29…”