Beta Blockers, Sotalol, or Amiodarone for the Treatment of Malignant Ventricular Arrhythmias?

2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA)

“…In patients with unexplained syncope at the end of a complete workup and absence of any conduction disturbance, the lack of a rationale and the negative results of small studies 234,235 give sufficient evidence of inefficacy of cardiac pacing. Thus, cardiac pacing is not recommended until a diagnosis is made (Figure 8).…”

“…Pacing is not recommended in patients with unexplained syncope without evidence of SND or conduction disturbance. 234 In contemporary clinical trials of HFrEF, 1-year mortality rates of $6% are seen, whereas in large registry-based surveys, 1-year mortality rates exceed 20% in patients recently hospitalized for HF, but are closer to 6% in those recruited with stable outpatient HF. 243 The concept of CRT is based on the fact that in patients with HF and LV systolic dysfunction, high-grade intraventricular conduction delays are frequently observed, with a prevalence of QRS duration >120 ms in 25À50% of patients and of LBBB in 15À27% of cases.…”