Table of Contents Preamblee79 Introductione81 Methodology and Evidence Reviewe81 Organization of the GWCe82 Document Review and Approvale82 Scope of the CPGe82 Definitions of Urgency and Riske83 ...Clinical Risk Factorse83 Coronary Artery Diseasee83 Heart Failuree85 Role of HF in Perioperative Cardiac Risk Indicese85 Risk of HF Based on Left Ventricular Ejection Fraction: Preserved Versus Reducede85 Risk of Asymptomatic Left Ventricular Dysfunctione85 Role of Natriuretic Peptides in Perioperative Risk of HFe86 Cardiomyopathye86 Valvular Heart Disease: Recommendationse87 Aortic Stenosis: Recommendatione87 Mitral Stenosis: Recommendatione88 Aortic and Mitral Regurgitation: Recommendationse88 Arrhythmias and Conduction Disorderse88 Cardiovascular Implantable Electronic Devices: Recommendatione89 Pulmonary Vascular Disease: Recommendationse90 Adult Congenital Heart Diseasee90 Calculation of Risk to Predict Perioperative Cardiac Morbiditye90 Multivariate Risk Indices: Recommendationse90 Inclusion of Biomarkers in Multivariable Risk Modelse91 Approach to Perioperative Cardiac Testinge91 Exercise Capacity and Functional Capacitye91 Stepwise Approach to Perioperative Cardiac Assessment: Treatment Algorithme93 Supplemental Preoperative Evaluatione95 The 12-Lead Electrocardiogram: Recommendationse95 Assessment of LV Function: Recommendationse96 Exercise Stress Testing for Myocardial Ischemia and Functional Capacity: Recommendationse97 Cardiopulmonary Exercise Testing: Recommendatione97 Pharmacological Stress Testinge97 Noninvasive Pharmacological Stress Testing Before Noncardiac Surgery: Recommendationse97 Radionuclide MPIe98 Dobutamine Stress Echocardiographye98 Stress Testing--Special Situationse99 Preoperative Coronary Angiography: Recommendatione99 Perioperative Therapye99 Coronary Revascularization Before Noncardiac Surgery: Recommendationse100 Timing of Elective Noncardiac Surgery in Patients With Previous PCI: Recommendationse115 Future Research Directionse116 Referencese117 Appendix 1 Author Relationships With Industry and Other Entities (Relevant)e129 Appendix 2 Reviewer Relationships With Industry and Other Entities (Relevant)e131 Appendix 3 Related Recommendations From Other CPGse136 Appendix 4 Abbreviationse137 Preamble The American College of Cardiology (ACC) and the American Heart Association (AHA) are committed to the prevention and management of cardiovascular diseases through professional education and research for clinicians, providers, and patients. Since 1980, the ACC and AHA have shared a responsibility to translate scientific evidence into clinical practice guidelines (CPGs) with recommendations to standardize and improve cardiovascular health.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Recommendations2389 Future Research Directions2389 References2390 Appendix 1 Author Relationships With Industry and Other Entities (Relevant)2397 Appendix 2 Reviewer Relationships With Industry and ...Other Entities (Relevant)2399 Appendix 3 Related Recommendations From Other CPGs2404 Preamble The American College of Cardiology (ACC) and the American Heart Association (AHA) are committed to the prevention and management of cardiovascular diseases through professional education and research for clinicians, providers, and patients. Since 1980, the ACC and AHA have shared a responsibility to translate scientific evidence into clinical practice guidelines (CPGs) with recommendations to standardize and improve cardiovascular health. Harm B (187,211,218,219,224-227,238) Table A Left Main CAD Revascularization Recommendations From the 2011 CABG and PCI CPGs CABG indicates coronary artery bypass graft; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; COR, Class of Recommendation; CPG, clinical practice guideline; EF, ejection fraction; LAD, left anterior descending; LIMA, left internal mammary artery; LOE, Level of Evidence; LV, left ventricular; N/A, not applicable; PCI, percutaneous coronary intervention; SIHD, stable ischemic heart disease; STEMI, ST-elevation myocardial infarction; STS, Society of Thoracic Surgeons; SYNTAX, Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery; TIMI, Thrombolysis In Myocardial Infarction; UA/NSTEMI, unstable angina/non-ST-elevation myocardial infarction; UPLM, unprotected left main disease; and VT, ventricular tachycardia.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
On the basis of this information, the writing committee was constituted to ensure that the Chair and a majority of members have no relevant RWI.\n Miles University of Florida--Professor of Medicine ...Content Reviewer, EP Training Program Director None None None Medtronic UCSF/ZOLL Medical Boston Scientificlow * Medtroniclow * St. Jude Medicallow * None Maged Nageh Kaiser Permanente Los Angeles Medical Center--Attending Physician; Clinical Cardiac Electrophysiology Program Director Content Reviewer, EP Training Program Director None None None None None None Duy Thai Nguyen University of Colorado--Electrophysiology Training Program Director Content Reviewer, EP Training Program Director None None None None None None Kristen K. Patton University of Washington--Associate Professor of Medicine Content Reviewer, ACC EP Section Leadership Council None None None None None None Marwan Refaat American University of Beirut Medical Center--Assistant Professor of Medicine Content Reviewer, ACC EP Section Leadership Council None None None None None None Lynda Rosenfeld Yale University School of Medicine--Director, Yale University Clinical Cardiac Electrophysiology Fellowship Program Content Reviewer, EP Training Program Director None None None Medtronicdagger Boston Scientificlow * Medtroniclow * St. Jude Medicallow * None Peter Santucci Loyola University-- Electrophysiology Training Program Director; Professor of Medicine Content Reviewer, EP Training Program Director None None None None Biosense Websterlow * Biotroniklow * Boston Scientificlow * Medtroniclow * None Komandoor Srivathsan Mayo Clinic--Associate Professor, College of Medicine Content Reviewer, EP Training Program Director St. Jude Medical Biosense Webster None None None None Gregory Supple University of Pennsylvania Health System--Associate Director, Cardiac Electrophysiology Fellowship Program; Assistant Professor of Clinical Medicine Content Reviewer, EP Training Program Director Biotronik St. Jude Medical None None Boston Scientific Medtronic None None Gaurav A. Upadhyay University of Chicago--Assistant Professor of Medicine Content Reviewer, ACC EP Section Leadership Council Biosense Webster Biotronik Boston Scientific Medtronic None None None None None * This table reflects peer reviewers' relationships with industry and other entities that were reported and deemed to be relevant to this document, as well as employment, representation in the review process, and reporting categories.
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Because the ACCF/AHA practice guidelines address patient populations (and healthcare providers) residing in North America, drugs that are not currently available in North America are discussed in the ...text without a specific COR.\n Markowitz Content Reviewer--ACCF EP Committee New York Hospital Biotronik Boston Scientific Medtronic St. Jude Medical None None None Biosense Webster* Boston Scientific* Medtronic* St. Jude Medical* None Marco A. Mercader Content Reviewer George Washington University None None None None None None Simone Musco Content Reviewer Saint Patrick Hospital Boston Scientific None None None None None L. Kristin Newby Content Reviewer Duke University Medical Center None None None None None None Brian Olshansky Content Reviewer--ACCF EP Committee University of Iowa Hospitals Boston Scientific Guidant Medtronic None None None None None Richard L. Page Content Reviewer University of Wisconsin Hospital and Clinics None None None None None None Allen J. Solomon Content Reviewer Medical Faculty Associates None None None None None None John S. Strobel Content Reviewer Internal Medicine Associates None None None Medtronic* None None Stephen L. Winters Content Reviewer Morristown Medical Center Biosense Webster None None None Boston Scientific Medtronic St. Jude Medical Defendant, 2011, complication of ICD placement * Reviewer Relationships With Industry and Other Entities (Relevant)--2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities This table represents the relationships of reviewers with industry and other entities that were disclosed at the time of peer review and determined to be relevant. Names are listed in alphabetical order within each category of review.According to the ACCF/AHA, a person has a relevant relationship IF: (a) the relationship or interest relates to the same or similar subject matter, intellectual property or asset, topic, or issue addressed in the document; or (b) the company/entity (with whom the relationship exists) makes a drug, drug class, or device addressed in the document or makes a competing drug or device addressed in the document; or (c) the person or a member of the person's household has a reasonable potential for financial, professional, or other personal gain or loss as a result of the issues or content addressed in the document.AATS indicates American Association for Thoracic Surgery; ACCF, American College of Cardiology Foundation; AHA, American Heart Association; EP, Electrophysiology; HFSA, Heart Failure Society of America; HRS, Heart Rhythm Society; ICD, implantable cardioverter-defibrillator; MADIT-RIT, Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy; and STS, Society of Thoracic Surgeons.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Long-Term Efficacy of Catheter Ablation of Ventricular Tachycardia in Patients With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Darshan Dalal, Rahul Jain, Harikrishna Tandri, Jun Dong, ...Shaker M. Eid, Kalpana Prakasa, Crystal Tichnell, Cynthia James, Theodore Abraham, Stuart D. Russell, Sunil Sinha, Daniel P. Judge, David A. Bluemke, Joseph E. Marine, Hugh Calkins Prior studies have reported conflicting results concerning the efficacy of radiofrequency catheter ablation (RFA) of ventricular tachycardia (VT) in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) patients. We sought to evaluate the efficacy of RFA procedures in ARVD/C. Among 48 RFA procedures performed in 24 patients, 46%, 31%, and 23% resulted in elimination of all inducible VTs, the clinical VT but not all, and none of the inducible VTs, respectively. The cumulative recurrence-free survival was 75%, 50%, and 25% after 1.5, 5, and 14 months, respectively. Long-term VT recurrence did not differ by procedural success, mapping technique, or repetition of the procedure. Our study shows a high rate of VT recurrence in ARVD/C patients undergoing RFA of VT.
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