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ACCF/AHA Device-Based Therapy Guidelines

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Pacing After Cardiac Transplantation Key Point ����The incidence of bradyarrhythmias after cardiac transplantation varies from 8% to 23%. Treatment ����Permanent pacing is indicated for: ������ persistent inappropriate or symptomatic bradycardia not expected to resolve and for other Class I indications for permanent pacing. (I-C) ����Permanent pacing may be considered: ������ when relative bradycardia is prolonged or recurrent, which limits rehabilitation or discharge after postoperative recovery from cardiac transplantation. (IIb-C) ������ for syncope after cardiac transplantation even when bradyarrhythmia has not been documented. (IIb-C) Permanent Pacemakers That Automatically Detect and Pace to Terminate Tachycardias Treatment ����Permanent pacing is reasonable for: ������ symptomatic recurrent supraventricular tachycardia (SVT) that is reproducibly terminated by pacing when catheter ablation and/or drugs fail to control the arrhythmia or produce intolerable side effects. (IIa-C) ����Permanent pacing is NOT indicated: ������ in the presence of an accessory pathway that has the capacity for rapid anterograde conduction. (III-C) Pacing to Prevent Tachycardia Treatment ����Permanent pacing is indicated for: ������ sustained pause-dependent VT, with or without QT prolongation. (I-C) ����Permanent pacing is reasonable for: ������ high-risk patients with congenital long-QT syndrome. (IIa-C) ����Permanent pacing may be considered for: ������ prevention of symptomatic, drug-refractory, recurrent AF in patients with coexisting SND. (IIb-B) ����Permanent pacing is NOT indicated for: ������ frequent or complex ventricular ectopic activity without sustained VT in the absence of the long-QT syndrome. (III-C) ������ torsade de pointes VT due to reversible causes. (III-A) Pacing to Prevent Atrial Fibrillation Treatment ����Permanent pacing is NOT indicated for: ������ the prevention of AF in patients without any other indication for pacemaker implantation. (III-B) 7

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