10
Indications for CPP in Patients with
Indications for Pacemaker Therapy
Substantial ventricular pacing
COR LOE Recommendations
2a B-R
(CRT)
1. In patients with an indication for permanent pacing with an
LVEF 36%–50% who are anticipated to require substantial
ventricular pacing, CPP is reasonable to reduce the risk of
PICM.
B-NR
(HBP,
LBBAP)
2b B-NR 2. In patients with normal LVEF who are anticipated to require
substantial ventricular pacing, it may be reasonable to treat
patients with CPP to reduce the risk of PICM.
2b C-LD 3. In patients who are ventricular pacing-dependent undergoing
HBP pacemaker implantation, placement of an additional
backup lead may be reasonable to mitigate the risk of high
pacing capture thresholds, lead dislodgment, loss of capture,
or oversensing.
Less than substantial ventricular pacing
COR LOE Recommendations
2a B-R 1. In patients with an indication for permanent pacing with
LVEF >35% who are anticipated to require less than
substantial ventricular pacing, it is reasonable to choose
traditional RV lead placement and minimize RVP.
2b C-LD 2. In patients with an indication for permanent pacing with
LVEF 36%–50% who are anticipated to require less than
substantial ventricular pacing, a CSP lead with HBP or
LBBAP may be considered as an alternative to an RVP lead.
2b C-LD 3. In patients with an indication for permanent pacing, LVEF
36%–50% and LBBB, and who are anticipated to require less
than substantial ventricular pacing, CPP may be considered to
potentially improve symptoms and LVEF.
2b C-LD 4. In patients who are undergoing permanent pacing with
normal LVEF and are anticipated to require less than
substantial ventricular pacing, an LBBAP lead may be
considered as an alternative to an RVP lead.
3: No
Benefit
B-R 5. In patients with normal LVEF who are anticipated to require
less than substantial ventricular pacing, CRT with BiV pacing
is not indicated.
