27
YES
YES
YES
YES
YES YES
YES
YES
HV ≥70 ms
Inducible
VT/VF
NO
NO
ICD
f
(1)
PPM
(1)
ICD
f
(2a)
ICD
f
(2b)
EP study
c
(2b)
ICD concordant with
patient goals of care
and clinical status
a
Patients with indications
for pacemaker or ICD
implantation, including CRT,
based on recommendations
from previously published
guidelines are not represented
in this flow diagram.
b
Physical examination, ECG,
ambulatory ECG, and cardiac
imaging (echocardiography
or CMR) at diagnosis with
periodic retesting.
c
e purpose of EP testing
is to assess integrity of AV
conduction, in particular,
the His-Purkinje system and
HV interval, and inducibility
of clinically significant
VAs. e discussion of
device implantation should
be carried out prior to
EP testing to confirm a
patient's preference, desire,
and willingness to undergo
implantation.
d
Mild to moderate conduction
disorder is defined as PR
interval 200–230 ms and/or
QRS duration 100–120 ms.
e
Noninvasive testing includes
12-lead ECG, telemetry
recordings, ambulatory ECG,
or implantable loop recorder.
f
ICD system with permanent
pacing capability.
Colors correspond to the class
of recommendation (COR) on
pages 48–49.
