ÎÎCRT may be considered for patients who have LVEF of 35% or less,
sinus rhythm, a non-LBBB pattern with a QRS duration of 150 ms or
greater, and NYHA class II symptoms on GDMT. (IIb-B)
ÎÎCRT may be considered for patients who have LVEF of 30% or less,
ischemic etiology of HF, sinus rhythm, LBBB with a QRS duration of
150 ms or greater, and NYHA class I symptoms on GDMT. (IIb-C)
ÎÎCRT is NOT recommended for patients with NYHA class I or II
symptoms and non-LBBB pattern with a QRS duration of less than
150 ms. (III-B: No Benefit)
ÎÎCRT is NOT indicated for patients whose comorbidities and/or frailty
limit survival with good functional capacity to less than 1 year. (III-C:
No Benefit)
a
Counseling should be specific to each individual patient and should include documentation of
a discussion about the potential for sudden death and nonsudden death from HF or noncardiac
conditions. Information should be provided about the efficacy, safety, and potential complications
of an ICD and the potential for defibrillation to be inactivated if desired in the future, notably when
a patient is approaching end of life. This will facilitate shared decision-making between patients,
families, and the medical care team about ICDs.
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