The American College of Cardiology (ACC), the American Heart Association (AHA), and the Heart Rhythm Society (HRS) have issued new guidelines for the treatment of adult patients with ventricular arrhythmias (VA) or who are at risk for sudden cardiac death (SCD). The new guidelines provide recommendations regarding general evaluation of patients with documented or suspected VA; treatments, therapies, and prevention of VA; acute management of specific VA; and VA in the structurally normal heart. Guidance on VA and SCD related to special populations is also provided, as well as recommendations on the use of implantable cardiac defibrillators (ICDs) in patients with left ventricular assist devices, use of subcutaneous ICDs, and the role of catheter ablation of ventricular arrhythmias. Among areas of interest in the guidelines:
- Indications for ICDs for the treatment of VA and prevention of SCD are discussed.
- Indications for catheter ablation of VA are discussed, but there are no recommendations on specific techniques or ablation technologies.
- Recommendations for interventional therapies, including ablation and the implantation of devices, apply only if these therapies can be implemented by qualified clinicians.
- All recommendations related to ICDs require that meaningful patient survival of >1 year is expected.
Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force Clinical Practice Guidelines and the Heart Rhythm Society. [Published online ahead of print October 30, 2017]. J Am Coll Cardiol. doi:10.1016/j.jacc.2017.10.053.