Heart Failure Guideline Recommendations for Device Therapy and Ejection Fraction (EF) Measurement Heart Failure Guideline Recommendations for Device Therapy and Ejection Fraction (EF) Measurement

Heart Failure Guideline Recommendations for Device Therapy and Ejection Fraction (EF) Measurement ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult ( www.acc.org and www.americanheart.org ). Copyright 2005 The American College of Cardiology Foundation and American Heart Association, Inc. Permission granted for limited use. Further reproduction is not permitted without permission of the ACC/AHA.

ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic HF in the Adult ,[object Object],[object Object],[object Object],[object Object],[object Object]

ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic HF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ACC/AHA Task Force on Practice Guidelines ,[object Object],[object Object],[object Object]

Heart Failure Background ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Heart Failure Background Heart Failure At Risk for Heart Failure Stage D Refractory HF requiring specialized interventions Stage B Structural heart disease but without signs or symptoms of HF Stage C Structural heart disease with prior or current HF symptoms Stage A At high risk of HF but without structural heart disease or HF symptoms

[object Object],Structural heart disease but without signs or symptoms of HF: Patients with previous MI, LV remodeling including LVH and low EF, or asymptomatic valvular disease ,[object Object],Refractory HF requiring specialized interventions: Patients who have marked symptoms at rest despite maximal medical therapy (e.g., those who are recurrently hospitalized or cannot be safely discharged from the hospital without specialized interventions) Stage A Stage B Stage C Stage D

2005 Heart Failure Guideline Update Diagnosis and Management of Chronic HF in Adults - Devices in Selected Patients - ,[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],2005 Heart Failure Guideline Update Diagnosis and Management of Chronic HF in Adults - Devices in Selected Patients -

ACC/AHA Classification of Recommendations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ACC/AHA Level of Evidence ,[object Object],[object Object],[object Object]

Stage B: ICD Guideline Class IIa, Level of Evidence B ,[object Object],[object Object],[object Object],[object Object],[object Object],Placement of an ICD is reasonable in patients with ,[object Object],[object Object],[object Object],[object Object]

Stage B: ICD Guideline Class IIb, Level of Evidence C ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Placement of an ICD might be considered in patients ,[object Object],[object Object]

Stage C: ICD Guideline Class I, Level of Evidence A ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],An implantable cardioverter-defibrillator is recommended as secondary prevention to prolong survival in patients with

Stage C: ICD Guideline Class I, Level of Evidence A ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Implantable cardioverter-defibrillator therapy is recommended for primary prevention to reduce total mortality by a reduction in sudden cardiac death in patients with

Stage C: ICD Guideline Class I, Level of Evidence B ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Implantable cardioverter-defibrillator therapy is recommended for primary prevention to reduce total mortality by a reduction in sudden cardiac death in patients with

Stage C: ICD Guideline Class IIa, Level of Evidence B ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Placement of an implantable cardioverter-defibrillator is reasonable in patients with

Stage C: CRT Guideline Class I, Level of Evidence A ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Patients with should receive cardiac resynchronization therapy unless contraindicated.

Assessment of Patients: EF Measurement Class I, Level of Evidence C ,[object Object],[object Object],[object Object],Two-dimensional echocardiography with Doppler should be performed Radionuclide ventriculography can be performed

Assessment of Patients: EF Measurement Class IIa, Level of Evidence C ,[object Object],[object Object],[object Object],Repeat measurement of EF and the severity of structural remodeling can provide useful information in patients with HF

Stage A: EF Measurement Class I, Level of Evidence C ,[object Object],[object Object],Healthcare providers should perform a noninvasive evaluation of LV function (i.e., LVEF) in patients with ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult ( www.acc.org and www.americanheart.org ). Copyright 2005 The American College of Cardiology Foundation and American Heart Association, Inc. Permission granted for limited use. Further reproduction is not permitted without permission of the ACC/AHA.

Heart Failure Guideline Recommendations for Device Therapy and Ejection Fraction (EF) Measurement Heart Failure Guideline Recommendations for Device Therapy and Ejection Fraction (EF) Measurement

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Heart Failure Guideline Recommendations for Device Therapy and Ejection Fraction (EF) Measurement Heart Failure Guideline Recommendations for Device Therapy and Ejection Fraction (EF) Measurement