2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapyDeveloped by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA)

Cardiac pacing has been incorporated into so many areas and can be used to treat such a range of clinical conditions, that it has become a pillar of cardiology practice. Technological advances in recent years have led to marked changes in the characteristics and functions of the systems that are used, broadening the horizons for the management of a variety of clinical conditions, while minimizing unwanted effects. However, the paradigm shift goes beyond mere improvements in hardware, software, and lead structure. Compared with previous decades, huge strides have been made in how we assess, follow-up and detect patients’ problems and needs. Indeed, we now talk about not just ‘‘following up’’ patients but also ‘‘monitoring’’ them, which implies a major change in the volume of data, access, responsiveness, and the way we interact with patients. Recent years have also seen the introduction of new technologies, such as leadless pacemakers, which have become highly prominent and, in the future, may become the first choice of treatment. There has also been strong renewed interest in ‘‘physiological’’ methods of cardiac pacing, some of our colleagues being veritable pioneers of these methods. This, and much more, means that the ESC 2021 guidelines on cardiac pacing and cardiac resynchronization therapy include significant changes from their previous version. The most noteworthy aspects are discussed in this editorial.

/pdf/2021-esc-guidelines-on-cardiac-pacing-and-cardiac-kz0aans6lp.pdf

2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy.

2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction

2023 ESC Guidelines for the management of cardiomyopathies

Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta-analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow-up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias.

/pdf/2019-hrs-ehra-aphrs-lahrs-expert-consensus-statement-on-3p2ufvqfaj.pdf

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias.

BackgroundThe presence of a cardiovascular implantable electronic device has long been a contraindication for the performance of magnetic resonance imaging (MRI). We established a prospective registry to determine the risks associated with MRI at a magnetic field strength of 1.5 tesla for patients who had a pacemaker or implantable cardioverter–defibrillator (ICD) that was “non–MRI-conditional” (i.e., not approved by the Food and Drug Administration for MRI scanning). MethodsPatients in the registry were referred for clinically indicated nonthoracic MRI at a field strength of 1.5 tesla. Devices were interrogated before and after MRI with the use of a standardized protocol and were appropriately reprogrammed before the scanning. The primary end points were death, generator or lead failure, induced arrhythmia, loss of capture, or electrical reset during the scanning. The secondary end points were changes in device settings. ResultsMRI was performed in 1000 cases in which patients had a pacemaker and in 500 ...

https://www.nejm.org/doi/suppl/10.1056/NEJMoa1603265/suppl_file/nejmoa1603265_appendix.pdf

Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator

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Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator