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Management of Patients With Ventricular Arrhythmias and Prevention of Sudden Cardiac Death PowerPoint Presentation

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Description : Check out this medical presentation on Emergency Medical Services (EMS), which is titled "Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death", to know about the AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.

Tags : Emergency Medical Services, EMS, Guideline, Management, Patients, Ventricular Arrhythmias, Prevention, Sudden Cardiac Death

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Slide 1-

2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Developed in Collaboration With the Heart Failure Society of America Endorsed by Heart Failure Society of America © American College of Cardiology Foundation and American Heart Association
Slide 2-

Citation This slide set is adapted from the 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Published on [Date], available at: Journal of the American College of Cardiology [(insert full link)] and Circulation [(insert full link)] The full-text guidelines are also available on the following Web sites: ACC (www.acc.org) and AHA (professional.heart.org)
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VA/SCD Guideline Writing Committee Sana M. Al-Khatib, MD, MHS, FACC, FAHA, FHRS, Chair William G. Stevenson, MD, FACC, FAHA, FHRS, Vice Chair †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ║ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Richard L. Page, MD, FACC, FAHA, FHRS‡
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Table 1. Applying Class of Recommendation and Level of Evidence to Clinical Strategies, Interventions, Treatments, or Diagnostic Testing in Patient Care* (Updated August 2015)
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2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death General Evaluation of Patients with Documented or Suspected VA
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History and Physical Examination *This section covers practices that are well accepted, and a new recommendation was determined to only be warranted for syncope.
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12-lead ECG and Exercise Testing Noninvasive Evaluation
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Ambulatory Electrocardiography Noninvasive Evaluation Implanted Cardiac Monitors
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Noninvasive Cardiac Imaging Noninvasive Evaluation
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Biomarkers Noninvasive Evaluation Genetic Considerations in Arrhythmia Syndromes
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Invasive Cardiac Imaging: Cardiac Catheterization or CT Angiography Invasive Evaluation
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Electrophysiological Study for VA Invasive Evaluation
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2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Therapies for Treatment or Prevention of VA
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Preventing SCD with HF Medications
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Surgery and Revascularization Procedures in Patients With Ischemic Heart Disease
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Surgery for Arrhythmia Management Surgery and Revascularization Procedures in Patients With IHD
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Autonomic Modulation
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2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Acute Management of Specific VA
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Acute Management of Specific VA
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Acute Management of Specific VA (contd.)
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Acute Management of Specific VA (contd.)
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Colors correspond to Class of Recommendation in Table 1. *Known history of Verapamil sensitive or classical ECG presentation. ACLS indicates advanced cardiovascular life support; ECG, electrocardiogram; VA, ventricular arrhythmia; and VT, ventricular tachycardia. Management of Sustained Monomorphic VT
Slide 23-

2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Ongoing Management of VA and SCD Risk Related to Specific Disease States
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Secondary Prevention of SCD in Patients With Ischemic Heart Disease Ischemic Heart Disease
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Colors correspond to Class of Recommendation in Table 1. *Exclude reversible causes. †History consistent with an arrhythmic etiology for syncope. ║ICD candidacy as determined by functional status, life expectancy, or patient preference. EP indicates electrophysiological; GDMT, guideline-directed management and therapy; ICD, implantable cardioverter-defibrillator; IHD, ischemic heart disease; LVEF, left ventricular ejection fraction; SCA, sudden cardiac arrest; SCD, sudden cardiac death; and VT, ventricular tachycardia Secondary Prevention Patients With IHD
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Secondary Prevention of SCD in Patients With Ischemic Heart Disease Coronary Artery Spasm Ischemic Heart Disease
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Primary Prevention of SCD in Patients With Ischemic Heart Disease Ischemic Heart Disease
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Primary Prevention of SCD in Patients With Ischemic Heart Disease (contd.) Ischemic Heart Disease
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Primary Prevention of SCD in Patients With Ischemic Heart Disease (contd.) Ischemic Heart Disease
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Colors correspond to Class of Recommendation in Table 1. *Advanced HF therapy includes CRT, cardiac transplant, and LVAD. †Scenarios exist for early ICD placement in select circumstances such as patients with a pacing indication or syncope thought due to VT. These are detailed elsewhere in a HRS/ACC/AHA expert consensus statement. CRT indicates cardiac resynchronization therapy; EP, electrophysiological; GDMT, guideline-directed management and therapy; HF, heart failure; ICD, implantable cardioverter-defibrillator; IHD, ischemic heart disease; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NSVT, nonsustained ventricular tachycardia; NYHA, New York Heart Association; SCD, sudden cardiac death; VT, ventricular tachycardia; and WCD, wearable cardioverter-defibrillator. Primary Prevention of SCD in Patients With Ischemic Heart Disease
Slide 31-

Treatment and Prevention of Recurrent VA in Patients With Ischemic Heart Disease Ischemic Heart Disease
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Treatment and Prevention of Recurrent VA in Patients With Ischemic Heart Disease (contd.) Ischemic Heart Disease
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Treatment and Prevention of Recurrent VA in Patients With Ischemic Heart Disease (contd.) Ischemic Heart Disease
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Treatment of Recurrent VA in Patients With Ischemic Heart Disease or NICM Colors correspond to Class of Recommendation in Table 1. *Management should start with ensuring that the ICD is programmed appropriately and that potential precipitating causes, including heart failure exacerbation, are addressed. For information regarding optimal ICD programming, refer to the 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement. APHRS indicates Asia Pacific Heart Rhythm Society; EHRA, European Heart Rhythm Association; HRS, Heart Rhythm Society; IHD, ischemic heart disease; ICD, implantable cardioverter-defibrillator; PVC, premature ventricular complex; NICM, nonischemic cardiomyopathy; SOLAECE, Sociedad Latinoamericana de Estimulación Cardíaca y Electroﬁsiología; VF, ventricular fibrillation; and VT, ventricular tachycardia.
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Nonischemic Cardiomyopathy
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Nonischemic Cardiomyopathy Secondary Prevention of SCD in Patients With NICM
Slide 37-

Nonischemic Cardiomyopathy Primary Prevention of SCD in Patients With NICM
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Nonischemic Cardiomyopathy Primary Prevention of SCD in Patients With NICM (contd.)
Slide 39-

Nonischemic Cardiomyopathy Treatment of Recurrent VA in Patients With NICM
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Colors correspond to Class of Recommendation in Table 1. *ICD candidacy as determined by functional status, life expectancy or patient preference. 2° indicates secondary; EP, electrophysiological; GDMT, guideline-directed management and therapy; HF, heart failure; ICD, implantable cardioverter-defibrillator; LVEF, left ventricular ejection fraction; NICM, nonischemic cardiomyopathy; SCA, sudden cardiac arrest; SCD, sudden cardiac death; VA, ventricular arrhythmia; and WCD, wearable cardiac-defibrillator. Secondary and Primary Prevention of SCD in Patients With NICM
Slide 41-

Arrhythmogenic Right Ventricular Cardiomyopathy
Slide 42-

Arrhythmogenic Right Ventricular Cardiomyopathy (contd.)
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Arrhythmogenic Right Ventricular Cardiomyopathy (contd.)
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Hypertrophic Cardiomyopathy
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Hypertrophic Cardiomyopathy (contd.)
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Hypertrophic Cardiomyopathy (contd.)
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Hypertrophic Cardiomyopathy (contd.)
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Myocarditis
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Cardiac Sarcoidosis
Slide 50-

Cardiac Sarcoidosis (contd.)
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Colors correspond to Class of Recommendation in Table 1. *ICD candidacy as determined by functional status, life expectancy, or patient preference. †For recurrent sustained monomorphic VT, refer to Figure Management of Sustained Monomorphic VT. CEP indicates electrophysiological; GDMT, guideline-directed management and therapy; ICD, implantable cardiac-defibrillator; LVEF, left ventricular ejection fraction; MRI, magnetic resonance imaging; PET, positron emission tomography; SCA, sudden cardiac arrest; SCD, sudden cardiac death; VA, ventricular arrhythmia; and VT, ventricular tachycardia. Prevention of SCD in Patients With Cardiac Sarcoidosis
Slide 52-

Heart Failure HF With Reduced Ejection Fraction Left Ventricular Assist Device
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Heart Failure ICD Use After Heart Transplantation
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Neuromuscular Disorders
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Cardiac Channelopathies
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Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Congenital Long QT Syndrome
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Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Congenital Long QT Syndrome (contd.)
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Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Congenital Long QT Syndrome (contd.)
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Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Congenital Long QT Syndrome (contd.)
Slide 60-

Colors correspond to Class of Recommendation in Table 1. *ICD candidacy as determined by functional status, life expectancy, or patient preference. †High-risk patients with LQTS include those with QTc >500 ms, genotypes LQT2 and LQT3, females with genotype LQT2, <40 years of age, onset of symptoms at <10 years of age, and patients with recurrent syncope ICD indicates implantable cardioverter-defibrillator; LQTS, long-QT syndrome; VT, ventricular tachycardia. Prevention of SCD in Patients With Long QT Syndrome
Slide 61-

Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Catecholaminergic Polymorphic Ventricular Tachycardia
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Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Brugada Syndrome
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Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Brugada Syndrome (contd.)
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Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Brugada Syndrome (contd.) SR indicates systematic review.
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Colors correspond to Class of Recommendation in Table 1. *ICD candidacy as determined by functional status, life expectancy or patient preference. 1° indicates primary; ECG, electrocardiogram; EP, electrophysiological; ICD implantable cardioverter-defibrillator; SCD, sudden cardiac death; VT, ventricular tachycardia; and VF, ventricular fibrillation. Prevention of SCD in Patients With Brugada Syndrome
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Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Early Repolarization “J-wave” Syndrome
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Cardiac Channelopathies Specific Cardiac Channelopathy Syndromes Short QT Syndrome
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2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death VA in the Structurally Normal Heart
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VA in the Structurally Normal Heart
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Outflow Tract and AV Annular VA
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Papillary Muscle VA
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Interfascicular Reentrant VT (Belhassen Tachycardia)
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Idiopathic Polymorphic VT/VF
Slide 74-

2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death PVC-Induced Cardiomyopathy
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PVC-Induced Cardiomyopathy
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2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death VA and SCD Related to Specific Populations
Slide 77-

Pregnancy
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SR indicates systematic review. Older Patients With Comorbidities
Slide 79-

Medication-Induced Arrhythmias
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Medication-Induced Arrhythmias
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Adult Congenital Heart Disease
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Adult Congenital Heart Disease (contd.)
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Adult Congenital Heart Disease (contd.)
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Adult Congenital Heart Disease (contd.)
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Colors correspond to Class of Recommendation in Table 1. *High-risk features: prior palliative systemic to pulmonary shunts, unexplained syncope, frequent PVC, atrial tachycardia, QRS duration ≥180 ms, decreased LVEF or diastolic dysfunction, dilated right ventricle, severe pulmonary regurgitation or stenosis, or elevated levels of BNP. †Frequent VA refers to frequent PVCs and/or nonsustained VT. ACHD indicates adult congenital heart disease; BNP, B-type natriuretic peptide; EP, electrophysiological; ICD, implantable cardioverter-defibrillator; LVEF, left ventricular ejection fraction; PVC, premature ventricular complexes; SCD, sudden cardiac death; TOF, tetralogy of Fallot; VA, ventricular arrhythmia; and VT, ventricular tachycardia. Prevention of SCD in Patients With Adult Congenital Heart Disease
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2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Defibrillators Other than Transvenous ICDs
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Subcutaneous Implantable Cardioverter-Defibrillator
Slide 88-

Wearable Cardioverter-Defibrillator
Slide 89-

2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Special Considerations for Catheter Ablation
Slide 90-

Special Considerations for Catheter Ablation
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2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Post-Mortem Evaluation of SCD
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Post-Mortem Evaluation of SCD
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2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Terminal Care
Slide 94-

Terminal Care
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2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Shared Decision Making
Slide 96-

Shared Decision Making