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For all indications patient should be on optimal medical therapy and have a life expectancy of > 1 year. | For all indications patient should be on optimal medical therapy and have a life expectancy of > 1 year. | ||
==Class I== | ==Class I (recommendations)== | ||
* Patients with left ventricular dysfunction due to prior myocardial infarction who are at least 40 days post MI with LVEF <30-40%, are NYHA class II or III and are receiving chronic optimal medical therapy and with life expectancy > 1 year. IA<cite>ESCSCD</cite> | * Patients with left ventricular dysfunction due to prior myocardial infarction who are at least 40 days post MI with LVEF <30-40%, are NYHA class II or III and are receiving chronic optimal medical therapy and with life expectancy > 1 year. IA<cite>ESCSCD</cite> | ||
* LV dysfunction due to prior MI, presenting with hemodynamically unstable sustained VT. IA<cite>ESCSCD</cite><cite>ESCHF</cite> | * LV dysfunction due to prior MI, presenting with hemodynamically unstable sustained VT. IA<cite>ESCSCD</cite><cite>ESCHF</cite> | ||
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* CRTD is recommended in patients with sinus rhythm, LBBB, QRS > 120ms, EF<35%, NYHA III-IV. IA <cite>ESCHF</cite> | * CRTD is recommended in patients with sinus rhythm, LBBB, QRS > 120ms, EF<35%, NYHA III-IV. IA <cite>ESCHF</cite> | ||
==Class IIa== | ==Class IIa (should be considered)== | ||
* LV dysfunction due to prior MI, at least 40 days post MI, LVEF < 30-35%, NYHA I, on chronic medical therapy, life expectancy >1y. IIaB<cite>ESCSCD</cite> | * LV dysfunction due to prior MI, at least 40 days post MI, LVEF < 30-35%, NYHA I, on chronic medical therapy, life expectancy >1y. IIaB<cite>ESCSCD</cite> | ||
* Recurrent VT in post MI patient with normal or near normal LVEF on chronic medical therapy, life expectancy > 1y. IIaC<cite>ESCSCD</cite> | * Recurrent VT in post MI patient with normal or near normal LVEF on chronic medical therapy, life expectancy > 1y. IIaC<cite>ESCSCD</cite> | ||
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* A CRTD/CRTP may be considered to reduce the risk of HF worsening in a patient with atrial fibrillation who is pacemaker dependant, after AV nodal ablation QRS > 150ms, EF<35%, NYHA III-IV . IIaA<cite>ESCHF</cite> | * A CRTD/CRTP may be considered to reduce the risk of HF worsening in a patient with atrial fibrillation who is pacemaker dependant, after AV nodal ablation QRS > 150ms, EF<35%, NYHA III-IV . IIaA<cite>ESCHF</cite> | ||
==Class IIb== | ==Class IIb (may be considered)== | ||
* nonischemic DCM, LVEF < 30-35%, NYHA I. optimal medical therapy, LE>1y. IIbC<cite>ESCSCD</cite> | * nonischemic DCM, LVEF < 30-35%, NYHA I. optimal medical therapy, LE>1y. IIbC<cite>ESCSCD</cite> | ||
* CRT may be considered to reduce the risk of HF worsening in a patient with atrial fibrillation who requires pacing because of intrinsically slow ventricular rate with QRS > 120ms, EF<35%, NYHA III-IV . IIbC<cite>ESCHF</cite> | * CRT may be considered to reduce the risk of HF worsening in a patient with atrial fibrillation who requires pacing because of intrinsically slow ventricular rate with QRS > 120ms, EF<35%, NYHA III-IV . IIbC<cite>ESCHF</cite> | ||
* CRT may be considered to reduce the risk of HF worsening in a patient with atrial fibrillation who requires pacing because of a rate of < 60 bpm in rest and < 90 bpm on exercise with QRS > 120ms, EF<35%, NYHA III-IV . IIbC<cite>ESCHF</cite> | * CRT may be considered to reduce the risk of HF worsening in a patient with atrial fibrillation who requires pacing because of a rate of < 60 bpm in rest and < 90 bpm on exercise with QRS > 120ms, EF<35%, NYHA III-IV . IIbC<cite>ESCHF</cite> | ||
* CRT should be considered in those patient with atrial fibrillation in NYHA functional class II with an EF ≤35%, irrespective of QRS duration, to reduce the risk of worsening of HF. IIbC<cite>ESCHF</cite> | * CRT should be considered in those patient with atrial fibrillation in NYHA functional class II with an EF ≤35%, irrespective of QRS duration, to reduce the risk of worsening of HF. IIbC<cite>ESCHF</cite> | ||
==Class III (not recommended)== | |||
* ICD implantation is not recommended during the acute phase of myocarditis<cite>ESCSCD</cite> | |||
==References== | ==References== |