They are joint guidelines from ACC, AHA and HRS. These are noteworthy because they are the first update since 2002. If recent clinical trials regarding implantable defibrillators (AICDs) and cardiac resynchronization therapy (CRT) seem like a confusing morass these guidelines package them more neatly. They emphasize persistence of criteria despite optimal medical therapy in assessing patients’ candidacy for AICDs and CRT. A trial of evidence based medical therapy can be considered pre-requisite for consideration of these therapies, so if nothing else the guidelines may encourage evidence based medical management of patients with left ventricular dysfunction.
Although the section on for AV block seems jumbled up and hard to read, the guidelines for common pacing indications are not substantially changed from previous versions.