心脏起搏器植入指南-文档资料
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2019年ACC/AHA/NASPE 心脏起搏器植入指南
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
ACC/AHA 适应证分类
III类:
根据病情状况，专家们一致认为起搏治
疗无效，某些情况下甚至对患者有害。
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
I 类适应证: 获得性房室阻滞的起搏治疗
1. 任何阻滞部位的三度和高度房室阻滞伴:
a) 房室阻滞伴可能由心动过缓所致的症状(包括心 力衰竭)
b) 需要药物治疗其他心律失常或其他疾病，而所用 药物治疗导致症状性心动过缓
c) 清醒状态下虽无症状，但证实心室停搏 >3.0s或 逸搏心律<40 bpm
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
I 类适应证: 获得性房室阻滞的起搏治疗
d) 射频消融后 e) 心脏外科手术后发生的不可逆性房室阻滞
f)
神经肌源性疾病伴发的房室阻滞，无论是否有 症状
2. 任何阻滞部位和类型的二度房室阻滞产生的 症状性心动过缓
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
ACC/AHA 临床证据分类
Level A Level B
为最有力的证据。结论源于包含大数量病 例的多次随机临床试验。 从含有较少量病人的有限次试验得出的数 据或从设计较好的非随机研究分析得出的 数据或登记观察的数据.
Level C
专家共识是建议的主要来源.
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
ACC/AHA 适应证分类
I类 : 有明确证据或专家们一致认为起搏治疗对患者有益和 有效。
II类:
起搏治疗是否给患者带来益处/有效的研究结果不一致/ 专家们的意见有分歧。 IIa类:
证据/意见偏向有用/有效。
IIb类:
证据/意见不能说明有用/有效。
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
Section I-A:
成人获得性房室阻滞的起搏治疗
wk.baidu.com
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
ACC/AHA 适应证分类
III类:
根据病情状况，专家们一致认为起搏治
疗无效，某些情况下甚至对患者有害。
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
I 类适应证: 获得性房室阻滞的起搏治疗
1. 任何阻滞部位的三度和高度房室阻滞伴:
a) 房室阻滞伴可能由心动过缓所致的症状(包括心 力衰竭)
b) 需要药物治疗其他心律失常或其他疾病，而所用 药物治疗导致症状性心动过缓
c) 清醒状态下虽无症状，但证实心室停搏 >3.0s或 逸搏心律<40 bpm
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
I 类适应证: 获得性房室阻滞的起搏治疗
d) 射频消融后 e) 心脏外科手术后发生的不可逆性房室阻滞
f)
神经肌源性疾病伴发的房室阻滞，无论是否有 症状
2. 任何阻滞部位和类型的二度房室阻滞产生的 症状性心动过缓
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
ACC/AHA 临床证据分类
Level A Level B
为最有力的证据。结论源于包含大数量病 例的多次随机临床试验。 从含有较少量病人的有限次试验得出的数 据或从设计较好的非随机研究分析得出的 数据或登记观察的数据.
Level C
专家共识是建议的主要来源.
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
ACC/AHA 适应证分类
I类 : 有明确证据或专家们一致认为起搏治疗对患者有益和 有效。
II类:
起搏治疗是否给患者带来益处/有效的研究结果不一致/ 专家们的意见有分歧。 IIa类:
证据/意见偏向有用/有效。
IIb类:
证据/意见不能说明有用/有效。
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf
Section I-A:
成人获得性房室阻滞的起搏治疗
wk.baidu.com
Gregoratos G. et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2002. Available at www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf