January 31, 2026Canadian Journal of Cardiology1 citationsOpen Access
The Canadian Cardiovascular Society/Canadian Heart Rhythm Society Comprehensive Guidelines for the Selection, Implantation, and Management of Patients With Cardiac Implantable Electronic Devices
Key Result
Comprehensive Canadian guidelines were developed using the GRADE system to aid clinicians in the selection, implantation, and management of patients with cardiac implantable electronic devices.
Key Points
- The aim is to provide comprehensive guidelines for the management of patients with cardiac implantable electronic devices (CIEDs) in Canada.
- Developed guidelines using the GRADE system to evaluate recommendation strength and quality of evidence.
- Focused on areas including bradycardia, cardiac resynchronization therapy, and perioperative considerations.
- Utilized tables and figures to present key concepts for clinicians.
- Establishes clear recommendations for CIED management across various clinical scenarios.
- Highlights importance of lead extraction and post-implant management in improving patient outcomes.
- Aids knowledge translation for health care providers involved in patient care with CIEDs.
Structured PICO
P
Population
Patients assessed for possible Cardiac Implantable Electronic Device (CIED) implantation or those who already have CIEDs.
I
Intervention
Selection, implantation, and management of Cardiac Implantable Electronic Devices (CIEDs) including pacemakers, implantable cardioverter defibrillators (ICDs), and cardiac resynchronization therapy (CRT).
This document provides the first comprehensive Canadian Cardiovascular Society/Canadian Heart Rhythm Society guidelines for the clinical management of patients with or being assessed for cardiac implantable electronic devices.
Abstract
The Canadian Cardiovascular Society/Canadian Heart Rhythm Society cardiac implantable electronic device (CIED) guidelines program was developed to aid clinicians in the management of patients with a CIED, as well as to provide direction to policy makers and health care systems regarding issues related to CIEDs. There has never before been a comprehensive Canadian Cardiovascular Society/Canadian Heart Rhythm Society guideline to address the management of patients with CIEDs. This guideline is intended to be used by practicing clinicians across all disciplines who care for patients with CIEDs. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system to grade recommendation strength and the quality of evidence. Areas of focus include bradycardia, syncope, cardiac resynchronization therapy, and conduction system pacing, sudden death prevention, and defibrillator therapy, the role of leadless devices, perioperative considerations and complications, lead extraction, postimplant CIED management, and competency and training standards. Extensive use is made of tables and figures to synthesize important material and present key concepts. This document should be an important aid for knowledge translation and a valuable reference tool to help improve the clinical management of patients who are assessed for possible CIED implantation or to improve decision-making for those who already have CIEDs.