2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

Fred M. KusumotoCardiologist, Mayo Clinic Florida, Jacksonville

“Treatment decisions are based not only on the best available evidence but also on the patient's goals of care and preferences. Patients should be referred to trusted material to aid in their understanding and awareness of the consequences and risks of any proposed action.”

Fred M. KusumotoCardiologist, Mayo Clinic Florida, Jacksonville

“We're the first guideline [in this area] that talks about the fact that you can remove or withdraw pacemaker therapy and that that would not be considered assisted suicide.... Including the patient and their family in all discussions about whether to implant the device or whether to withdraw therapy is really critical, because unfortunately we doctors have not been that good about that in the past.”

Fred M. KusumotoCardiologist, Mayo Clinic Florida, Jacksonville

“Identifying patient populations who will benefit the most from emerging pacing technologies, such as His bundle pacing and transcatheter leadless pacing systems, will require further investigation as these modalities are incorporated into clinical practice. Regardless of technology, for the foreseeable future, pacing therapy requires implantation of a medical device, and future studies are warranted to focus on the long-term implications associated with lifelong therapy.”