JCS/JHRS 2021 Guideline Focused Update on Non-Pharmacotherapy of Cardiac Arrhythmias

Q: What are the key findings of this study?

The JCS/JHRS 2021 focused update provides revised recommendations for non-pharmacotherapy of cardiac arrhythmias, including leadless pacemakers, conduction system pacing, and ICD deactivation.

Q: What is the clinical evidence from this study?

Study design: Review. Population: Cardiac Arrhythmias. Intervention: Non-Pharmacotherapy (CIEDs, Catheter Ablation, Left Atrial Appendage Closure).

Akihiko Nogami; Takashi Kurita; Kengo Kusano; Masahiko Goya; Morio Shoda; Hiroshi Tada; Shigeto Naito; Teiichi Yamane; Masaomi Kimura; Tsuyoshi Shiga; Kyoko Soejima; Takashi Noda; Hiro Yamasaki; Yoshifusa Aizawa; Tohru Ohe; Takeshi Kimura; Shun Kohsaka; Hideo Mitamura

doi:10.1253/circj.cj-21-0162

January 5, 2022Circulation JournalOpen Access

JCS/JHRS 2021 Guideline Focused Update on Non-Pharmacotherapy of Cardiac Arrhythmias

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Key Points

To provide updated evidence-based clinical recommendations on non-pharmacological interventions, including cardiovascular implantable electronic devices and catheter ablation, for cardiac arrhythmias.
Convened a joint working group across nine Japanese cardiovascular and surgical societies to synthesize recent clinical trials, registries, and meta-analyses.
Evaluated emerging evidence concerning conduction system pacing, leadless pacemakers, transcutaneous lead extraction, radiation reduction via 3D mapping, and catheter ablation strategies.
Established indications for conduction system pacing (His bundle and left bundle pacing) as an alternative to biventricular pacing in candidates failing conventional cardiac resynchronization therapy.
Synthesized meta-analytic evidence (N=1,438) demonstrating that His bundle pacing increased left ventricular ejection fraction from 42.8% to 49.5% in patients with baseline values <50%.
Defined clinical practice updates for leadless pacemaker adoption, antitachycardia pacing for atrial fibrillation, advance care planning for defibrillator deactivation, and peri-procedural anticoagulation.

Structured PICO

P

Population

Patients with cardiac arrhythmias requiring non-pharmacotherapy, including those with symptomatic bradycardic atrial fibrillation, atrioventricular block, or heart failure indications for pacing.

I

Intervention

Non-pharmacotherapy including VVI leadless pacemakers and conduction system pacing (His bundle pacing).

This focused update provides updated Japanese recommendations for non-pharmacological arrhythmia treatments, establishing indications for emerging technologies like leadless pacemakers and His bundle pacing.

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Implication

Guides immediate updates to arrhythmia device protocols; extends prior JCS/JHRS guidelines with focused 2021 revisions.

Abstract

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Cite This Study

Nogami et al. (2022) conducted a review in Cardiac Arrhythmias. Non-Pharmacotherapy (CIEDs, Catheter Ablation, Left Atrial Appendage Closure) was evaluated. The JCS/JHRS 2021 focused update provides revised recommendations for non-pharmacotherapy of cardiac arrhythmias, including leadless pacemakers, conduction system pacing, and ICD deactivation.

synapsesocial.com/papers/6aa00aaa963e757bfd72fe45 https://doi.org/10.1253/circj.cj-21-0162

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JCS/JHRS 2021 Guideline Focused Update on Non-Pharmacotherapy of Cardiac Arrhythmias

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

JCS/JHRS 2021 Guideline Focused Update on Non-Pharmacotherapy of Cardiac Arrhythmias

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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