3. Bradycardia
(1) In patients with irreversible and symptomatic bradycardia, pacemaker guidelines should be considered for implantation of CRT devices to avoid right ventricular pacing only, according to patients with heart failure (NYHA class I-III).
(2) Heart failure patients with reduced ejection fraction associated with atrioventricular block may benefit from CRT pacing, but further evidence of standard (RV) pacing and implantation of CRT devices is needed to recommend.
4. Ventricular arrhythmias
(1) In patients with persistent VA, ICD therapy is required in most patients after exclusion of potential reversible factors, such as significant electrolyte disturbances or acute myocardial ischemia. In addition, β-blockers and amiodarone gradually increase the amount may help reduce the incidence of arrhythmia.
(2) It is generally recommended that ICD or ICD-CRT be used as primary prevention in patients with a significant reduction in ejection fraction, unless the patient has severe heart failure symptoms (resting state), no improvement is expected or life expectancy is less than 1 year.
(3) acute myocardial infarction, the need for early application of optimal drug therapy, including β-blockers to reduce the risk of arrhythmia.
(4) High-risk patients (low EF) should be reassessed for optimal drug therapy at 4-6 weeks (or 3 months after revascularization), and ICD should be considered as primary prevention.
(5) The choice of wearable defibrillator therapy can be evaluated at the time of bridging.
5. Heart failure after heart failure and arrhythmia
(1) left ventricular systolic dysfunction and heart failure is still a common complication of acute myocardial infarction.
(2) STEMI should be treated as soon as possible with reperfusion, preferably with direct PCI or immediately with thrombolysis. The risk of death and reinfarction in one subsequent MI was increased in most patients following a MI, the majority of which occurred during discharge After a few weeks.
(3) All patients should undergo optimal drug therapy for the first 4-6 weeks until reassessment. Patients with reduced EED (35%) and NYHA class II-III should be considered for ICD with or without CRT therapy, as appropriate.
(4) Patients with angina pectoris, heart failure, or VA who have an MI are at high risk and need to be immediately reevaluated. Consideration should be given to revascularization to prevent recurrent ischemia and / or early implantation of ICDs or the use of wearable defibrillators.
(5) Unless there is a special taboo, all patients with myocardial infarction should be treated with β-blockers.
(6) In addition, patients with significant left ventricular dysfunction should be treated with ACEI or ARB and MRA.
(7) large area anterior infarction patients with thromboembolism, VA and heart failure risk, should be given appropriate treatment.
6. Cardiac resynchronization therapy and heart failure patients
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