2017 AHA/ACC/HRS Guideline for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

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The 2017 AHA/ACC/HRS Guideline for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death, accompanied by the Executive Summary  and the Systematic Review,  is intended to guide management of adults who have ventricular arrhythmias or who are at risk for sudden cardiac death (SCD), including diseases and syndromes associated with a risk of SCD from ventricular arrhythmias. It replaces the ACC/AHA/ESC 2006 Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death and also supersedes sections on indications for the implantable cardioverter defibrillator (ICD) of the ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities and updates the SCD prevention recommendations in the 2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy.

This guideline also includes indications for catheter ablation of ventricular arrhythmias, but does not provide recommendations on specific techniques or ablation technologies, which were beyond the scope of this document. It is the first to include value statements, specifically on the strength of evidence surrounding ICDs and cost-effectiveness. Although this document is aimed at the adult population aged ≥18 years and offers no specific recommendations for pediatric patients, some of the literature on pediatric patients was examined and helped to inform this guideline. The document recognizes the importance of patient-centered care and shared decision-making process in which the patient, family, and clinicians discuss risks and benefits of diagnostic and treatment options and consider the patients’ personal preferences.