NICE guidance (2006)10 | ESC guidance (2006)5 | NICE guidance (2014)11 |
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Primary MI (more than 4 weeks) AND; Either LVEF ≤35% (no worse than NYHA III) and Non-sustained VT on holter (24 h) and Inducible VT (EPS) OR LVEF <30% and QRS >120 ms | Primary MI (at least 40 days post-MI) AND LVEF ≤35% (NYHA class II or III) On optimal medical treatment and who have reasonable expectation of survival with a good functional status of more than 1 year | Patients with heart failure who have LVEF ≤35% AND; NYHA class I–III symptoms, and a QRS duration of <120 ms *ICD if there is a high risk of sudden cardiac death Or NYHA class I-III symptoms and a QRS duration of 120–149 ms without LBBB Or NYHA class I symptoms and a QRS duration of 120–149 ms with LBBB (NYHA class II-III consider CRT-D) Or NYHA class I-III symptoms and a QRS duration ≥150 ms with LBBB or no LBBB consider CRT-D |
*ICD if there is a high risk of sudden cardiac death—these may include: age, sex, degree of left ventricular dysfunction, history of myocardial infarction, presence of cardiomyopathy and a range of other potential prognostic factors like B-type natriuretic peptide.
CRT-D, cardiac resynchronisation therapy with defibrillator; EPS, electrophysiology study; ICD, implantable cardioverter defibrillators; LBBB, left bundle branch block; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NICE, National Institute of Health and Care Excellence; NYHA, New York Heart association; VT, ventricular tachycardia. Bold text are key parts of the guidance.