Bradycardia and cardiac conduction abnormalities are common in both health and disease. The evaluation and treatment for these conditions can vary broadly based on symptoms, context, comorbidities including structural heart disease, and patient preferences. The 2018 American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Rhythm Society (HRS) Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay developed by the ACC, AHA, and HRS offers guidance to clinicians for treating adult patients with bradycardia or cardiac conduction system disorders, rather than technology-specific information (Table).1 To our knowledge, the diagnostic evaluation of bradycardia and conduction disorders and the acute management of bradycardia are topics that have not been addressed by prior guideline documents, while the permanent pacemaker recommendations are meant to supersede the pacemaker recommendations made in the 2012 ACCF/AHA/HRS Focused Update Incorporated Into the ACCF/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities.2
Oken K, Schoenfeld MH, Kusumoto F. Evaluation and Treatment of Patients With Bradycardia and Cardiac Conduction Delay. JAMA Cardiol. Published online April 24, 20194(7):708–709. doi:10.1001/jamacardio.2019.1069
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