ESC updates guidelines for device therapy in heart failure

3 Sept 2010

The European Society of Cardiology (ESC) has updated its Clinical Practice Guidelines covering device therapy in heart failure. The update reflects the pace of research in this field and the importance of recently published evidence.

The update is the result of collaboration between ESC Heart Failure Association (HFA) and European Heart Rhythm Association (EHRA) and was presented at the ESC Congress in Stockholm last week.

The update focuses on the use of devices for the treatment of heart failure, with an emphasis on cardiac resynchronisation therapy (CRT). Professor Kenneth Dickstein from Norway and Professor Panos Vardas from Greece were Co-Chairs of the Task Force responsible for developing the original guidelines, and were the natural choices to lead the new Task Force, which was formed of experts drawn equally from the HFA and the EHRA.

“This focused update to the guidelines provides recommendations for the use of devices to treat heart failure and includes the indications in conditions such as atrial fibrillation and those situations in which patients require pacemaker implantation,” says Professor Vardas. “A primary objective was to close some of the gaps in evidence that were apparent when the original guidelines were published.”

The changes made in the guidelines take account of:

  • recently published evidence from clinical trials;
  • new developments in device technology and performance;
  •  more extensive understanding of treatment options and responses.

The updated guidelines represent a fresh approach to analysing clinical trial outcomes. “In several areas we used a modified methodology to review the outcomes of clinical trials, with an emphasis on the cohort actually recruited for the trial rather than a strict interpretation of the protocol inclusion criteria,” says Professor Dickstein. “This increases the likelihood that the recommendations made are valid for the target patient population. This process impacts on the class of recommendations made and the determination of levels of evidence for therapy for specific patient populations.”

The updated Device Therapy in Heart Failure guidelines can be downloaded from the ESC website at:


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