ACCF/HRS/AHA/ASE/HFSA/SCAI/SCCT/SCMR 2013 Appropriate Use Criteria for Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy: A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Heart Rhythm Society, American Heart Association, American Society of Echocardiography, Heart Failure Society of America, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascul

Journal of the American College of Cardiology (Impact Factor: 15.34). 02/2013; DOI: 10.1016/j.jacc.2012.12.017
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    ABSTRACT: We report the case of a 56-year-old male with ischemic cardiomyopathy, severe left ventricular dysfunction and right bundle branch block (RBBB) with a wide QRS duration (180ms) who received dual-chamber implantable cardioverter-defibrillator for primary prevention of sudden death. After having placed the right ventricular lead in the middle of the inter-ventricular septum, a significant narrowing of QRS duration was observed, thus obtaining "de facto" a cardiac resynchronization therapy (CRT). This type of cardiac pacing could be an alternative to conventional CRT with left ventricular pacing in patients with wide QRS due to RBBB. The long-term effects of this RV only pacing strategy with ICD in patients with heart failure yet remain to be determined. Copyright © 2014 Elsevier Inc. All rights reserved.
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    ABSTRACT: Cardiac imaging is one of the basic pillars of modern cardiology. The potential list of scenarios where cardiac imaging techniques can provide relevant information is simply endless so it is impossible to include all relevant new features of cardiac imaging published in the literature in 2012 in the limited format of a single article. We summarize the year's most relevant news on cardiac imaging, highlighting the ongoing development of myocardial deformation and 3-dimensional echocardiography techniques and the increasing use of magnetic resonance imaging and computed tomography in daily clinical practice. Full English text available
    Revista Espa de Cardiologia 01/2013; 68(2). DOI:10.1016/j.recesp.2012.10.007 · 3.34 Impact Factor
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    ABSTRACT: Recently the American College of Cardiology Foundation in collaboration with the Heart Rhythm Society published Appropriate Use Criteria (AUC) for Implantable Cardioverter-Defibrillators (ICDs) and Cardiac Resynchronization Therapy (CRT). These criteria were developed to critically review clinical situations that may warrant implantation of an ICD or CRT device, and were based on a synthesis of practice guidelines and practical experience from a diverse group of clinicians. When the AUC was drafted, the writing committee recognized that some of the scenarios that were deemed "appropriate" or "may be appropriate" were discordant with the clinical requirements of many payors including the Medicare National Coverage Determination (NCD). To charge Medicare for a procedure that is not covered by the NCD may be construed as fraud. Discordance between the guidelines, the AUC and the NCD places clinicians in the difficult dilemma of trying to do the "right thing" for their patients, while recognizing that the "right thing" may not be covered by the payor or insurer. This commentary addresses these issues. Options for reconciling this disconnect are discussed, and recommendations to help clinicians provide the best care for their patients are offered.
    Journal of the American College of Cardiology 07/2013; 63(1). DOI:10.1016/j.jacc.2013.07.016 · 15.34 Impact Factor