John P. DiMarco

Guidelines for clinical intracardiac electrophysiological and catheter ablation procedures: A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on Clinical Intracardiac electrophysiologic and catheter ablation procedures), developed in collaboration with the North American Society of pacing and electrophysiology☆

Guidelines for Clinical lntracardiac Electrophysiological and Catheter Ablation Procedures was approved by the American Heart Association SAC/Steering Committee in May 1995 and the American College of Cardiology Board of Trustees in March 1995 and was endorsed by the North American Society of Pacing and Eleetrophysiology Board of Directors in May 1995. This statement is being published simultaneously in Circulation, the Journal of the American College of Cardiology, and the Journal of Cardiovascular Electrophysiology. Address for renrints: Educational Services, American College of Cardiology, l i l t ()ld Georgetown Road, Bethesda, Maryland 208141699. cardiology. Such analysis, carefully conducted, could potentially impact the cost of medical care without diminishing the effectiveness of that care. To this end, the American College of Cardiology and the American Heart Association in 1980 established a Task Force on the Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (now the ACC/AHA Task Force on Practice Guidelines) with the following charge: The task force of the American College of Cardiology and the American Heart Association shall develop guidelines relative to the role of new therapeutic approaches and specific noninvasive and invasive procedures in the diagnosis and management of cardiovascular disease. The task force shall address, when appropriate, the contribution, uniqueness, sensitivity, specificity, indications, contraindications and cost-effectiveness of such diagnostic procedures and therapeutic modalities. The task force shall emphasize the role and value of the developed guidelines as an educational resource. The task force shall include a chair and six members, three representatives from the American Heart Association

American College of Cardiology/American Heart Association clinical competence statement on invasive electrophysiology studies, catheter ablation, and cardioversion: A report of the American College of Cardiology/American Heart Association/American College of Physicians-American Society of Internal Medicine Task Force on Clinical Competence

The granting of clinical staff privileges to physicians is a primary mechanism used by institutions to uphold the quality of patient care. The Joint Commission on Accreditation of Healthcare Organizations requires that the granting of continuing medical staff privileges be based on assessments of

Current role of catheter ablative procedures in patients with cardiac arrhythmias. A report for health professionals from the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association.

Catheter ablative techniques have assumed an increasingly important role in the treatment of patients with drug-refractory cardiac arrhythmias. Catheter ablation of the AV junction is considered the procedure of choice for management of patients without bypass tracts with drug-resistant supraventricular arrhythmias. Catheter techniques have been used with increasing frequency in attempts to ablate accessory AV tracts. These techniques currently appear to be less effective than surgical techniques but involve less morbidity and expense. In some centers, accessory pathway ablation using catheter techniques is the procedure of first choice in selected patients with drug-refractory tachycardia mediated by an accessory pathway. Catheter ablation of ventricular tachycardia should be reserved for patients with mappable ventricular tachycardia who are not candidates for cardiac electrosurgery or insertion of an automatic defibrillator. The development of more flexible catheters and more manageable energy delivery systems holds promise for more effective catheter techniques.