title: Canadian Cardiovascular Society guidelines on the use of cardiac resynchronization therapy: implementation.
abstract: Recent studies have provided the impetus to update the recommendations for cardiac resynchronization therapy (CRT). This article provides guidance on the implementation of CRT and is intended to serve as a framework for the implementation of CRT within the Canadian health care system and beyond. These guidelines were developed through a critical evaluation of the existing literature, and expert consensus. The panel unanimously adopted each recommendation. The 9 recommendations relate to patient selection in the presence of comorbidities, delivery and optimization of CRT, and resources required to deliver this therapy. The strength of evidence was weighed, taking full consideration of any risk of bias, and any imprecision, inconsistency, and indirectness of the available data. The strength of each recommendation and the quality of evidence were adjudicated. Trade-offs between desirable and undesirable consequences of alternative management strategies were considered, as were values, preferences, and resource availability. These guidelines were externally reviewed by experts, modified based on those reviews, and will be updated as new knowledge is acquired.
authors.affiliation: Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: parkashr@cdha.nshealth.ca.
authors.forename: Ratika
authors.initials: R
authors.lastname: Parkash
authors.forename: François
authors.initials: F
authors.lastname: Philippon
authors.forename: Miriam
authors.initials: M
authors.lastname: Shanks
authors.forename: Bernard
authors.initials: B
authors.lastname: Thibault
authors.forename: Jafna
authors.initials: J
authors.lastname: Cox
authors.forename: Aaron
authors.initials: A
authors.lastname: Low
authors.forename: Vidal
authors.initials: V
authors.lastname: Essebag
authors.forename: Jamil
authors.initials: J
authors.lastname: Bashir
authors.forename: Gordon
authors.initials: G
authors.lastname: Moe
authors.forename: David H
authors.initials: DH
authors.lastname: Birnie
authors.forename: Eric
authors.initials: E
authors.lastname: Larose
authors.forename: Raymond
authors.initials: R
authors.lastname: Yee
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Swiggum
authors.forename: Padma
authors.initials: P
authors.lastname: Kaul
authors.forename: Damian
authors.initials: D
authors.lastname: Redfearn
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Tang
authors.forename: Derek V
authors.initials: DV
authors.lastname: Exner
mesh_terms: D000367:Age Factors; D000368:Aged; D054537:Atrioventricular Block / Q000628:therapy; D058406:Cardiac Resynchronization Therapy / Q000592:standards*; D015897:Comorbidity; D004567:Electrodes, Implanted; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D016330:Frail Elderly; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000145:classification / Q000628:therapy; D006801:Humans; D017053:Infection Control; D053783:Magnetic Resonance Imaging, Interventional; D016273:Occupational Exposure / Q000517:prevention & control; D018579:Patient Selection; D059035:Perioperative Period; D011835:Radiation Protection; D011839:Radiation, Ionizing; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000628:therapy
chemical_list: D005343:Fibrinolytic Agents