2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy

ESC Clinical Practice Guidelines

29 Aug 2021

Pacing is an important part of electrophysiology and of cardiology in general. Whereas some of the situations requiring pacing are clear and have not changed over the years, many others have evolved and have been the subject of extensive recent research, such as pacing after syncope, pacing following transcatheter aortic valve implantation, cardiac resynchronisation therapy (CRT) for heart failure (HF) and for prevention of pacing-induced cardiomyopathy, and pacing in various infiltrative and inflammatory diseases of the heart, as well as in different cardiomyopathies.

Other novel topics include new diagnostic tools for decision-making on pacing, as well as a whole new area of pacing the His bundle and the left bundle branch. In addition, attention has increased in other areas, such as how to systematically minimise procedural risk and avoid complications of cardiac pacing, how to manage patients with pacemakers in special situations, such as when magnetic resonance imaging (MRI) or irradiation are needed, how to follow patients with a pacemaker with emphasis on the use of remote monitoring, and how to include shared decision-making in caring for this patient population.

Guidelines and related materials are for use by individuals for personal or educational purposes. No commercial use is allowed. Re-use permission must be correctly obtained from the publisher.

ESC Guidelines are protected by copyright. As per opt out option under Article 4 §3 of EU Directive 2019/790, the ESC reserves all rights to license uses of ESC Guidelines to train or develop generative artificial intelligence (AI) models, large language models or other deep learning or machine learning models. Any use of ESC Guidelines in software tools, generative AI models, computational models, or algorithms in which ESC Guideline content is included, cited, or transformed in any way requires a formal license agreement.

Topic(s):

Cardiac Resynchronization Therapy (CRT)

Chronic Heart Failure

Arrhythmias and Device Therapy

Endorsed by cardiac societies

Austrian Society of Cardiology , Belgian Society of Cardiology , Association of Cardiologists of Bosnia & Herzegovina , British Cardiovascular Society , Bulgarian Society of Cardiology , Cyprus Society of Cardiology , Croatian Cardiac Society , Czech Society of Cardiology , Danish Society of Cardiology , Egyptian Society of Cardiology , Estonian Society of Cardiology , Finnish Cardiac Society , French Society of Cardiology , German Cardiac Society , Hellenic Society of Cardiology , Hungarian Society of Cardiology , Italian Federation of Cardiology , Israel Heart Society , Latvian Society of Cardiology , Luxembourg Society of Cardiology , Maltese Cardiac Society , National Society of Cardiology of North Macedonia , Norwegian Society of Cardiology , Polish Cardiac Society , Portuguese Society of Cardiology , Romanian Society of Cardiology , Russian Society of Cardiology* , San Marino Society of Cardiology , Cardiology Society of Serbia , Slovak Society of Cardiology , Spanish Society of Cardiology , Swiss Society of Cardiology , Tunisian Society of Cardiology and Cardiovascular Surgery , Turkish Society of Cardiology , Ukrainian Association of Cardiology

Main resources

: Full text and related materials

Full text
https://doi.org/10.1093/eurheartj/ehab364

Corrigendum (Published on 16 February 2022)

https://doi.org/10.1093/eurheartj/ehac075

Declarations of interest

Read the full text

: Scientific Presentation at ESC Congress 2021

Relive the presentation as it was live.

Watch now

More resources

: ESC TV Interview

The essentials of the Guidelines in less than four minutes.

Watch

: Congress News Article

Insights from the Chairs of the Guidelines Task Force.

Read

: Slide set

Educational material.

Download

: ESC Cardio Talk

With Michael Glikson from Israel and Jens Cosedis Nielsen from Denmark.

Listen

ESC Pocket Guidelines App

Have the ESC Pocket Guidelines with you all the time.

Download for free

Back to ESC Guidelines list