You are here

  • Home
  • Archive
  • Volume 110, Issue 5
  • Review of the National Institute for Health and Care Excellence guidelines on the management of atrial and ventricular arrhythmias

Article Text

Article menu
Download PDFPDF
Review
Review of the National Institute for Health and Care Excellence guidelines on the management of atrial and ventricular arrhythmias
  1. Pier D Lambiase1,2,
  2. Edd Maclean1,3
  1. 1 Cardiac Electrophysiology, St Bartholomew's Hospital, London, UK
  2. 2 Institute of Cardiovascular Sciences, University College London, London, UK
  3. 3 Queen Mary University of London, William Harvey Research Institute, London, UK
  1. Correspondence to Professor Pier D Lambiase, St Bartholomew's Hospital, London, EC1A 7BE, UK; p.lambiase{at}ucl.ac.uk

Abstract

The National Institute for Health and Care Excellence (NICE) guidelines present a synopsis of extensive internal evidence and technology reviews, with a particular focus on clinical efficacy and cost-effectiveness within the NHS in England. This approach has delivered a novel perspective on arrhythmia management, with important distinctions from other policymakers’ recommendations. For example, when compared with the European Society of Cardiology (ESC) and the American Heart Association (AHA)/Heart Rhythm Society (HRS)/American College of Cardiology (ACC) guidelines on atrial fibrillation (AF), NICE advocates unique strategies regarding arrhythmia detection, stroke and bleeding risk stratification, and rhythm control (NICE CG 196). Likewise, for patients at risk of sudden cardiac death, NICE TA314 not only recommends device therapy based on New York Heart Association class and ECG findings, but also incorporates quality-adjusted life year data from analysis of key randomised controlled trials.

This review examines the NICE guidelines, together with those from the AHA/HRS/ACC and ESC, on the management of AF and ventricular arrhythmias and highlights the key common features and discrepancies between these important documents.

  • Atrial Fibrillation
  • Tachycardia, Ventricular
  • Defibrillators, Implantable

https://doi.org/10.1136/heartjnl-2022-322122

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Twitter @qrs_120

    • Contributors Both authors participated equally in researching, drafting and proofing this review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests PDL: educational and research grants from Boston Scientific, Abbott and Biosense Webster; supported by UCLH Biomedicine NIHR and Barts BRC; chief Investigator of the BHF funded CRAAFT HF randomised controlled trial of AF ablation in heart failure.

    • Provenance and peer review Commissioned; externally peer reviewed.