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August 20, 2019 Circulation. 2019;140:e382–e482. DOI: 10.1161/CIR.0000000000000628 e382

WRITING COMMITTEE MEMBERS* Fred M. Kusumoto, MD, FACC, FAHA, FHRS, Chair Mark H. Schoenfeld, MD, FACC, FAHA, FHRS, Vice Chair Coletta Barrett, RN, FAHA† James R. Edgerton, MD, FACC, FHRS‡ Kenneth A. Ellenbogen, MD, FACC, FAHA, FHRS*† Michael R. Gold, MD, PhD, FACC*§ Nora F. Goldschlager, MD, FACC, FAHA, FHRS† Robert M. Hamilton, MD‖ José A. Joglar, MD, FACC, FAHA, FHRS¶ Robert J. Kim, MD† Richard Lee, MD, MBA# Joseph E. Marine, MD, MBA, FACC, FHRS§ Christopher J. McLeod, MB, ChB, PhD, FACC, FAHA, FHRS† Keith R. Oken, MD, FACC† Kristen K. Patton, MD, FACC, FAHA, FHRS† Cara N. Pellegrini, MD, FHRS*§** Kimberly A. Selzman, MD, MPH, FACC, FHRS† Annemarie Thompson, MD† Paul D. Varosy, MD, FACC, FAHA, FHRS††

© 2018 by the American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society.

ACC/AHA/HRS GUIDELINE

2018 ACC/AHA/HRS Guideline on the Evaluation and

Management of Patients With Bradycardia and Cardiac Conduction Delay

A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

Circulation

ACC/AHA Task Force Members, see page e452

Developed in Collaboration With the American Association for Thoracic Surgery, the Pediatric & Congenital Electrophysiology Society, and the Society of Thoracic Surgeons Endorsed by the American Association for Thoracic Surgery, the Pediatric & Congenital Electrophysiology Society, and the Society of Thoracic Surgeons

https://www.ahajournals.org/journal/circ

Key Words:  AHA Scientific Statements ◼ ablation ◼ ambulatory electrocardiography ◼ aminophylline ◼ atrioventricular block ◼ atropine ◼ AV block ◼ beta-adrenergic agonist ◼ bradyarrhythmia ◼ bradycardia ◼ bundle branch block ◼ cardiac pacing ◼ cardiac resynchronization therapy ◼ cardiac sinus pause ◼ cardiac surgery ◼ congenital heart disease ◼ digoxin antibodies Fab fragments ◼ electrocardiogram ◼ glucagon ◼ heart block ◼ Holter monitoring ◼ intraoperative ◼ isoproterenol ◼ lamin A-C ◼ left bundle branch block ◼ muscular dystrophies ◼ myocardial infarction ◼ myotonic dystrophy ◼ pacemaker ◼ pacing ◼ preoperative ◼ quality of life ◼ right bundle branch block ◼ sarcoidosis ◼ shared decisionmaking ◼ sick sinus syndrome ◼ sinus arrest ◼ sinus bradycardia syndrome ◼ sinus node dysfunction ◼ spinal cord injuries ◼ syncope ◼ theophylline ◼ transcatheter aortic valve replacement

The American Heart Association requests that this document be cited as follows: Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ, Lee R, Marine JE, McLeod CJ, Oken KR, Patton KK, Pellegrini C, Selzman KA, Thompson A, Varosy PD. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2019;140:e382–e482. DOI: 10.1161/CIR.0000000000000628

*Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡STS Representative. §HRS Representative. ‖PACES Representative. ¶ACC/AHA Task Force on Clinical Practice Guidelines Liaison. #AATS Representative. **Dr. Pellegrini contributed to this article in her personal capacity. The views expressed are her own and do not necessarily represent the views of the US Department of Veterans Affairs or the US government. ††ACC/AHA Performance Measures Representative.

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