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............................................................................................................................................................................ HFrEF Heart failure with reduced ejection fraction HOT-CRT His-optimized cardiac resynchronization therapy HR Hazard ratio HV Hisventricular interval (time from the beginning of the H deflection to the earliest onset of ventricular depolarization recorded in any lead, electrophysiology study of the heart) ICD Implantable cardioverter-defibrillator ILR Implantable loop recorder LBBB Left bundle branch block LGE Late gadolinium contrast enhanced LQTS Long QT syndrome LV Left ventricular LVEF Left ventricular ejection fraction MADIT-CRT Multicenter Automatic Defibrillator Implantation with Cardiac Resynchronization Therapy (trial) MI Myocardial infarction MIRACLE Multicenter Insync RAndomized Clinical Evaluation (trial) MOST MOde Selection Trial in Sinus-Node Dysfunction MRI Magnetic resonance imaging MUSTIC MUltisite STimulation In Cardiomyopathies (trial) NOAC Non-vitamin K antagonist oral anticoagulant NYHA New York Heart Association OAC Oral anticoagulant OMT Optimal medical therapy OR Odds ratio PATH-CHF PAcing THerapies in Congestive Heart Failure (trial) PCCD Progressive cardiac conduction disease PCI Percutaneous coronary intervention PET Positron emission tomography PM Pacemaker RA Right atrium/atrial RAFT ResynchronizationDefibrillation for Ambulatory Heart Failure Trial RBBB Right bundle branch block RCT Randomized controlled trial RESET-CRT Re-evaluation of Optimal Resynchronisation Therapy in Patients with Chronic Heart Failure (trial) REVERSE REsynchronization reVErses Remodelling in Systolic left vEntricular dysfunction (trial) RV Right ventricular/right ventricle RVA Right ventricular apical RVOT Right ventricular outflow tract RVS Right ventricular septum S. aureus Staphylococcus aureus SAR Specific absorption rate SAS Sleep apnoea syndrome SCD Sudden cardiac death SND Sinus node dysfunction SR Sinus rhythm TAVI Transcatheter aortic valve implantation VKA Vitamin K antagonist WRAP-IT World-wide Randomized Antibiotic Envelope Infection Prevention Trial

1 Preamble

Guidelines summarize and evaluate available evidence with the aim of assisting health professionals in proposing the best management strategies for an individual patient with a given condition. Guidelines and their recommendations should facilitate decision-making of health professionals in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver, as appropriate. A great number of guidelines have been issued in recent years by the European Society of Cardiology (ESC), as well as by other societies and organizations. Because of their impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines can be found on the ESC website (https://www.escardio.org/Guidelines). The ESC Guidelines represent the official position of the ESC on a given topic and are regularly updated. In addition to the publication of Clinical Practice Guidelines, the ESC carries out the EurObservational Research Programme of international registries of cardiovascular diseases and interventions which are essential to assess diagnostic/therapeutic processes, use of resources, and adherence to guidelines. These registries aim at providing a better understanding of medical practice in Europe and around the world, based on high-quality data collected during routine clinical practice. Furthermore, the ESC has developed and embedded in this document a set of quality indicators (QIs), which are tools to evaluate the level of implementation of the guidelines and may be used by the ESC, hospitals, healthcare providers, and professionals to measure clinical practice as well as in educational programmes, alongside the key messages from the guidelines, to improve quality of care and clinical outcomes. The Members of this Task Force were selected by the ESC, including representation from its relevant ESC subspecialty groups, in order to represent professionals involved with the medical care of patients with this pathology. Selected experts in the field undertook a comprehensive review of the published evidence for management of a given condition according to ESC Clinical Practice Guidelines Committee (CPG) policy. A critical evaluation of diagnostic and therapeutic procedures was performed, including assessment of the riskbenefit ratio. The level of evidence and the strength of the recommendation of particular management options were weighed and graded according to pre-defined scales, as outlined below. The experts of the writing and reviewing panels provided declaration of interest forms for all relationships that might be perceived as Downloaded from academic.oup.com/eurheartj/article/42/35/3427/6358547 by guest on 07 October 2026