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and inclusion, notably with respect to gender and country of origin. The task force performed a critical review and evaluation of the published literature on diagnostic and therapeutic approaches including assessment of the risk–benefit ratio. The strength of every recommendation and the level of evidence supporting them were weighed and scored according to predefined scales as outlined in Tables 1 and 2 below. Patient-reported outcome measures (PROMs) and patient-reported experience measures were also evaluated as the basis for recommendations and/or discussion in these guidelines. The task force followed ESC voting procedures and all approved recommendations were subject to a vote and achieved at least 75% agreement among voting members. Members of the task force with declared interests on specific topics were asked to abstain from voting on related recommendations. Table 1 Classes of recommendations ©ESC 2024 Classes of recommendations Class I Evidence and/or general agreement that a given treatment or procedure is beneficial, useful, effective. Conflicting evidence and/or a divergence of opinion about the usefulness/ efficacy of the given treatment or procedure. Is recommended or is indicated Wording to use Definition Class III Evidence or general agreement that the given treatment or procedure is not useful/effective, and in some cases may be harmful. Is not recommended Class IIb Usefulness/efficacy is less well established by evidence/opinion. May be considered Class IIa Weight of evidence/opinion is in favour of usefulness/efficacy. Should be considered Class II Table 2 Levels of evidence Level of evidence A Level of evidence B Level of evidence C Data derived from multiple randomized clinical trials or meta-analyses. Data derived from a single randomized clinical trial or large non-randomized studies. Consensus of opinion of the experts and/or small studies, retrospective studies, registries. ©ESC 2024 Downloaded from academic.oup.com/eurheartj/article/45/36/3314/7738779 by guest on 07 October 2026