《2008年心脏节律异常装置治疗指南》内容预览：

   The American College of Cardiology Foundation(ACCF) and the American Heart Association (AHA) havejointly engaged in the production of such guidelines in thearea of cardiovascular disease since 1980. The AmericanCollege of Cardiology (ACC)/AHA Task Force on PracticeGuidelines, whose charge is to develop, update, or revisepractice guidelines for important cardiovascular diseases andprocedures, directs this effort. Writing committees arecharged with the task of performing an assessment of theevidence and acting as an independent group of authors todevelop, update, or revise written recommendations forclinical practice.
  
    Experts in the subject under consideration have beenselected from both organizations to examine subject-specificdata and write guidelines. The process includes additionalrepresentatives from other medical practitioner and specialtygroups when appropriate. Writing committees are specifi-cally charged to perform a formal literature review, weighthe strength of evidence for or against a particular treatmentor procedure, and include estimates of expected healthoutcomes where data exist. Patient-specific modifiers andcomorbidities and issues of patient preference that mayinfluence the choice of particular tests or therapies areconsidered, as well as frequency of follow-up and cost-effectiveness. When available, ***rmation from studies oncost will be considered; however, review of data on efficacyand clinical outcomes will constitute the primary basis forpreparing recommendations in these guidelines.
  
    The ACC/AHA Task Force on Practice Guidelinesmakes every effort to avoid any actual, potential, or per-ceived conflicts of interest that may arise as a result of anindustry relationship or personal interest of the writingcommittee. Specifically, all members of the writing com-mittee, as well as peer reviewers of the document, wereasked to provide disclosure statements of all such relation-ships that may be perceived as real or potential conflicts ofinterest. Writing committee members are also stronglyencouraged to declare a previous relationship with industrythat may be perceived as relevant to guideline development.If a writing committee member develops a new relationshipwith industry during his or her tenure, he or she is requiredto notify guideline staff in writing. The continued partici-pation of the writing committee member will be reviewed.These statements are reviewed by the parent task force,reported orally to all members of the writing committee ateach meeting, and updated and reviewed by the writingcommittee as changes occur. Please refer to the methodol-ogy manual for ACC/AHA guideline writing committeesfor further desc**tion of the relationships with industrypolicy (1). See Appendix 1 for author relationships withindustry and Appendix 2 for peer reviewer relationshipswith industry that are pertinent to this guideline.These practice guidelines are intended to assist healthcare providers in clinical decision making by describing arange of generally acceptable approaches for the diagnosis,management, and prevention of specific diseases or condi-tions. Clinical decision making should consider the qualityand availability of expertise in the area where care isprovided. These guidelines attempt to define practices thatmeet the needs of most patients in most circumstances.These guideline recommendations reflect a consensus ofexpert opinion after a thorough review of the availablecurrent scientific evidence and are intended to improvepatient care.
  
      Patient adherence to prescribed and agreed upon medicalregimens and lifestyles is an important aspect of treatment.Prescribed courses of treatment in accordance with theserecommendations will only be effective if they are followed.Because lack of patient understanding and adherence mayadversely affect treatment outcomes, physicians and otherhealth care providers should make every effort to engage thepatient in active participation with prescribed medical reg-imens and lifestyles.
  
      If these guidelines are used as the basis for regulatory orpayer decisions, the ultimate goal is quality of care and servingthe patient’s best interests. The ultimate judgment regardingcare of a particular patient must be made by the health careprovider and the patient in light of all of the circumstancespresented by that patient. There are circumstances in whichdeviations from these guidelines are appropriate.The guidelines will be reviewed annually by the ACC/AHA Task Force on Practice Guidelines and will beconsidered current unless they are updated, revised, orsunsetted and withdrawn from distribution. The executivesummary and recommendations are published in the May27, 2008, issue of the Journal of the American College ofCardiology, May 27, 2008, issue of Circulation, and the June2008 issue of Heart Rhythm. The full-text guidelines aree-published in the same issue of the journals noted above, aswell as posted on the ACC (www.acc.org), AHA (http://my.americanheart.org), and Heart Rhythm Society (HRS)(www.hrsonline.org) Web sites. Copies of the full-text andthe executive summary are available from each organization.Sidney C. Smith, Jr, MD, FACC, FAHAChair, ACC/AHA Task Force on Practice Guidelines

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