{"id":9053,"date":"2025-10-27T21:22:05","date_gmt":"2025-10-27T18:22:05","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=9053"},"modified":"2025-10-27T21:22:05","modified_gmt":"2025-10-27T18:22:05","slug":"jordanian-task-force-2025-indications-for-cardiac-device-implants","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/jordanian-task-force-2025-indications-for-cardiac-device-implants\/","title":{"rendered":"Jordanian Task Force 2025 \u2013 Indications for Cardiac Device Implants"},"content":{"rendered":"
Jordanian Task Force 2025 \u2013 Indications for Cardiac Device Implants<\/div>\n
<\/div>\n
Source: Dr. Basil Abu El Haija-Chair, Scientific Committee-Jordan EP Group (JCS)<\/div>\n
\u00a0Electrophysiology Task Force, October 2025<\/div>\n
Event: Jordan Cardiac Society \u2013 1st Electrophysiology Group Meeting<\/div>\n
<\/div>\n
Keynotes:<\/div>\n
1.\u2060 \u2060Overview<\/div>\n
\u2022 The Jordanian guidelines adopt international standards (ACC, AHA, HRS, ESC).<\/span><\/div>\n
\u2022 Devices covered: Pacemaker (PPM), Implantable Cardioverter-Defibrillator (ICD), and Cardiac Resynchronization Therapy (CRT).<\/span><\/div>\n
<\/div>\n
2.\u2060 \u2060Permanent Pacemaker (PPM)<\/div>\n
\u2022 Purpose: Prevent symptomatic bradycardia or AV conduction failure.<\/span><\/div>\n
\u2022 Sinus Node Dysfunction (SND):<\/span><\/div>\n
\u2022 Most common indication, especially in elderly (>65 years).<\/span><\/div>\n
\u2022 ECG findings:<\/span><\/div>\n
\u2022\u2060\u00a0 \u2060Sinus bradycardia <40 bpm (with symptoms)<\/div>\n
\u2022\u2060\u00a0 \u2060Sinus pause \u22653 sec (\u22655 sec in AF)<\/div>\n
\u2022\u2060\u00a0 \u2060Chronotropic incompetence (fails to reach 85% predicted HR)<\/div>\n
\u2022 Symptoms: dizziness, fatigue, syncope, low exercise capacity.<\/span><\/div>\n
\u2022 Atrioventricular (AV) Block:<\/span><\/div>\n
\u2022 Complete (3rd-degree) or Mobitz II \u2192 always pace.<\/span><\/div>\n
\u2022 Symptomatic Type I or marked 1st-degree \u2192 may benefit.<\/span><\/div>\n
\u2022 Alternating bundle branch block \u2192 pacing due to high risk of progression.<\/span><\/div>\n
\u2022 Post-MI AV Block:<\/span><\/div>\n
\u2022 Inferior MI \u2192 observe 48\u201372 hrs (may recover).<\/span><\/div>\n
\u2022 Anterior MI \u2192 implant early (rare recovery).<\/span><\/div>\n
<\/div>\n
3.\u2060 \u2060Implantable Cardioverter-Defibrillator (ICD)<\/div>\n
\u2022 Goal: Prevent Sudden Cardiac Death (SCD) from VT\/VF.<\/span><\/div>\n
A. Secondary Prevention<\/div>\n
\u2022 Survivors of cardiac arrest, sustained VT\/VF, or arrhythmic syncope.<\/span><\/div>\n
\u2022 Exclude reversible causes (ischemia, electrolytes, SVT).<\/span><\/div>\n
\u2022 Post-MI VT\/VF >48 hrs \u2192 revascularize; if persistent risk \u2192 ICD.<\/span><\/div>\n
<\/div>\n
B. Primary Prevention<\/div>\n
\u2022 Ischemic Cardiomyopathy:<\/span><\/div>\n
\u2022\u2060\u00a0 \u2060LVEF \u226435%, \u226540 days post-MI, not revascularizable.<\/div>\n
\u2022\u2060\u00a0 \u2060LVEF <40% + non-sustained VT + inducible VT\/VF on EPS.<\/div>\n
\u2022\u2060\u00a0 \u2060Delay evaluation \u226590 days post-revascularization.<\/div>\n
\u2022 Non-Ischemic Cardiomyopathy (NIDCM):<\/span><\/div>\n
\u2022\u2060\u00a0 \u2060LVEF \u226435% with NYHA II\u2013III despite \u22653 months GDMT.<\/div>\n
\u2022\u2060\u00a0 \u2060Evidence: DEFINITE, SCD-HeFT trials.<\/div>\n
<\/div>\n
\u2022\u2060\u00a0 \u2060Inherited & Specific Diseases:<\/div>\n
Long QT syndrome, Brugada syndrome, ARVC, and HCM.<\/div>\n
Cardiac Sarcoidosis: if pacing is indicated, implant an ICD instead of a pacemaker because of the high risk of VT\/VF and sudden death associated with diffuse myocardial involvement.<\/div>\n
<\/div>\n
4.\u2060 \u2060Cardiac Resynchronization Therapy (CRT)<\/div>\n
\u2022 Goal: Improve LV synchrony and outcomes in systolic HF with electrical dyssynchrony.<\/span><\/div>\n
\u2022 Device types: CRT-P (Pacemaker) or CRT-D (with Defibrillator).<\/span><\/div>\n
<\/div>\n
Indications:<\/div>\n
\u2022 Class I (Strong):<\/span><\/div>\n
\u2022\u2060\u00a0 \u2060LVEF \u226435%, QRS \u2265150 ms, LBBB, NYHA II\u2013IV.<\/div>\n
\u2022 Class IIa (Intermediate):<\/span><\/div>\n
\u2022\u2060\u00a0 \u2060LVEF \u226435%, QRS 130\u2013149 ms, LBBB.<\/div>\n
\u2022 Non-LBBB (Consider):<\/span><\/div>\n
\u2022\u2060\u00a0 \u2060LVEF \u226435%, QRS \u2265150 ms, NYHA III\u2013IV.<\/div>\n
<\/div>\n
Special Scenarios:<\/div>\n
\u2022 Frequent ventricular pacing >40%, LVEF <50% \u2192 CRT (BLOCK-HF trial).<\/span><\/div>\n
<\/div>\n
5.\u2060 \u2060Clinical Summary<\/div>\n
\u2022 PPM: for bradyarrhythmia (SND, AV block, post-MI block).<\/span><\/div>\n
\u2022 ICD: for SCD prevention (ischemic, non-ischemic, or inherited).<\/span><\/div>\n
\u2022 CRT: for heart failure with wide QRS or high pacing burden.<\/span><\/div>\n
\u2022 Sarcoidosis: if pacing required, always implant ICD.<\/span><\/div>\n
\u2022 Jordanian protocols align fully with ACC\/AHA\/HRS\/ESC standards to ensure evidence-based and unified national practice.<\/span><\/div>\n","protected":false},"excerpt":{"rendered":"

Jordanian Task Force 2025 \u2013 Indications for Cardiac Device Implants Source: Dr. Basil Abu El Haija-Chair, Scientific Committee-Jordan EP Group (JCS) \u00a0Electrophysiology Task Force, October 2025 Event: Jordan Cardiac Society \u2013 1st Electrophysiology Group Meeting Keynotes: 1.\u2060 \u2060Overview \u2022 The Jordanian guidelines adopt international standards (ACC, AHA, HRS, ESC). \u2022 Devices covered: Pacemaker (PPM), Implantable […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9053","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9053","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=9053"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9053\/revisions"}],"predecessor-version":[{"id":9054,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9053\/revisions\/9054"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=9053"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=9053"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=9053"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}