{"id":9222,"date":"2025-11-22T13:09:35","date_gmt":"2025-11-22T10:09:35","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=9222"},"modified":"2025-11-22T13:09:35","modified_gmt":"2025-11-22T10:09:35","slug":"jordan-cardiac-society-jcs-taskforce-congress-october-2025-indications-for-cardiac-device-implants","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/jordan-cardiac-society-jcs-taskforce-congress-october-2025-indications-for-cardiac-device-implants\/","title":{"rendered":"Jordan Cardiac Society (JCS) Taskforce Congress, October 2025 Indications for Cardiac Device Implants"},"content":{"rendered":"

Jordan Cardiac Society (JCS) Taskforce Congress, October 2025<\/span><\/p>\n

Indications for Cardiac Device Implants<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Source: Dr. Basil Abu El Haija-Chair, Scientific Committee-Jordan EP Group (JCS)<\/span><\/p>\n

Keynotes:<\/span><\/p>\n

1. Overview<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>The Jordanian guidelines adopt international standards (ACC, AHA, HRS, ESC).<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Devices covered: Pacemaker (PPM), Implantable Cardioverter-Defibrillator (ICD), and Cardiac Resynchronization Therapy (CRT).<\/span><\/p>\n

\u00a0<\/span><\/p>\n

2. Permanent Pacemaker (PPM)<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Purpose: Prevent symptomatic bradycardia or AV conduction failure.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Sinus Node Dysfunction (SND):<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Most common indication, especially in elderly (>65 years).<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>ECG findings:<\/span><\/p>\n

\u2022 Sinus bradycardia <40 bpm (with symptoms)<\/span><\/p>\n

\u2022 Sinus pause \u22653 sec (\u22655 sec in AF)<\/span><\/p>\n

\u2022 Chronotropic incompetence (fails to reach 85% predicted HR)<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Symptoms: dizziness, fatigue, syncope, low exercise capacity.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Atrioventricular (AV) Block:<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Complete (3rd-degree) or Mobitz II \u2192 always pace.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Symptomatic Type I or marked 1st-degree \u2192 may benefit.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Alternating bundle branch block \u2192 pacing due to high risk of progression.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Post-MI AV Block:<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Inferior MI \u2192 observe 48\u201372 <\/span>hrs<\/span> (may recover).<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Anterior MI \u2192 implant early (rare recovery).<\/span><\/p>\n

\u00a0<\/span><\/p>\n

3. Implantable Cardioverter-Defibrillator (ICD)<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Goal: Prevent Sudden Cardiac Death (SCD) from VT\/VF.<\/span><\/p>\n

A. Secondary Prevention<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Survivors of cardiac arrest, sustained VT\/VF, or arrhythmic syncope.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Exclude reversible causes (ischemia, electrolytes, SVT).<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Post-MI VT\/VF >48 <\/span>hrs<\/span> \u2192 revascularize; if persistent risk \u2192 ICD.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

B. Primary Prevention<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Ischemic Cardiomyopathy:<\/span><\/p>\n

\u2022 LVEF \u226435%, \u226540 days post-MI, not <\/span>revascularizable<\/span>.<\/span><\/p>\n

\u2022 LVEF <40% + non-sustained VT + inducible VT\/VF on EPS.<\/span><\/p>\n

\u2022 Delay evaluation \u226590 days post-revascularization.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Non-Ischemic Cardiomyopathy (NIDCM):<\/span><\/p>\n

\u2022 LVEF \u226435% with NYHA II\u2013III despite \u22653 months GDMT.<\/span><\/p>\n

\u2022 Evidence: DEFINITE, SCD-<\/span>HeFT<\/span> trials.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u2022 Inherited & Specific Diseases:<\/span><\/p>\n

Long QT syndrome, <\/span>Brugada<\/span> syndrome, ARVC, and HCM.<\/span><\/p>\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.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

4. Cardiac Resynchronization Therapy (CRT)<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Goal: Improve LV synchrony and outcomes in systolic HF with electrical <\/span>dyssynchrony<\/span>.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Device types: CRT-P (Pacemaker) or CRT-D (with Defibrillator).<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Indications:<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Class I (Strong):<\/span><\/p>\n

\u2022 LVEF \u226435%, QRS \u2265150 <\/span>ms<\/span>, LBBB, NYHA II\u2013IV.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Class <\/span>IIa<\/span> (Intermediate):<\/span><\/p>\n

\u2022 LVEF \u226435%, QRS 130\u2013149 <\/span>ms<\/span>, LBBB.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Non-LBBB (Consider):<\/span><\/p>\n

\u2022 LVEF \u226435%, QRS \u2265150 <\/span>ms<\/span>, NYHA III\u2013IV.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Special Scenarios:<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Frequent ventricular pacing >40%, LVEF <50% \u2192 CRT (BLOCK-HF trial).<\/span><\/p>\n

\u00a0<\/span><\/p>\n

5. Clinical Summary<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>PPM: for bradyarrhythmia (SND, AV block, post-MI block).<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>ICD: for SCD prevention (ischemic, non-ischemic, or inherited).<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>CRT: for heart failure with wide QRS or high pacing burden.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Sarcoidosis: if pacing required, always implant ICD.<\/span><\/p>\n

\u200b<\/span>\u2022<\/span>\u200b<\/span>Jordanian protocols align fully with ACC\/AHA\/HRS\/ESC standards to ensure evidence-based and unified national practice.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Jordan Cardiac Society (JCS) Taskforce Congress, October 2025 Indications for Cardiac Device Implants \u00a0 Source: Dr. Basil Abu El Haija-Chair, Scientific Committee-Jordan EP Group (JCS) Keynotes: 1. Overview \u200b\u2022\u200bThe Jordanian guidelines adopt international standards (ACC, AHA, HRS, ESC). \u200b\u2022\u200bDevices covered: Pacemaker (PPM), Implantable Cardioverter-Defibrillator (ICD), and Cardiac Resynchronization Therapy (CRT). \u00a0 2. Permanent Pacemaker (PPM) […]<\/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-9222","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9222","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=9222"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9222\/revisions"}],"predecessor-version":[{"id":9223,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9222\/revisions\/9223"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=9222"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=9222"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=9222"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}