[ST-24]Statement on Indications for the Use of Permanently
Implanted Cardiac Pacemakers
[by the American College of Surgeons]
In July 1991 a joint task force of the American College of
Cardiology and the American Heart Association published a report
that set forth guidelines for the implantation of cardiac pacemakers
and antiarrhythmia devices.¹ The report was comprehensive
in scope and described the multiple abnormalities of intracardiac
conduction in both adults and children for whom pacemaker implantation
is appropriate. The report also described tachyarrhythmias that
might be treated effectively with pacing. In addition, a section
of the report discussed the use of implantable cardioverter-defibrillator
devices. Finally, the report contained a section describing the
various types of pacing devices that are currently available
and the conditions for which they are useful.
The report did not specify that pacemakers or cardioverter-defibrillators
should, or should not, be implanted by a specific type of physician.
It was strongly recommended, however, that pacing "be performed
by individuals with appropriate training who maintain their skills
by participating in an adequate number of operations."
Although the technical information in this report will require
periodic updating, the Advisory Council for Cardiothoracic Surgery
of the American College of Surgeons finds it to be informative
and the recommendations to be appropriate. The American College
of Surgeons recognizes that many cardiothoracic surgeons are
actively involved in this important and continually evolving
area of practice.² The College believes that the implantation
of pacemakers and cardioverter-defibrillators is an appropriate
part of residency training for cardiothoracic surgery.
Further, the College encourages practicing surgeons to remain
current in their knowledge and application of available technology.
References
¹ACC/AHA Task Force Report: Guidelines for implantation
of cardiac pacemakers and antiarrhythmia devices. JACC,
191;18:1-13.
²Ferguson TB Jr, Linsday BD, Boineau JP: Should surgeons
still be implanting pacemakers? Ann Thor Surg, 57:588-97,
1994.
Statements
menu
__________
Reprinted from Bulletin of the American College
of Surgeons
Vol. 81, No. 2, Page 40, February 1996
