Cardiovascular Disability Updating the Social Security Listings (2010) / Chapter Skim
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13 Arrhythmias
13 Arrhythmias
Pages 199-208
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From page 199... ...
, which can be caused not only by arrhythmias but also by other etiologies. this chapter recommends that the listing be met if recurrent episodes of tachycardia or bradycardia cause syncope, near syncope, or other debilitating symptoms that very seriously limit the ability of the claimant to independently initiate, sustain, or complete activities of daily living or instrumental activities of daily living.
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From page 200... ...
Supraventricular arrhythmias may be often highly symptomatic but are rarely life threatening (Wood et al., 2010)
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From page 201... ...
The most common ventricular arrhythmias requiring treatment are those that occur in association with coronary artery disease. They are responsible for cardiac arrest and sudden cardiac death, which are not chronic conditions (although cardiac arrest may result in a chronic cardiovascular or other condition)
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From page 202... ...
Ventricular arrhythmias may be treated by drug therapy, catheter ablation, and ICDs, the latter being the mainstay of therapy when they occur in patients with structural heart disease (e.g., coronary artery disease, cardiomyopathy, genetic heart diseases)
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Similarly, ICDs are extremely effective in resuscitating cardiac arrest, and in some instances can use pacing techniques to terminate ventricular arrhythmias without resorting to shock therapy. ICDs, however, do not prevent arrhythmias and thus may not prevent syncope.
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From page 204... ...
evaluates claimants for disability with recurrent arrhythmias with uncontrolled and recurrent episodes of cardiac syncope or near syncope documented by a resting or ambulatory (Holter) ECG or other appropriate medically acceptable tests.
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CONCLUSIONS AND RECOMMENDATION After review of the most recent medical literature and related American College of Cardiology/American Heart Association treatment and practice guidelines, the committee determined the arrhythmias listing should be revised to allow claimants to meet the listing with objective diagnosis of recurrent (as defined by SSA) episodes of tachycardia or bradycardia, that cause cardiac syncope, near syncope, or other debilitating symptoms, confirmed by ECG or other appropriate medically acceptable testing.
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From page 206... ...
2006. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation)
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From page 207... ...
2006. ACC/AHA/ ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/ American Heart Association Task Force and the European Society of Cardiology Com mittee for Practice Guidelines (Writing Committee to Develop Guidelines for Manage ment of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death)
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