Condition | Examples |
Unstable coronary syndromes | Unstable or severe angina—CCS class III or IV* |
Recent MI† | |
Decompensated heart failure |
|
Significant arrhythmias | High-grade atrioventricular block |
Mobitz II atrioventricular block | |
Third degree atrioventricular heart block | |
Symptomatic ventricular arrhythmias | |
Supraventricular arrhythmias including atrial fibrillation with uncontrolled ventricular rate: HR >100 beats/min at rest | |
Symptomatic bradycardia | |
Newly recognised ventricular tachycardia | |
Severe heart valve disease | Severe aortic stenosis: mean pressure gradient >40 mm Hg, aortic valve area <1.0 cm2 or symptomatic |
Symptomatic mitral stenosis: progressive dyspnoea on exertion, exertional presyncope or heart failure |
↵* May include ‘stable’ angina in patients who are unusually sedentary.
↵† The American College of Cardiology National Database Library defines recent MI as >7 days but ≤1 month within 30 days.
CCS, Canadian Cardiovascular Society grading for angina pectoris; HR, heart rate; MI, myocardial infarction; NYHA, New York Heart Association.