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American Heart / American College of Cardiology
Guidelines
References>AHA/ACC Guidelines>1
ACC/AHA Level of Evidence Classification and Recommendations
Class
Description
Class I
Conditions for which there is evidence for and/or general agreement that the procedure or treatment is benficial, useful, and effective
Class II
Conditions for which there is conflicting evidence and/or divergence of opionion about the usefulness/efficacy of a procedure or treatment
Class IIA
Weight of evidence/opinion is in favor of usefulness/efficacy
Class IIB
Usefulness/efficacy is less well established by evidence/opinion
Class III
Conditions for which there is evidence and/or general agreement that the procedure/treatment is not useful/effective and in some cases may be harmful
Level of Evidence Classification
Evidence Level
Description
Level of Evidence A
Data derived from multiple randomized clinical trials.
Level of Evidence B
Data derived from a single randomized trial or nonrandomized trial.
Level of Evidence C
Only consensus opinion of experts, case studies, or standard-of-care.
New York Association (NYHA) Functional Classification
This scale assists in the determination of functional ability in
patients with cardiac disease.
Class I
Patients with cardiac disease, but without resulting limitation of
physical activity. Ordinary physical activity does not cause undue
fatigue, palpitation, dyspnea, or anginal pain.
Class II
Patients with cardiac disease resulting in slight limitation of
physical activity. They are comfortable at rest. Ordinary physical
activity results in fatigue, palpitation, dyspnea or anginal pain.
Class III
Patients with marked limitation of physical activity. They are
comfortable at rest. Less than ordinary activity causes fatigue,
palpitation, dyspnea, or anginal pain.
Class IV
Patients with cardiac disease resulting in inability to carry on
any physical activity without discomfort. Symptoms of heart failure
or of the anginal syndrome may be present even at rest. If any
physical activity is undertaken, discomfort is increased.
