American Heart / American College of Cardiology
Guidelines
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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.
 
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