Clinical Resources

Authored and endorsed clinical documents provide three main components vital to advancements in the heart rhythm field: analysis, discussion of current issues, and suggestions for clinical application.

HRS Clinical Document Methodology

The HRS Clinical Document Development Methodology Manual and Policies transparently declares the standards by which the HRS develops clinical practice documents, which include clinical practice guidelines, expert consensus statements, scientific statements, clinical competency statements, task force policy statements, and proceedings statements.

HRS White Paper on Atrial Fibrillation Centers of Excellence: Rationale, Considerations, and Goals

Atrial Fibrillation
Clinical EP

May 5, 2020—This white paper reviews the rationale for atrial fibrillation (AF) “centers of excellence” (CoE), the available evidence for integrated and multidisciplinary care, and future challenges and opportunities. The document also defines the key priorities to be used as a guide for the Heart Rhythm Society (HRS) and its diverse stakeholders to build consensus on defining the core components of an AF CoE.

Guidance for Cardiac Electrophysiology During the COVID-19 Pandemic from the HRS COVID-19 Task Force, ACC Electrophysiology Section, and the AHA Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology

Clinical EP
Atrial Arrhythmias
Heart Failure / CRT
Ventricular Arrhythmias

April 1, 2020—The HRS COVID-19 Task Force, ACC Electrophysiology Section, and the AHA Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology have partnered to provide guidance and recommendations to support rapid COVID-19 response efforts. This joint document, accompanied by a video interview, identifies the potential risks of exposure to patients, allied health care staff, industry representatives, and hospital administrators and describes the impact of COVID-19 on cardiac arrhythmias and methods of triage based on acuity and patient comorbidities.

2019 APHRS Expert Consensus Statement on Three-Dimensional Mapping Systems for Tachycardia, Developed in Collaboration with HRS, EHRA, and LAHRS

HRS Endorsed / Affirmed
Electrophysiology
Atrial Fibrillation
Atrial Arrhythmias
Ventricular Arrhythmias
Clinical EP
Ablation

The Heart Rhythm Society endorsed the document on October 21, 2019. 

March 9, 2020—This document provides a state-of-the-art review of currently available three-dimensional mapping systems in the field of cardiac tachyarrhythmias and describes the use of three-dimensional mapping systems and includes recommendations regarding their application in clinical practice based on scientific evidence. In cases where these useful systems are not available or cannot be used in a wide scale due to financial constraints, electrophysiology procedures should be offered to patients based on established indications.  

SCAI Multi-Society Position Statement on Occupational Health Hazards of the Catheterization Laboratory: Shifting the Paradigm for Healthcare Workers' Protection

HRS Endorsed / Affirmed
Clinical EP

The Heart Rhythm Society endorsed the document on October 16, 2019.

February 11, 2020—The purpose of this position statement (accompanied by an editorial) is to review the data documenting occupational health injuries, summarize current equipment and processes that can be widely applied to optimize protection, emphasize the importance of investment by hospitals and health systems in protective equipment established to enhance workplace safety, examine barriers that need to be overcome to spur advances to enhance the occupational safety of the fluoroscopic laboratory environment, and propose enhanced advocacy for innovation.

2019 EHRA International Consensus Document on How to Prevent, Diagnose, and Treat Cardiac Implantable Electronic Device Infections

HRS Endorsed / Affirmed
Device Therapy

The Heart Rhythm Society endorsed the document on July 28, 2019.
November 8, 2019—The aim of this document is to describe the current knowledge on the risks for device-related infections and to assist health care professionals in clinical decision making regarding their prevention, diagnosis, and management by providing the latest update of the most effective strategies.

2019 HRS/EHRA/APHRS/LAHRS Focused Update to 2015 Expert Consensus Statement on Optimal Implantable Cardioverter-Defibrillator Programming and Testing

Clinical EP
Device Therapy

May 15, 2019—Developed in partnership with and endorsed by the European Heart Rhythm Association, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society, the focused update (centered on Appendix B) relates to the updated manufacturer-specific programming settings/choices based on a compilation of clinical expertise and clinical trial data as reported in the 2015 HRS/EHRA/APHRS/SOLAECE Expert Consensus Statement on Optimal Implantable Cardioverter-Defibrillator Programming and Testing of which Appendix B is a part.

2019 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Catheter Ablation of Ventricular Arrhythmias

Ablation
Ventricular Arrhythmias

May 10, 2019—The consensus statement, accompanied by a systematic review and meta-analysis and an Executive Summary, serves as a resource guide and comprehensive review of the field for clinicians working to improve the care of patients undergoing ablation for ventricular arrhythmias. It offers guidance on how to select patients for catheter ablation, perform procedures in a safe and efficacious manner, and provide follow-up and adjunctive care to obtain the best possible outcomes for patients with ventricular arrhythmias.


The document features a pocket guide, developed in partnership with Guideline Central and available across multiple platforms, including print, electronic media, and the Guideline Central mobile app. A slide set,  Heart Rhythm Journal webinar and Twitter chat, and video interview with Edmond M. Cronin, MB, BCh, BAO, FHRS, CCDS, CEPS-A (Chair) and Frank M. Bogun, MD (Vice-Chair) by Heart Rhythm Journal Online Editor Daniel P. Morin, MD, MPH, FHRS, are also available. The document’s presentation during the 40th Annual Heart Rhythm Scientific Sessions with slides and fully synchronized audio can be accessed on the Society’s learning center, Heart Rhythm 365.

2019 HRS Expert Consensus Statement on Evaluation, Risk Stratification, and Management of Arrhythmogenic Cardiomyopathy

Atrial Arrhythmias
Device Therapy
Heart Failure / CRT
Sudden Cardiac Arrest
Ventricular Arrhythmias

May 9, 2019The expert consensus statement defines the broader condition of arrhythmogenic cardiomyopathy (ACM) that incorporates a spectrum of genetic, systematic, infectious, and inflammatory disorders. The designation includes, but is not limited to, arrhythmogenic right/left ventricular cardiomyopathy, ion channel abnormalities, amyloidosis, and left ventricular noncompaction. The consensus statement provides the clinician with guidance on evaluation and management of ACM and includes clinically relevant information on genetics and disease mechanisms. PICO (Patient, Intervention, Comparison, Outcome) questions were utilized to evaluate contemporary evidence and provide clinical guidance related to exercise in arrhythmogenic right ventricular cardiomyopathy.


The document features an Executive Summary and a video interview with the Chair of the Writing Committee, Jeffrey A. Towbin, MS, MD, by Heart Rhythm Journal Online Editor Daniel P. Morin, MD, MPH, FHRS. 

The Evaluation, Risk Stratification, and Management of Arrhythmogenic Cardiomyopathy pocket guide, a valuable educational reference tool developed in partnership with Guideline Central, is available across multiple platforms, including print, electronic media, and the Guideline Central mobile app.

 

HRS White Paper on Interoperability of Data from Cardiac Implantable Electronic Devices

Clinical EP
Training

May 8, 2019—This document provides a brief overview of U.S. federal initiatives to promote interoperability of data, the requirements needed to communicate data between information technology systems in a way that permits the sending and receiving systems to understand and process the data, a summary of the work of HRS to date, and finally strategies for clinicians seeking an environment in which they can manage their cardiac implantable electronic device (CIED) patient data in a single IT system.

Transparent Sharing of Digital Health Data: A Call to Action

Clinical EP
Training

May 8, 2019—This document (accompanied by an editorial) focuses on digital health and cardiac electrophysiology, outlining the present state and future vision of key stakeholder groups. It also is meant to serve as a call to action to heart rhythm professionals to join in leading this transformation.