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.

Quality Indicators for the Care and Outcomes of Adults with Atrial Fibrillation: Task Force for the Development of Quality Indicators in Atrial Fibrillation of the European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC)

HRS Endorsed / Affirmed
Atrial Fibrillation

August 29, 2020—Developed in collaboration with the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS), this document presents quality indicator (QIs) for the diagnosis and management of adults with atrial fibrillation (AF). The document defines six domains of AF care (patient assessment, anticoagulation, rate control, rhythm control, risk factor management, and outcomes) and provides 17 main and 17 secondary QIs for the diagnosis and management of AF. It is anticipated that implementation of these QIs will improve the quality of AF care.

EHRA/HRS/APHRS/LAHRS Expert Consensus on Risk Assessment in Cardiac Arrhythmias: Use the Right Tool for the Right Outcome

Clinical EP
Atrial Fibrillation
Ablation
Sudden Cardiac Arrest

June 15, 2020—The expert consensus statement recommends how best to determine the likelihood of developing a heart rhythm disorder and how to assess the risk for poor outcome in patients with that condition. The document focuses on atrial fibrillation, the most common heart rhythm disorder and a major cause of disabling stroke, and ventricular tachyarrhythmia (fast heart rate), a leading cause of sudden cardiac death.

Guidance for Rebooting Electrophysiology Through the COVID-19 Pandemic from the Heart Rhythm Society and the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology

Clinical EP

June 12, 2020In response to the challenges that the COVID-19 pandemic has created for electrophysiology (EP) practice, this document provides guidance for clinicians and institutions to reestablish safe EP care during the COVID-19 pandemic and addresses regional and local COVID-19 disease status, the role of viral screening and serologic testing, return-to-work considerations for exposed or infected health care workers, risk stratification and management strategies based on COVID-19 disease burden, institutional preparedness for resumption of elective procedures, patient preparation and communication, prioritization of procedures, and development of outpatient and periprocedural care pathways.

HRS/EHRA/APHRS/LAHRS/ACC/AHA Worldwide Practice Update for Telehealth and Arrhythmia Monitoring During and After a Pandemic

Electrophysiology

June 11, 2020—The Heart Rhythm Society (HRS), the European Heart Rhythm Association (EHRA), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), the American College of Cardiology (ACC), and the American Heart Association (AHA) have partnered to address the strategies for telehealth and arrhythmia monitoring during and after the COVID-19 pandemic.

Rationale, Considerations, and Goals for Atrial Fibrillation Centers of Excellence: A Heart Rhythm Society Perspective

Atrial Fibrillation
Clinical EP

May 5, 2020—This document reviews the rationale for atrial fibrillation (AF) “centers of excellence” (CoE), the available evidence for integrated and multidisciplinary care, and future challenges and opportunities. It 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.

Considerations for Drug Interactions on QTc Interval in Exploratory COVID-19 Treatment

Clinical EP

April 14, 2020The American Heart Association (AHA), the American College of Cardiology (ACC), and the Heart Rhythm Society (HRS) jointly developed this new guidance to detail critical cardiovascular considerations in the use of hydroxychloroquine and azithromycin for the treatment of COVID-19. The statement also includes a table rating potential adverse cardiac events of medications repurposed for COVID-19 treatment, such as chloroquine and lopinavir/ritonavir (antimalarial and antiviral agents, respectively).

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.

2020 ACC Clinical Competencies for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine

HRS Endorsed / Affirmed
Allied Professional
Training

The Heart Rhythm Society endorsed the document on February 19, 2020.

March 20, 2020—This competency document identifies the knowledge and skills important for nurse practitioners (NPs) and physician assistants (PAs) working in general cardiovascular medicine and cardiac subspecialty areas, thereby assisting NPs and PAs in identifying learning needs and opportunities for professional growth. It also helps to increase awareness of the roles that NPs and PAs have within the cardiovascular team. Such efforts will promote and enhance collaborative, high-quality, patient-centered care teams.

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.