Clinical Resources | Heart Rhythm Society

Clinical Resources

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

Published Clinical Documents

2020 ACC / AHA / ASE / HRS / ISACHD / SCAI / SCCT / SCMR / SOPE Appropriate Use Criteria for Multimodality Imaging During the Follow-up Care of Patients with Congenital Heart Disease

HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document on October 2, 2019.

January 6, 2020—This document addresses only the follow-up of patients with established congenital heart disease using various cardiovascular imaging modalities. It is assumed that a complete anatomic cardiac diagnosis has been established by a qualified clinician using 1 or more modalities. The goal of this document is to determine the modalities that may be reasonable for a specific indication and not to designate the single best modality or the rank order of modalities. For each indication, the rating reflects whether the imaging modality is reasonable for the patient according to the appropriate use definition.

"Real-World" Observational Studies in Arrhythmia Research: Data Sources, Methodology, and Interpretation: A Position Document from the European Heart Rhythm Association

HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document on June 19, 2019.

November 14, 2019—This document describes the usual data sources for observational studies, reviews common and important techniques, overviews the proper interpretation of results, and finally makes appropriate recommendations regarding the design, conduct, and interpretation of observational data. The intended reader is the clinical cardiologist who wishes to get an overview of current methodology. It is hoped that the document will aid the discussion between clinicians and cardiologists. 

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

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

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.

HRS/ACP Atrial Fibrillation Screening and Education Initiative

Atrial Fibrillation

April 4, 2019—The goal of the Heart Rhythm Society (HRS) and the American College of Physicians (ACP) collaborative initiative was to develop a systematic screening and educational program aimed at patients from internal medicine practices to identify undiagnosed atrial fibrillation (AF) and educate participants about the risk of stroke associated with AF. Additional goals included informing patient caregivers about the risks associated with AF as well as facilitating follow-up and treatment as warranted for those patients with screenings indicating possible AF.

Management of Asymptomatic Arrhythmias: A European Heart Rhythm Association (EHRA) Consensus Document

HRS Endorsed / Affirmed
Atrial Arrhythmias
Ventricular Arrhythmias

The Heart Rhythm Society endorsed the document on February 11, 2019.
March 18, 2019—Asymptomatic arrhythmias are frequently encountered in clinical practice. Although studies specifically dedicated to these asymptomatic arrhythmias are lacking, many arrhythmias still require proper diagnostic and prognostic evaluation and treatment to avoid severe consequences, such as stroke or systemic emboli, heart failure, or sudden cardiac death. Given that the approach to asymptomatic arrhythmias is neither particularly clear nor straightforward, the European Heart Rhythm Association (EHRA), in collaboration with the Heart Failure Association (HFA), the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Cardiac Arrhythmia Society of Southern Africa (CASSA), and the Latin American Heart Rhythm Society (LAHRS), convened a Task Force to review the clinical management of specific types of asymptomatic arrhythmias. The goal was to emphasize evidence-based approaches for risk stratification and appropriate pharmacological or nonpharmacological treatments, where evidence exists for asymptomatic arrhythmias.

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