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

2018 ACC/HRS/NASCI/SCAI/SCCT Expert Consensus Document on Optimal Use of Ionizing Radiation in Cardiovascular Imaging: Best Practices for Safety and Effectiveness

Clinical EP

The Heart Rhythm Society endorsed the document on January 10, 2018. 

May 2, 2018—The stimulus to create this document was the recognition that ionizing radiation-based cardiovascular procedures are being performed with increasing frequency. Although the clinical benefit of these procedures is substantial, there is concern about the implications of medical radiation exposure both to patients and to medical personnel. This document's purpose is to assist cardiovascular practitioners to provide optimal cardiovascular care when employing ionizing radiation in diagnostic and therapeutic procedures.

 This document is a more comprehensive treatment of the knowledge base covered in two documents published under this document’s title with subtitles "Part 1: Radiation Physics and Radiation Biology" and "Part 2: Radiological Equipment Operation, Dose-Sparing Methodologies, Patient and Medical Personnel Protection."

Arrhythmias in Congenital Heart Disease: A Position Paper of EHRA, AEPC, and ESC Working Group on Grown-up Congenital Heart Disease

HRS Endorsed / Affirmed
Clinical EP
Heart Failure / CRT
Ventricular Arrhythmias

The Heart Rhythm Society endorsed the document on October 5, 2017. 

March 20, 2018—This position statement summarizes knowledge and provides recommendations on diagnosis and treatment of arrhythmias in patients with congenital heart defects (CHD), because, in many cases, the anatomy and management of arrhythmias in adult patients cannot directly be applied to patients with CHD. This document mainly addresses arrhythmias in adult CHD.

2018 EHRA/HRS/APHRS/LAHRS Expert Consensus on Arrhythmias and Cognitive Function: What Is the Best Practice?

Atrial Fibrillation

March 18, 2018—The document is intended to describe the impact of different types of arrhythmias on cognitive function, to highlight possible risk markers for cognitive decline, and to formulate implications for clinical practice regarding follow-up methods, prevention, and treatment strategies. The objective is to raise awareness of cognitive function among physicians treating patients with arrhythmias and to provide them with practical proposals that may lead to improvement of patient care in this regard.

2018 EHRA Expert Consensus Statement on Lead Extraction: Recommendations on Definitions, Endpoints, Research Trial Design, and Data Collection Requirements for Clinical Scientific Studies and Registries: Endorsed by APHRS/HRS/LAHRS

HRS Endorsed / Affirmed
Clinical EP

The Heart Rhythm Society endorsed the document on January 8, 2018.

March 16, 2018—This expert consensus statement provides recommendations for designing scientific studies, reports, and registries relating to lead extraction. The recommendations are directed to all scientists and health care professionals and are pertinent to clinical trials, registries, guidelines, quality assurance, and educational programs. The document also lists numerous gaps in evidence related to lead extraction, with the purpose to trigger joint collaboration in scientific trials and registries.

Antiarrhythmic Drugs—Clinical Use and Clinical Decision Making: A Consensus Document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group on Cardiovascular Pharmacology

HRS Endorsed / Affirmed
Atrial Arrhythmias
Atrial Fibrillation

The Heart Rhythm Society affirmed the value of the document on August 24, 2017.

February 9, 2018—The European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Working Group on Cardiovascular Pharmacology convened a Task Force, with representation from the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS), with the remit to comprehensively review the available evidence to publish a joint practical guide on antiarrhythmic drug therapy and to provide up-to-date consensus recommendations for decision making and its use in everyday clinical practice. The ultimate judgement regarding the care of a particular patient must be made by the health care provider and the patient in light of all of the circumstances presented by that patient.

Arrhythmia Care in a Value-Based Environment: Past, Present, and Future

Clinical Topics

December 15, 2017—The Medicare Access and CHIP Reauthorization Act (MACRA), passed by Congress in 2015, establishes the Quality Payment Program (QPP), which represents a significant change in how physicians are paid by the Centers for Medicare and Medicaid Services (CMS). This document provides guidance to heart rhythm specialists in navigating the changes into the U.S. health care system.

2017 ACC/HRS Lifelong Learning Statement for Clinical Cardiac Electrophysiology Specialists

Clinical EP

November 27, 2017—The 2017 ACC/HRS Lifelong Learning Statement for Clinical Cardiac Electrophysiology Specialists complements the 2015 ACC/AHA/HRS Advanced Training Statement on Clinical Cardiac Electrophysiology by focusing on the competencies expected of practicing cardiac electrophysiologists throughout their careers. It also recognizes those competencies that exceed standard expectations and may be achieved and maintained by some cardiac electrophysiologists based on their specific training and practice focus. This document provides examples of appropriate measures for assessing competence in the context of lifelong learning.

Occupational Radiation Exposure in the Electrophysiology Laboratory with a Focus on Personnel with Reproductive Potential and During Pregnancy: 2017 EHRA Consensus Document

HRS Endorsed / Affirmed
Clinical EP

The Heart Rhythm Society endorsed the document on July 11, 2017

November 6, 2017—The purpose of this document as an adjunct to the EHRA practical guide, issued in 2014 on ways to reduce radiation dose for patients and staff during electrophysiological procedures, is to describe the current knowledge on the risks and to inform about current international recommendations and legislation on occupational exposure in the electrophysiology laboratory to personnel with childbearing potential and during pregnancy.

2017 AHA/ACC/HRS Guideline for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

Ventricular Arrhythmias

October 30, 2017—The 2017 AHA/ACC/HRS Guideline for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death, accompanied by the Executive Summary and the Systematic Review, is intended to guide management of adults who have ventricular arrhythmias or who are at risk for sudden cardiac death (SCD), including diseases and syndromes associated with a risk of SCD from ventricular arrhythmias.

2017 HRS Expert Consensus Statement on Cardiovascular Implantable Electronic Device Lead Management and Extraction

Clinical EP
Device Therapy

September 14, 2017—The document, developed in collaboration with the ACC, AHA, APHRS, ASA, EHRA, IDSA, LAHRS, PACES, and STS, is intended to help clinicians in their decision-making process for managing leads and builds on the 2009 Transvenous Lead Extraction: Heart Rhythm Society Expert Consensus on Facilities, Training, Indications, and Patient Management. It provides practical clinical guidance in the broad field of lead management, including lead extraction.

 This document was reaffirmed on May 1, 2022 and will be formally assessed again in 2027.

Membership Reminder