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

ACC / AATS / AHA / ASE / ASNC / HRS / SCAI / SCCT / SCMR / STS 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease

HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document on June 28, 2017. 

September 1, 2017—This document is one of two companion appropriate use criteria documents developed by the American College of Cardiology, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. This document addresses the evaluation and use of multimodality imaging in the diagnosis and management of valvular heart disease, whereas the second, companion document addresses this topic with regard to structural heart disease.

2017 Antithrombotic Therapy in Atrial Fibrillation Associated with Valvular Heart Disease: A Joint Consensus Document from EHRA and ESC Working Group on Thrombosis

HRS Endorsed / Affirmed
Atrial Fibrillation

The Heart Rhythm Society affirmed the value of the document on June 8, 2017.

August 30, 2017—This consensus document was developed by the European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Working Group on Thrombosis, with representation from the ESC Working Group on Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart Association (SA Heart), and SOLAECE, and addresses management of patients with atrial fibrillation and associated valvular heart disease (VHD), with up-to-date consensus recommendations for clinical practice for different forms of VHD. 

Screening for Atrial Fibrillation: 2017 European Heart Rhythm Association (EHRA) Consensus Document

HRS Endorsed / Affirmed
Atrial Fibrillation

The Heart Rhythm Society endorsed the document on May 30, 2017.

July 5, 2017—Atrial fibrillation (AF) is the most common cardiac arrhythmia, occurring in 1–2% of the general population. An earlier detection of AF could allow an earlier adequate management to avoid later complications. Screening for AF is not yet recommended by all scientific AF guidelines, even in specific at-risk populations. This document summarizes the available data, discusses the different strategies, and highlights the importance of implicating all stakeholders from the various health systems.

Radiation Safety in Children with Congenital and Acquired Heart Disease: A Scientific Position Statement on Multimodality Dose Optimization from the Image Gently Alliance

HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document on April 4, 2017. 

May 18, 2017—The purpose of this scientific statement is to provide expert consensus recommendations for optimization of medical imaging procedures commonly performed in children with congenital and acquired heart disease, including cardiac computed tomography, nuclear cardiology studies, and fluoroscopically guided diagnostic and interventional catheterization and electrophysiology procedures. These recommendations specifically focus on optimization approaches that, when properly implemented, will improve the radiation safety profile for children with heart disease, without compromising the diagnostic information provided by these valuable studies or other aspects of procedural safety.

2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation

Atrial Fibrillation
Atrial Arrhythmias

May 12, 2017—This expert consensus statement represents a complete rewrite of the 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation. The document provides updated definitions, mechanisms, and rationale for atrial fibrillation (AF) ablation and consensus recommendations concerning indications, strategies, techniques, and endpoints, technology and tools, and follow-up considerations for AF ablation. The document also provides definitions to be used in clinical trials and recommendations that will impact clinical trial design.

 This document features a clinician summary (an educational derivative product of the full document), a slide set (an educational tool for electrophysiologists, cardiologists, and other licensed health care practitioners), an Executive Summary, and an interview with Hugh Calkins, MD, FHRS, by Heart Rhythm Online Editor Daniel P. Morin, MD, MPH, FHRS.

The Catheter and Surgical Ablation of Atrial Fibrillation pocket card, a valuable educational reference tool created in partnership with Guideline Central, is available across multiple platforms, including print, electronic media, and the Guideline Central mobile app. Visit to access the pocket card.

2017 HRS Expert Consensus Statement on Magnetic Resonance Imaging and Radiation Exposure in Patients with Cardiovascular Implantable Electronic Devices

Device Therapy

May 11, 2017—This expert consensus statement presents recommendations intended to help health care providers of various backgrounds involved in the care of adult and pediatric patients with cardiovascular implantable electronic devices (CIEDs) who are to undergo magnetic resonance imaging, computed tomography, and/or radiation treatment. The document also addresses the safety of employees with CIEDs who may come into an MRI environment.

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

This document features a clinician summary—an educational derivative product of the full document. The MRI and Radiation Exposure in Patients with CIEDs pocket card, a valuable educational reference tool created in partnership with Guideline Central, is available across multiple platforms, including print, electronic media, and the Guideline Central mobile app.

2017 ISHNE-HRS Expert Consensus Statement on Ambulatory ECG and External Cardiac Monitoring/Telemetry

Atrial Arrhythmias

May 8, 2017—Ambulatory ECG (AECG) is commonly used in a variety of clinical contexts to detect cardiac arrhythmias and/or arrhythmia patterns that are not readily obtained from the standard ECG. Accurate and timely characterization of arrhythmias is crucial to direct therapies that can have an important impact on diagnosis, prognosis, or patient symptom status. The rhythm information derived from the large variety of AECG recording systems can often lead to appropriate and patient-specific medical and interventional management. This document provides background and framework from which to apply AECG techniques in clinical practice, as well as clinical research.

 The Russian translation is available for download. 

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients with Syncope

Device Therapy
Ventricular Arrhythmias

March 9, 2017—Syncope has many causes and clinical presentations; the incidence depends on the population being evaluated. The purpose of this ACC/AHA/HRS guideline is to provide contemporary, accessible, and succinct guidance on the management of adult and pediatric patients with suspected syncope.

 The Chinese translation is available for download. 

EHRA Consensus Document on the Management of Supraventricular Arrhythmias

HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document.

November 17, 2016—This document provides expert recommendations for professionals participating in the care of patients presenting with supraventricular tachycardias (SVT). In addition, several associated conditions where SVTs may co-exist are explained in more detail.

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