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, 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 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.

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

Atrial Arrhythmias
Clinical EP

January 28, 2019—The purpose of this document is to update the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (2014 AF Guideline) in areas for which new evidence has emerged since its publication. The scope of this focused update includes revisions to the section on anticoagulant (because of the approval of new medications and thromboembolism protection devices), revisions to the section on catheter ablation of atrial fibrillation (AF), revisions to the section on the management of AF complicating acute coronary syndrome (ACS), and new sections on device detection of AF and weight loss.

A briefing with Hugh Calkins, MD, FACC, FAHA, FHRS, available on Heart Rhythm 365, highlights the most important modifications to the guidelines and their impact on patient management.  

ACC / AATS / AHA / ASE / ASNC / HRS / SCAI / SCCT / SCMR / STS 2019 Appropriate Use Criteria for Multimodality Imaging in the Assessment of Cardiac Structure and Function in Nonvalvular Heart Disease

HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document on November 28, 2018. 

January 2, 2019—This document is the second of two companion appropriate use criteria (AUC) 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. The first document addresses the evaluation and use of multimodality imaging in the diagnosis and management of valvular heart disease, whereas this document addresses this topic with regard to structural (nonvalvular) heart disease. While dealing with different subjects, the two documents do share a common structure and feature some clinical overlap. The goal of the companion AUC documents is to provide a comprehensive resource for multimodality imaging in the context of structural and valvular heart disease, encompassing multiple imaging modalities.

Pediatric and Congenital Electrophysiology Society Initiative on Device Needs in Pediatric Electrophysiology

HRS Endorsed / Affirmed
Device Therapy

The Heart Rhythm Society endorsed the document on October 12, 2018.

December 20, 2018—In the past 5 years, there have been several initiatives in pediatric cardiology, specifically in the heart failure and interventional cardiology domains, to develop and market devices that have been designed for the pediatric patient. PACES developed a task force in 2016 to specifically address comprehensive device development issues for the pediatric/congenital heart disease arrhythmia patient, ranging from cardiovascular implantable electronic devices to ablation catheters.

Harmonized Outcome Measures for Use in Atrial Fibrillation Patient Registries and Clinical Practice

Atrial Fibrillation

November 15, 2018—The purpose of this project was to develop a minimum set of standardized outcome measures that could be collected in atrial fibrillation (AF) patient registries and clinical practice. The harmonized measures represent a minimum set of outcomes that are relevant in AF research and clinical practice. Routine and consistent collection of these measures in registries and in other systems would support creation of a research infrastructure to efficiently address new questions and improve patient outcomes.

2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay

Clinical EP

November 6, 2018—The purpose of this guideline, accompanied by the Executive Summary and the Systematic Review, is to provide guidance to clinicians for the management of patients with bradycardia or symptoms thought to be associated with bradycardia or cardiac conduction system disorders. This guideline supersedes the pacemaker recommendations made in the ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities and 2012 ACCF/AHA/HRS Focused Update Incorporated Into the ACCF/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities. The guideline will be useful to general internists, family physicians, emergency physicians, anesthesiologists, surgeons, cardiologists, and arrhythmia specialists. This document is aimed at the adult population (>18 years of age) and offers no specific recommendations in pediatric patients, although some of the evidence review included pediatric patients.

2018 AHA/ACC Guideline for the Management of Adults with Congenital Heart Disease

HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document on June 20, 2018.

August 16, 2018—The 2018 adult congenital heart disease (ACHD) guideline is a full revision of the 2008 ACC/AHA Guidelines for the Management of Adults with Congenital Heart Disease, which was the first US guideline to be published on the topic. This revision uses the 2008 ACHD guideline as a framework and incorporates new data and growing ACHD expertise to develop recommendations.