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.

2014 AHA/ACC/HRS Guideline for the Management of Patients with Atrial Fibrillation

Atrial Arrhythmias
Clinical EP

March 28, 2014—The goal of this guideline is to establish revised recommendations for optimum management of atrial fibrillation. The guideline supersedes the 2006 ACC/AHA/ESC Guideline for the Management of Patients with Atrial Fibrillation and the two subsequent focused updates from 2011.

 See 2019 AHA/ACC/HRS Focused Update the scope of which 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.

2013 HRS/EHRA/APHRS Expert Consensus Statement on the Diagnosis and Management of Patients with Inherited Primary Arrhythmia Syndromes

Device Therapy
Clinical EP

September 3, 2013The objective of the document is to provide clinical guidance for diagnosis, risk stratification, and management of patients affected by inherited primary arrhythmia syndromes. It summarizes the opinion of the international writing group members based on their own experience and on a general review of the literature with respect to the clinical data on patients affected by channelopathies. This document does not address the indications of genetic testing in patients affected by inherited arrhythmias and their family members.

2013 ACCF/AHA Guideline for the Management of Heart Failure

Heart Failure / CRT
HRS Endorsed / Affirmed

June 5, 2013—A report of the ACC/AHA Task Force on Practice Guidelines, developed in collaboration with the American College of Chest Physicians, the Heart Rhythm Society, and the International Society for Heart and Lung Transplantation, and endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, this guideline covers multiple management issues for the adult patient with heart failure. 

2013 Recommendations for Advanced Fellowship Training in Clinical Pediatric and Congenital Electrophysiology: A Report from the Training and Credentialing Committee of the Pediatric and Congenital Electrophysiology Society


April 30, 2013—The report expands upon guidelines published in 2005 and a supplemental consensus statement issued by the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS) in 2008. The report provides an overview of training, didactic curriculum and research experience, clinical experience, and credentialing/certification.

 This document was reaffirmed on November 28, 2018, and will be formally assessed by November 2023.

ACCF/HRS/AHA/ASE/HFSA/SCAI/SCCT/SCMR 2013 Appropriate Use Criteria for Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy

Device Therapy
Heart Failure / CRT

March 7, 2013—This document was developed by the American College of Cardiology Foundation (ACCF) and the Heart Rhythm Society (HRS) along with key specialty societies. The document provides assessed levels of appropriateness for implanting ICDs and CRTs in 369 real-life case scenarios, with the goal of enhancing physician and patient decision making and improving care and health outcomes.

2012 EHRA/HRS Expert Consensus Statement on Cardiac Resynchronization Therapy in Heart Failure: Implant and Follow-up Recommendations and Management

Heart Failure / CRT

September 1, 2012The expert consensus statement provides recommendations for the practical management of cardiac resynchronization therapy (CRT) patients before, during, and after the implantation procedure. The statement does not discuss clinical indications for CRT therapy as these are covered by other guidelines statements.

2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities

Device Therapy

September 10, 2012—The statement provides expanded indications for cardiac resynchronization therapy (CRT) in an effort to clarify which patients are most likely to benefit from CRT. Additional updates include guidance regarding the frequency of in-person and remote monitoring of patients with cardiovascular implantable electronic devices. 

2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay supersedes the pacemaker recommendations made in this 2012 Focused Update and 2008 guidelines.

2012 HRS/ACCF Expert Consensus Statement on Pacemaker Device and Mode Selection

Device Therapy

June 26, 2012—The statement is the first of its kind to specifically address pacemaker device and mode selection, expanding upon the 2008 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities. The statement provides a state-of-the-art review of the field and reports consensus recommendations on pacemaker device and mode selection. It is a guide to facilitate the appropriate use of single vs. dual-chamber devices for patients who already meet guidelines for pacemaker implantation.

This document was reaffirmed on November 18, 2020, and will be formally assessed by November 2025.

2012 PACES/HRS Expert Consensus Statement on the Management of the Asymptomatic Young Patient with a Wolff-Parkinson-White (WPW, Ventricular Preexcitation) Electrocardiographic Pattern


May 10, 2012—The expert consensus statement provides first-of-its-kind clinical practice guidelines on the evaluation and management of asymptomatic young patients with a Wolff-Parkinson-White (WPW) electrocardiographic pattern. This is also the first collaboration between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS).

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Atrial Fibrillation

March 5, 2012—The purpose of this expert consensus statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of atrial fibrillation. It reports on the findings of a Task Force, convened by the Heart Rhythm Society (HRS), the European Heart Rhythm Association (EHRA), and the European Cardiac Arrhythmia Society (ECAS) and charged with defining the indications, techniques, and outcomes of this procedure.

 This document has been retired and replaced by 2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation.