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.

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

Ablation
Clinical Ep
Heart Failure / CRT
Ventricular Arrhythmias
HRS Endorsed / Affirmed

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

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 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

Clinical Ep
Training
HRS Endorsed / Affirmed

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

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

Clinical Ep
Training

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

Clinical Ep
HRS Endorsed / Affirmed

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
Pediatric

September 14, 2017—The 2017 HRS Expert Consensus Statement on Cardiovascular Implantable Electronic Device Lead Management and Extraction, 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 Managementdocument. It provides practical clinical guidance in the broad field of lead management, including lead extraction.

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

Clinical Ep
HRS Endorsed / Affirmed

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

August 30, 2017—This consensus document, featuring the Executive Summary, 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. 

2014 ESC Management of Antithrombotic Therapy in Atrial Fibrillation Patients Presenting With Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary or Valve Interventions

Atrial Arrhythmias
HRS Endorsed / Affirmed

August 25, 2014 - This document on the Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions is a joint consensus document of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI) and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS).