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.

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part IV: The ST Segment, T and U Waves, and the QT Interval


February 19, 2009—The present article is the fourth in a series of six documents focused on providing current guidelines for the standardization and interpretation of the electrocardiogram (ECG). Several issues relative to the measurement, description, and interpretation of ST segment, T and U waves, and QT interval are addressed.

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part VI: Acute Ischemia/Infarction


February 19, 2009—This is the sixth and final section of the project to update electrocardiography (ECG) standards and interpretation. The following topics are discussed: 1) the meaning and importance of both ST-segment elevation and depression; 2) the concept of anatomically contiguous leads; 3) the threshold values for ST-segment changes; 4) the use of the ST-segment spatial vector to determine the region involved and the occluded coronary artery; 5) the importance of postischemic T-wave changes; 6) the diagnosis of ischemia/infarction in the presence of intraventricular conduction disturbances; and 7) quantitative QRS changes for estimation of chronic infarct size.

2009 Occupational Health Hazards in the Interventional Laboratory: Time for a Safer Environment

Clinical EP

February 2, 2009—This document is a consensus statement by the major American societies of physicians who work in a laboratory environment and reviews available data on the prevalence of occupational health risks and summarizes ongoing epidemiologic studies designed to further elucidate these risks.

 See also SCAI Multi-Society Position Statement on Occupational Health Hazards of the Catheterization Laboratory: Shifting the Paradigm for Healthcare Workers' Protection.

2008 ACC/AHA Guidelines for the Management of Adults with Congenital Heart Disease

HRS Endorsed / Affirmed

November 7, 2008—Recognizing the compound effects of a complex and unfamiliar disease with an unprepared patient and health care system, the ACC/AHA adult congenital heart disease (ACHD) guideline writing committee has determined that the most immediate step it can take to support the practicing cardiologist in the care of ACHD patients is to provide a consensus document that outlines the most important diagnostic and management strategies and indicates when referral to a highly specialized center is appropriate. To provide ease of use, the writing committee constructed this document by lesion type and in each section included recommendations on topics common to all lesions (e.g., infective endocarditis prophylaxis, pregnancy, physical activity, and medical therapy).

 This document has been replaced by 2018 AHA/ACC Guideline for the Management of Adults with Congenital Heart Disease.

2008 Heart Rhythm Society Policy Statement Update: Recommendations on the Role of Industry-Employed Allied Professionals (IEAPs)

Allied Professional

September 26, 2008—This policy update revises the recommendations from the original statement published under the North American Society of Pacing and Electrophysiology (NASPE) in 2001. The current recommendations include revisions to criteria on billing and collection, assistance that should or should not be performed, and the proper supervision necessary.

2008 HRS/PACES Clinical Competency Statement: Training Pathways for Implantation of Cardioverter-Defibrillators and Cardiac Resynchronization Therapy Devices in Pediatric and Congenital Heart Patients


May 14, 2008—This clinical document details the training for ICD/CRT implants in patients who are either in the pediatric age range (birth–18 years of age) with or without congenital heart disease or adults with congenital heart disease. The health care team involved in the care of these patients should have knowledge and expertise about the implantation indications, implantation techniques, complications, programming, and follow-up for these devices, as well as the nontechnical treatment issues relevant to children.

 This document has been retired and replaced by 2013 Recommendations for Advanced Fellowship Training in Clinical Pediatric and Congenital Electrophysiology.

2008 HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs): Description of Techniques, Indications, Personnel, Frequency and Ethical Considerations

Device Therapy

April 24, 2008—This document represents expert consensus concerning the monitoring of cardiovascular implantable electronic devices (CIEDs). The topics covered by this document include the monitoring of CIEDs with a description of the technology, indications for use, personnel involved in monitoring, and the frequency and types of monitoring events. Also covered are issues in regard to data management, regulatory environments, reimbursement and ethical considerations in respect to device inactivation.

 This document has been retired and replaced by 2015 HRS Expert Consensus Statement on Remote Interrogation and Monitoring for Cardiovascular Electronic Implantable Devices

2008 Task Force 6: Training in Specialized Electrophysiology, Cardiac Pacing, and Arrhythmia Management

HRS Endorsed / Affirmed

February 1, 2008—This document is the result of a close collaboration between the American College of Cardiology's Adult Cardiovascular Medicine Core Cardiology Training (COCATS) Task Force 6 and the Heart Rhythm Society. This Task Force 6 Report is 1 of 13 COCATS 3 Task Force Reports, which encompass training recommendations for the fellowship programs in adult cardiovascular medicine.