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.

2009 ACCF/AHA Focused Update on Perioperative Beta Blockade

HRS Endorsed / Affirmed
Clinical EP

November 2, 2009—This document is a focused update to the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery. The update addresses predominantly the prophylactic use of beta blockers perioperatively to minimize cardiac risk, but it does not cover other legitimate uses of beta blockers (e.g., as an adjunct in anesthetic regimens, for intraoperative control of heart rate or blood pressure, or to achieve heart rate control in common perioperative arrhythmias such as atrial fibrillation).


 See also 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery.

2009 ESC Guidelines for the Diagnosis and Management of Syncope

HRS Endorsed / Affirmed
Clinical EP

August 27, 2009—Developed by the Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC), in collaboration with the European Heart Rhythm Association, the Heart Failure Association, and the Heart Rhythm Society, this document is a revised version of the 2004 ESC Guidelines on Syncope.


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

Transvenous Lead Extraction: Heart Rhythm Society Expert Consensus on Facilities, Training, Indications, and Patient Management

Device Therapy

May 25, 2009An international team of device and lead management experts from North America and Europe wrote this 2009 consensus document on the management of leads in patients with cardiovascular implantable electronic devices (CIEDs). Central to this effort was a focus on transvenous lead extraction, including standards for training and for the evaluation of new tools and techniques. The document is also an update/revision of the 2000 policy statement on the extraction of implanted pacing and defibrillator leads.


 An update to this document titled 2017 HRS Expert Consensus Statement on Cardiovascular Implantable Electronic Device Lead Management and Extraction was published in September 2017.

2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias

Ablation
Ventricular Arrhythmias

May 14, 2009—This consensus statement provides a state-of-the-art review on catheter ablation of ventricular tachycardia. It reports on the findings of a Task Force representing the European Heart Rhythm Association (EHRA) and the Heart Rhythm Society (HRS) charged with defining the indications, techniques, and outcomes of this procedure.


 This document has been retired and replaced by 2019 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Catheter Ablation of Ventricular Arrhythmias.

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part III: Intraventricular Conduction Disturbances

Electrophysiology

February 19, 2009—The purpose of the present report is to define the normal QRS duration, review the recommendations made in 1985 (electrocardiography criteria for intraventricular conduction disturbances and ventricular preexcitation reviewed by an ad hoc working group established by the World Health Organization and the International Society and Federation of Cardiology), recommend alterations and additions to those recommendations, and provide recommendations for children and adolescents.

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

Electrophysiology

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

Electrophysiology

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.