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.

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 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. 

Screening for Atrial Fibrillation: 2017 European Heart Rhythm Association (EHRA) Consensus Document

Clinical EP
HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document on May 30, 2017.

July 5, 2017—Atrial fibrillation (AF) is the most common cardiac arrhythmia, occurring in 1–2% of the general population. An earlier detection of AF could allow an earlier adequate management to avoid later complications. Screening for AF is not yet recommended by all scientific AF guidelines, even in specific at-risk populations. This document summarizes the available data, discusses the different strategies, and highlights the importance of implicating all stakeholders from the various health systems.

Radiation Safety in Children with Congenital and Acquired Heart Disease: A Scientific Position Statement on Multimodality Dose Optimization from the Image Gently Alliance

Pediatric
HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document on April 4, 2017. 

May 18, 2017—The purpose of this scientific statement is to provide expert consensus recommendations for optimization of medical imaging procedures commonly performed in children with congenital and acquired heart disease (CAHD), including cardiac computed tomography, nuclear cardiology studies, and fluoroscopically guided diagnostic and interventional catheterization and electrophysiology procedures. These recommendations specifically focus on optimization approaches that, when properly implemented, will improve the radiation safety profile for children with heart disease, without compromising the diagnostic information provided by these valuable studies or other aspects of procedural safety.

2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation

Ablation
Atrial Fibrillation
Atrial Arrhythmias

May 12, 2017—The 2017 Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation represents a complete rewrite of the 2012 HRS/EHRA/ECAS Expert Consensus Statement. This document provides updated definitions, mechanisms, and rationale for atrial fibrillation (AF) ablation and consensus recommendations concerning indications, strategies, techniques, and endpoints, technology and tools, and follow-up considerations for AF ablation. The document also provides definitions to be used in clinical trials and recommendations that will impact clinical trial design. The document was developed in joint partnership with EHRA, ECAS, APHRS, and SOLAECE. Collaborators on the document include STS, ACC, AHA, CHRS, JHRS, and SOBRAC. 


This document features a clinician summary  (an educational derivative product of the full document), a slide set  (an educational tool for electrophysiologists, cardiologists, and other licensed health care practitioners), an Executive Summary,  and an interview with Hugh Calkins, MD, FHRS, by HeartRhythm Online Editor Daniel P. Morin, MD, MPH, FHRS. 

The Catheter and Surgical Ablation of Atrial Fibrillation pocket card, a valuable educational reference tool created in partnership with Guideline Central, is available across multiple platforms, including print, electronic media, and the Guideline Central mobile app. Visit www.guidelinecentral.com to access the pocket card.

2017 HRS Expert Consensus Statement on Magnetic Resonance Imaging and Radiation Exposure in Patients with Cardiovascular Implantable Electronic Devices

Device Therapy

May 11, 2017—The 2017 HRS Expert Consensus Statement on Magnetic Resonance Imaging and Radiation Exposure in Patients with Cardiovascular Implantable Electronic Devices presents recommendations intended to help health care providers of various backgrounds involved in the care of adult and pediatric patients with cardiovascular implantable electronic devices (CIEDs) who are to undergo magnetic resonance imaging, computed tomography, and/or radiation treatment. The document also addresses the safety of employees with CIEDs who may come into an MRI environment.

This document features a clinician summary — an educational derivative product of the full document. The MRI and Radiation Exposure in Patients with CIEDs pocket card, a valuable educational reference tool created in partnership with Guideline Central, is available across multiple platforms, including print, electronic media, and the Guideline Central mobile app.

2017 ISHNE-HRS Expert Consensus Statement on Ambulatory ECG and External Cardiac Monitoring/Telemetry

Atrial Arrhythmias

May 8, 2017—Ambulatory ECG (AECG) is commonly used in a variety of clinical contexts to detect cardiac arrhythmias and/or arrhythmia patterns that are not readily obtained from the standard ECG. Accurate and timely characterization of arrhythmias is crucial to direct therapies that can have an important impact on diagnosis, prognosis, or patient symptom status. The rhythm information derived from the large variety of AECG recording systems can often lead to appropriate and patient-specific medical and interventional management. This document provides background and framework from which to apply AECG techniques in clinical practice, as well as clinical research.

Beta-Blocker Therapy for Long QT Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia: Are All Beta-Blockers Equivalent?

Allied Professional
Clinical EP
Pediatric

September 18, 2016—Drug therapy with beta-blockers represents the therapeutic mainstay for both LQTS and CPVT. The goal of the document is to help clinicians understand the importance of beta-blocker therapy in these two genetic disorders, as well as to provide clinical guidance on the choice of agents. Nadolol, when available, has been the preferred beta-blocker utilized by the largest LQTS/CPVT specialty centers throughout the world for the past 25 years.

2016 ACC/ASE/ASNC/HRS/SCAI Health Policy Statement on Integrating the Healthcare Enterprise

Clinical EP

August 15, 2016Interoperability is important partly because it facilitates easier extraction of accurate, high-quality data from clinical records. Clinical research and quality measurement are both, in turn, dependent on this data extraction. Presently, this is a time- and labor-intensive process that requires substantial resourcing. Data are the fundamental building blocks of clinical research and observational registries. Methods such as adoption of Integrating the Healthcare Enterprise (IHE) standards and profiles can increase autopopulation of NCDR data emanating from EHR systems and enhance the American Medical Association's key aim of “data liquidity.”