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.

2016 EHRA/EACPR Position Paper on How to Prevent Atrial Fibrillation

HRS Endorsed / Affirmed
Atrial Fibrillation

The Heart Rhythm Society endorsed the document.

November 4, 2016—This document aims to summarize the current evidence on the association of each modifiable risk factor with atrial fibrillation (AF) and the available data on the impact of possible interventions directed at these factors in preventing or reducing the burden of AF. 

Pre-Participation Cardiovascular Evaluation for Athletic Participants to Prevent Sudden Death: Position Paper from the EHRA and the EACPR, Branches of the ESC

HRS Endorsed / Affirmed

The Heart Rhythm Society endorsed the document.

November 4, 2016—The purpose of the position statement is to review the scientific evidence regarding the appropriate diagnostic methods to identify the cardiac conditions at risk in the athletic population, discuss the role of the different tests in the context of pre-participation evaluation, and, finally, offer the consensus opinions relative to the most efficient pre-participation screening to improve safe sport participation, according to the current scientific evidence and, if necessary, to update the last recommendations on this topic.

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

Clinical EP
Ventricular Arrhythmias

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.”


See also HRS White Paper on Interoperability of Data from Cardiac Implantable Electronic Devices

2016 ACC/AHA Clinical Performance and Quality Measures for Adults with Atrial Fibrillation or Atrial Flutter

HRS Endorsed / Affirmed
Atrial Fibrillation

The Heart Rhythm Society endorsed the document on February 25, 2016. 

June 27, 2016—This atrial fibrillation (AF) clinical performance and quality measure set is notable for several reasons. First, the writing committee considered whether measures should be developed for the inpatient setting, expanding the scope of the original measure set. Specifically, the writing committee decided to broaden the care setting, from a solely outpatient context to the inpatient setting, to further improve the continuity of care for these patients by addressing the multiple settings in which they receive care. Second, new measures were developed for care domains that were not previously addressed, including patient safety, effective clinical care, communication, and care coordination. 

2016 EHRA/HRS/APHRS/SOLAECE Expert Consensus on Atrial Cardiomyopathies: Definition, Characterization, and Clinical Implication

Atrial Arrhythmias
Clinical EP

June 10, 2016—Ventricular cardiomyopathies have been well classified; however, a definition and detailed analysis of atrial cardiomyopathy are lacking from the literature. The purpose of the present consensus report was to define atrial cardiomyopathy, to review the relevant literature, and to consider the impact of atrial cardiomyopathies on arrhythmia management and stroke.

SCAI/ACC/HRS Institutional and Operator Requirements for Left Atrial Appendage Occlusion

Clinical EP
Training
Atrial Fibrillation

December 10, 2015—The evolution of LAA occlusion technology has spanned nearly two decades and three FDA panel hearings, leading to FDA approval in 2015. As this technology becomes clinically available to a broader population of patients, it is essential that physician stakeholders establish criteria for the performance of these procedures that will be used in granting initial and ongoing privileges. These criteria are offered to support The Joint Commission mandate that medical staff privileges be granted on the basis of professional criteria specified in the medical staff bylaws to ensure safe and effective patient-centered care.

2015 HRS/EHRA/APHRS/SOLAECE Expert Consensus Statement on Optimal Implantable Cardioverter-Defibrillator Programming and Testing

Clinical EP
Device Therapy

November 19, 2015—The benefits and risks of ICD therapy for patients are directly impacted by the programming and surgical decisions made by the clinician. This expert consensus statement systemically describes four important clinical issues and addresses programming of bradycardia mode and rate, tachycardia detection, tachycardia therapy, and intraprocedural testing of defibrillation efficacy.


See 2019 Focused Update (centered on Appendix B) that relates to the updated manufacturer-specific programming settings/choices based on a compilation of clinical expertise and clinical trial data as reported in this expert consensus statement of which Appendix B is a part.