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.

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.

 This document was reaffirmed on October 21, 2020, and will be formally assessed by October 2025.

2015 ACC/AHA/HRS Advanced Training Statement on Clinical Cardiac Electrophysiology (A Revision of the ACC/AHA 2006 Update of the Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion)

Clinical EP
Training

September 18, 2015—This Advanced Training Statement addresses the added competencies required of subsubspecialists in CCEP for diagnosis and management of patients with cardiac arrhythmias and conduction disturbances at a high level of skill. It is intended to complement the basic training in cardiac electrophysiology required of all trainees during the standard 3-year cardiovascular fellowship.


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

2015 ACC/HRS/SCAI Left Atrial Appendage Occlusion Device Societal Overview

Atrial Arrhythmias
Clinical EP

June 29, 2015—The American College of Cardiology (ACC), the Heart Rhythm Society (HRS), and the Society for Cardiovascular Angiography and Interventions (SCAI) have collaborated in writing this overview as the first of a series of documents to address issues critical to the appropriate integration of new technologies into the care of patients with atrial fibrillation. 


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

2015 HRS Expert Consensus Statement on Remote Interrogation and Monitoring for Cardiovascular Electronic Implantable Devices

Device Therapy

May 13, 2015—The current document is developed from the foundations established by the 2008 HRS Consensus Statement as well as the 2012 International Society for Holter and Noninvasive Electrocardiography and European Heart Rhythm Association’s Expert Consensus Statement on Remote Monitoring of CIEDs. The goals of follow-up, definition of hardware, and personnel remain the same and will not be covered in this document except where evolution of remote technologies and responsibilities has occurred. The current document provides new recommendations based on data published since 2008, endorsing the need to maintain consistent follow-up and outlining the limitations of strictly in-person methods.


 This document was reaffirmed on October 21, 2020, and will be formally assessed by October 2025.

2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope

Device Therapy
Clinical EP

May 13, 2015—This document has three objectives: 1) to establish working criteria for the diagnosis of postural tachycardia syndrome (POTS), inappropriate sinus tachycardia (IST), and vasovagal syncope (VVS); 2) to provide guidance and recommendations on their assessment and management; and to 3) identify key areas in which knowledge is lacking to highlight opportunities for future collaborative research efforts.


 This document was reaffirmed on November 18, 2020, and will be formally assessed by November 2025.

Progress Toward the Prevention and Treatment of Atrial Fibrillation: A Summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, DC, December 9–10, 2013

Atrial Arrhythmias
Atrial Fibrillation

November 18, 2014The Heart Rhythm Society convened a research symposium on December 9–10, 2013, in Washington, DC, that focused on the prevention of atrial fibrillation (AF) as well as AF-related stroke and morbidity. Attendees sought to summarize advances in understanding AF since a 2008 National Institutes of Health (NIH) conference on this topic and to identify continued knowledge gaps and current research priorities. This resultant white paper was developed in collaboration with and endorsed by the European Heart Rhythm Association (EHRA) and the Canadian Heart Rhythm Society (CHRS). It summarizes the deliberations of the attendees in an effort to accelerate progress toward preventing AF and its consequences.

2014 Appropriate Use Criteria for Initial Transthoracic Echocardiography in Outpatient Pediatric Cardiology

Pediatric

September 29, 2014This document is a report of the American College of Cardiology Appropriate Use Criteria Task Force, American Academy of Pediatrics, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Pediatric Echocardiography. The purpose is to establish and evaluate Appropriate Use Criteria for the initial use of outpatient pediatric echocardiography.