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.

2018 ACC/HRS/NASCI/SCAI/SCCT Expert Consensus Document on Optimal Use of Ionizing Radiation in Cardiovascular Imaging: Best Practices for Safety and Effectiveness

Clinical Ep

The Heart Rhythm Society endorsed the document on January 10, 2018. 

May 2, 2018—The stimulus to create this document was the recognition that ionizing radiation-based cardiovascular procedures are being performed with increasing frequency. Although the clinical benefit of these procedures is substantial, there is concern about the implications of medical radiation exposure both to patients and to medical personnel. This document's purpose is to assist cardiovascular practitioners to provide optimal cardiovascular care when employing ionizing radiation in diagnostic and therapeutic procedures. 

This document is a more comprehensive treatment of the knowledge base covered in two documents published under this document’s title with subtitles "Part 1: Radiation Physics and Radiation Biology" and "Part 2: Radiological Equipment Operation, Dose-Sparing Methodologies, Patient and Medical Personnel Protection."

Cybersecurity Vulnerabilities of Cardiac Implantable Electronic Devices: Communication Strategies for Clinicians—Proceedings of the Heart Rhythm Society’s Leadership Summit

Training

May 10, 2018—The statement, accompanied by an editorial, captures the proceedings of the 2017 Leadership Summit on Cybersecurity Vulnerabilities: Communications Strategies for Clinicians and Patients that was attended by patient representatives, subject matter experts, the Heart Rhythm Society (HRS) and American College of Cardiology (ACC) leadership, the U.S. Food and Drug Administration (FDA) and Federal Bureau of Investigation (FBI) officials, and leadership from CIED manufacturers with the goal of developing patient-centered communication strategies for health care professionals, industry, and governmental agencies. The document outlines four key communication themes: when to notify patients, whom to notify, how to communicate with patients, and what elements to discuss with patients. 

2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay

Clinical Ep

November 6, 2018—The purpose of this guideline, accompanied by the Executive Summary and the Systematic Review, is to provide guidance to clinicians for the management of patients with bradycardia or symptoms thought to be associated with bradycardia or cardiac conduction system disorders. This guideline supersedes the pacemaker recommendations made in the ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities and 2012 ACCF/AHA/HRS Focused Update Incorporated Into the ACCG/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities. The guideline will be useful to general internists, family physicians, emergency physicians, anesthesiologists, surgeons, cardiologists, and arrhythmia specialists. This document is aimed at the adult population (>18 years of age) and offers no specific recommendations in pediatric patients, although some of the evidence review included pediatric patients.

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

Ablation
Atrial Arrhythmias
Clinical Ep

January 28, 2019—The purpose of this document is to update the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (2014 AF Guideline) in areas for which new evidence has emerged since its publication. The scope of this focused update of the 2014 AF Guideline includes revisions to the section on anticoagulant (because of the approval of new medications and thromboembolism protection devices), revisions to the section on catheter ablation of atrial fibrillation (AF), revisions to the section on the management of AF complicating acute coronary syndrome (ACS), and new sections on device detection of AF and weight loss.

2014 Diagnosis and Management of Arrhythmias Associated with Cardiac Sarcoidosis

Atrial Arrhythmias
Ventricular Arrhythmias
May 9, 2014 - This international expert consensus statement was written by experts in the field who were chosen by the Heart Rhythm Society in collaboration with representatives from the American College of Cardiology, American College of Chest Physicians, American Heart Association, Asia Pacific Heart Rhythm Society, European Hear Rhythm Association, and World Association for Sarcoidosis and Other Granulomatous Disorders (WASOG).

2013 Use of ICD Therapy in Patients Who Are Not Included or Not Well Represented in Clinical Trials

Clinical Ep
May 9, 2014 - This expert consensus statement was written by experts and developed in partnership with and endorsed by the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA); and in collaboration with and endorsed by the Heart Failure Society of America (HFSA) and the Society of Thoracic Surgeons (STS). Endorsed by the European Heart Rhythm Association (EHRA), the Asia Pacific Heart Rhythm Society (APHRS) and the Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE)-Latin American Society of Cardiac Pacing and Electrophysiology.

2014 EHRA/HRS/APHRS Expert Consensus on Ventricular Arrhythmias

Ventricular Arrhythmias

August 30, 2014-This international consensus statement of the European Heart Rhythm Association (EHRA), Heart Rhythm Society (HRS), and Asia Pacific Heart Rhythm Society is intended to provide clinical guidance for the management of patients with ventricular arrhythmias (VAs). It summarizes the consensus of the international writing group members and is based on a systematic review of the medical literature regarding Ventricular Arrhythmias.

2010 HRS Expert Consensus Statement on the Management of Cardiovascular Implantable Electronic Devices (CIEDs) in Patients Nearing End of Life or Requesting Withdrawal of Therapy

Ventricular Arrhythmias

May 17, 2010—This document was developed in collaboration with and endorsed by the American College of Cardiology (ACC), the American Geriatrics Society (AGS), the American Academy of Hospice and Palliative Medicine (AAHPM), the American Heart Association (AHA), the European Heart Rhythm Association (EHRA), and the Hospice and Palliative Nurses Association (HPNA). It focuses on patients nearing the end of life and addresses patients who have made a decision for CIED deactivation at other times, as well as the rights and responsibilities of clinicians (and others, such as industry-employed allied professionals) who may not wish to perform deactivation.

This document was reaffirmed on March 7, 2018, and will be formally assessed by March 2023.

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

Pediatric

September 29, 2014 - This 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 (AUC) for the initial use of outpatient pediatric echocardiography.

2014 HRS Progress Toward the Prevention and Treatment o 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

November 18, 2014 - The 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 whitepaper 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.