Clinical Guidelines & Documents
2021 PACES Expert Consensus Statement on the Indications and Management of Cardiovascular Implantable Electronic Devices in Pediatric Patients
In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories.2021 PACES Expert Consensus Statement on the Indications and Management of Cardiovascular Implantable Electronic Devices in Pediatric Patients: Executive Summary
Document Reviewers: Philip M. Chang, MD, FHRS, FACC; Fabrizio Drago, MD, FAIAC; Anne M. Dubin, MD, FHRS; Susan P. Etheridge, MD, FHRS; Apichai Kongpatanayothin, MD, FAsCC; Jose Manuel Moltedo, MD, FACC; Ashish A. Nabar, MD, DNB, PhD, FISE; George F. Van Hare, MD, FHRS, FACC, FAAPIntegrated electrophysiology care for patients with heart failure: An envisioned future
Heart failure (HF) is a chronic, progressive, and complex disease that is increasing in prevalence with a projected 46% increase from 2012 to 2030.1 Frequent hospital admissions have made HF one of the leading causes of health care expenditures, costing the system more than 30 billion US dollars a year.2 Many of these patients have cardiac implantable electronic devices (CIEDs), wearable devices, and atrial and ventricular arrhythmias. There is an increasing focus on how to best manage these patients, with the recognition that an integrated care model is optimal.Guidance for rebooting electrophysiology through the COVID-19 pandemic from the Heart Rhythm Society and the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology:
Coronavirus disease 2019 (COVID-19) has presented substantial challenges to patient care and impacted health care delivery, including cardiac electrophysiology practice throughout the globe. Based upon the undetermined course and regional variability of the pandemic, there is uncertainty as to how and when to resume and deliver electrophysiology services for arrhythmia patients. This joint document from representatives of the Heart Rhythm Society, American Heart Association, and American College of Cardiology seeks to provide guidance for clinicians and institutions reestablishing safe electrophysiological care.2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy: Executive summary
Arrhythmogenic cardiomyopathy (ACM) is an arrhythmogenic disorder of the myocardium not secondary to ischemic, hypertensive, or valvular heart disease. ACM incorporates a broad spectrum of genetic, systemic, infectious, and inflammatory disorders. This designation includes, but is not limited to, arrhythmogenic right/left ventricular cardiomyopathy, cardiac amyloidosis, sarcoidosis, Chagas disease, and left ventricular noncompaction. The ACM phenotype overlaps with other cardiomyopathies, particularly dilated cardiomyopathy with arrhythmia presentation that may be associated with ventricular dilatation and/or impaired systolic function.2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias
Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias.2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias: Executive summary
Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias.Systematic review and meta-analysis of catheter ablation of ventricular tachycardia in ischemic heart disease
Patients with ischemic heart disease (IHD) are at risk for ventricular tachycardia (VT). Catheter ablation (CA) may reduce this risk.2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy
Arrhythmogenic cardiomyopathy (ACM) is an arrhythmogenic disorder of the myocardium not secondary to ischemic, hypertensive, or valvular heart disease. ACM incorporates a broad spectrum of genetic, systemic, infectious, and inflammatory disorders. This designation includes, but is not limited to, arrhythmogenic right/left ventricular cardiomyopathy, cardiac amyloidosis, sarcoidosis, Chagas disease, and left ventricular noncompaction. The ACM phenotype overlaps with other cardiomyopathies, particularly dilated cardiomyopathy with arrhythmia presentation that may be associated with ventricular dilatation and/or impaired systolic function.2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction
Document Reviewers: Adrian M. Baranchuk, MD, FACC, FRCPC, FCCS; Carina Blomström-Lundqvist, MD, PhD; Frank A. Fish, MD; James M. Horton, MD; Roberto Keegan, MD; Miguel A. Leal, MD, FACC, FHRS; Nigel Lever, MBChB, FRACP; Aman Mahajan, MD, PhD, MBA; Marc R. Moon, MD; Siva K. Mulpuru, BS, MB, MBBS, MD, FHRS, CCDS2017 HRS expert consensus statement on magnetic resonance imaging and radiation exposure in patients with cardiovascular implantable electronic devices
Section I: Introduction and Methodology ...............e95Proceedings from Heart Rhythm Society’s emerging technologies forum, Boston, MA, May 12, 2015
Physicians are in an excellent position to significantly contribute to medical device innovation, but the process of bringing an idea to the bedside is complex. To begin to address these perceived barriers, the Heart Rhythm Society convened a forum of stakeholders in medical device innovation in conjunction with the 2015 Heart Rhythm Society Annual Scientific Sessions. The forum facilitated open discussion on medical device innovation, including obstacles to physician involvement and possible solutions.2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing
Document Reviewers: Giuseppe Boriani, MD, PhD (Italy); Michele Brignole, MD, FESC (Italy); Alan Cheng, MD, FHRS (USA); Thomas C. Crawford, MD, FACC, FHRS (USA); Luigi Di Biase, MD, PhD, FACC, FHRS (USA); Kevin Donahue, MD (USA); Andrew E. Epstein, MD, FAHA, FACC, FHRS (USA); Michael E. Field, MD, FACC, FHRS (USA); Bulent Gorenek, MD, FACC, FESC (Turkey); Jin-Long Huang, MD, PhD (China); Julia H. Indik, MD, PhD, FACC, FAHA, FHRS (USA); Carsten W. Israel, MD (Germany); Mariell L. Jessup MD, FACC, FAHA, FESC (USA); Christophe Leclercq, MD, PhD (France); Robert J.HRS/ACC/AHA Expert Consensus Statement on the Use of Implantable Cardioverter-Defibrillator Therapy in Patients Who Are Not Included or Not Well Represented in Clinical Trials
The implantable cardioverter defibrillator (ICD) has emerged as an important treatment option for selected patients who are at risk of sudden cardiac death. Randomized trials have consistently shown that ICD implantation reduces mortality in patients with heart failure and reduced left ventricular function, as well as in patients who have suffered a cardiac arrest.1–3 Recommendations on the use of the ICD in clinical practice have been provided in four important guideline documents sponsored by the American College of Cardiology (ACC), the American Heart Association (AHA), Heart Rhythm Society (HRS), and the European Society of Cardiology (ESC).Heart Rhythm Society Expert Consensus Statement on Electrophysiology Laboratory Standards: Process, Protocols, Equipment, Personnel, and Safety
The modern electrophysiology (EP) laboratory is a complex environment providing an array of interventions for the diagnosis and treatment of heart rhythm disorders and is a result of many transformations over the last three decades. The EP field has witnessed rapid expansion in the number of therapeutic procedures treating a wide range of arrhythmias and in the new technologies available to perform these procedures. Because of the increasing complexity of equipment and procedures and an ever-expanding knowledge base, it was concluded that the field would benefit from a consensus document that would define the critical components and processes of a modern EP laboratory.HRS/ACCF Expert Consensus Statement on Pacemaker Device and Mode Selection: Developed in partnership between the Heart Rhythm Society (HRS) and the American College of Cardiology Foundation (ACCF) and in collaboration with the Society of Thoracic Surgeons
The most recent American College of Cardiology Foundation/American Heart Association/Heart Rhythm Society (ACCF/AHA/HRS) guidelines related to pacemaker implantation were published as part of a larger document related to device-based therapy.1 While this document provides some comments on pacemaker mode selection and algorithms to guide selection, it does not provide specific recommendations regarding choices for single- or dual-chamber devices. Over the past 15 years multiple randomized trials have compared a number of cardiovascular outcomes among patients randomized to atrial or dual-chamber pacing vs those randomized to ventricular pacing.
