Clinical Guidelines & Documents
2015 ACC/HRS/SCAI left atrial appendage occlusion device societal overview
Left atrial appendage (LAA) occlusion devices have the potential to influence the clinical approach to stroke prevention in patients with atrial fibrillation (AF). A number of percutaneous techniques have been proposed, including intracardiac plugs and external ligation. Several devices have been adopted to various degrees in the United States and internationally. Only 1 (WATCHMAN, Boston Scientific, Marlborough, Massachusetts) has been evaluated in randomized controlled trials compared with the current standard of care.2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope
This international consensus statement was written by experts in the field who were chosen by the Heart Rhythm Society, in collaboration with representatives from the American Autonomic Society (AAS), the American College of Cardiology (ACC), the American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), the European Heart Rhythm Association (EHRA), the Pediatric and Congenital Electrophysiology Society (PACES), and the Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE)-Latin American Society of Cardiac Pacing and Electrophysiology.HRS/NSA 2014 survey of atrial fibrillation and stroke: Gaps in knowledge and perspective, opportunities for improvement
The prevalence of atrial fibrillation (AF) is substantial and increasing. Stroke is common in AF and can have devastating consequences. Oral anticoagulants are effective in reducing stroke risk, but are underutilized.HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices
Cardiovascular implantable electronic devices (CIEDs) have evolved significantly since the publication of the 2008 Heart Rhythm Society (HRS) consensus statement1 outlining recommended monitoring strategies. Novel embedded technologies have created the ability of the devices to monitor their own function, record arrhythmias and other physiological parameters, and communicate this information to health care providers without the active participation of the patient. CIEDs with wireless remote monitoring (RM) capabilities stand at the forefront of a new class of medical devices that will unobtrusively acquire vital data beyond the walls of health care facilities and seamlessly transmit the information back to health care providers.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
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 topic1 and to identify continued knowledge gaps and current research priorities. The research symposium also sought to identify key deficiencies and opportunities in research infrastructure, operations, and methodologies.EHRA/HRS/APHRS Expert Consensus on Ventricular Arrhythmias
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 VAs.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).PACES/HRS Expert Consensus Statement on the Recognition and Management of Arrhythmias in Adult Congenital Heart Disease: Executive Summary: Developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology (ACC), the American Heart Association (AHA), the European Heart Rhythm Association (EHRA), the Canadian Heart Rhythm Society (CHRS), and the International Society for Adult Congenital Heart Disease (ISACHD)
Nearly one-third of all major congenital anomalies are heart defects, with an estimated 9 per 1000 live births afflicted by congenital heart disease (CHD) worldwide.1 Remarkable advances in care have resulted in impressive gains in survival such that more than 90% of children with CHD in developed countries today are expected to survive to adulthood.2 Consequently, the past decades have witnessed historical shifts in population demographics, as adults now outnumber children with CHD. Population-based estimates indicate that there are currently more than 1 million adults with CHD in the United States alone, more than 100,000 in Canada, and 1.8 million in Europe.PACES/HRS Expert Consensus Statement on the Recognition and Management of Arrhythmias in Adult Congenital Heart Disease: Developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology (ACC), the American Heart Association (AHA), the European Heart Rhythm Association (EHRA), the Canadian Heart Rhythm Society (CHRS), and the International Society for Adult Congenital Heart Disease (ISACHD)
Nearly one third of all major congenital anomalies are heart defects, with an estimated 9 per 1000 live births afflicted by congenital heart disease (CHD) worldwide.1 Remarkable advances in care have resulted in impressive gains in survival such that over 90% of children with CHD in developed countries today are expected to survive into adulthood.2 Consequently, the past decades have witnessed historical shifts in population demographics, as adults now outnumber children with CHD. Population-based estimates indicate that there are currently over 1 million adults with CHD in the United States alone, over 100,000 in Canada, and 1.8 million in Europe.PACES/HRS Expert Consensus Statement on the Evaluation and Management of Ventricular Arrhythmias in the Child With a Structurally Normal Heart
The purpose of this consensus statement is to provide up-to-date recommendations on the evaluation and treatment of ventricular tachycardia (VT) in children with structurally normal hearts (idiopathic VT [IVT]). IVT is usually benign and often resolves spontaneously without treatment; however, it is essential to distinguish this problem from potentially life-threatening conditions that can occur with absent or minimal structural heart disease (long QT syndrome [LQTS], arrhythmogenic right ventricular dysplasia/cardiomyopathy [ARVC], myocarditis, and cardiac tumors).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/EHRA/APHRS Expert Consensus Statement on the Diagnosis and Management of Patients with Inherited Primary Arrhythmia Syndromes:
This international consensus statement is the collaborative effort of three medical societies representing electrophysiology in North America, Europe and Asian-Pacific area: the Heart Rhythm Society (HRS), the European Heart Rhythm Association (EHRA) and the Asia Pacific Heart Rhythm Society. The objective of the consensus document is to provide clinical guidance for diagnosis, risk stratification and management of patients affected by inherited primary arrhythmia syndromes. It summarizes the opinion of the international writing group members based on their own experience and on a general review of the literature with respect to the clinical data on patients affected by channelopathies.2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Andrew E. Epstein, MD, FACC, FAHA, FHRS, Chair; John P. DiMarco, MD, PhD, FACC, FHRS; Kenneth A. Ellenbogen, MD, FACC, FAHA, FHRS; N.A. Mark Estes III, MD, FACC, FAHA, FHRS; Roger A. Freedman, MD, FACC, FHRS; Leonard S. Gettes, MD, FACC, FAHA; A. Marc Gillinov, MD, FACC, FAHA; Gabriel Gregoratos, MD, FACC, FAHA; Stephen C. Hammill, MD, FACC, FHRS; David L. Hayes, MD, FACC, FAHA, FHRS; Mark A. Hlatky, MD, FACC, FAHA; L. Kristin Newby, MD, FACC, FAHA; Richard L. Page, MD, FACC, FAHA, FHRS; Mark H.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.PACES/HRS Expert Consensus Statement on the Management of the Asymptomatic Young Patient with a Wolff-Parkinson-White (WPW, Ventricular Preexcitation) Electrocardiographic Pattern: Developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the Canadian Heart Rhythm Society (CHRS)
The purpose of this consensus statement is to provide up-to-date clinical practice guidelines on the evaluation and management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW) electrocardiographic (ECG) pattern.1 The terminology WPW was first used to describe a “bundle-branch pattern” with a short PR interval in healthy young people prone to paroxysmal tachycardia and/or atrial fibrillation. Although isolated case reports preceded the 1930 landmark manuscript, history correctly credits identification of the syndrome to Drs.
