The Heart Rhythm Society offers its guidance through scientific and clinical documents to provide three main components vital to advancements in the field: analysis, discussion of current issues, and suggestions for clinical application. Those who utilize the Society’s Guidelines and Clinical Documents can apply what they have learned to:
- Improve patient care;
- Stay up-to-date on the latest in clinical practice and research;
- Improve the administration of heart rhythm management;
- Encourage continuing education, and;
- Advocate for fair reimbursement.
The listed documents have either been developed by the Heart Rhythm Society, or have been jointly produced, collaborated with, or endorsed by the Heart Rhythm Society. The Society's Scientific and Clinical Documents Committee oversees the development, peer-review and opportunity for collaborating with other similar societies.
Thank you for visiting our Clinical Guidelines page. Please check back regularly, we will post new documents when available.
Most Recent Additions
ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities Executive Summary (May 15, 2008)
The Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices updates the previous version published in 2002. This revision covers major studies on bradyarrhythmias and tachyarrhythmias, which may be treated optimally with device therapy; recent changes in the management of heart failure that involve both drug and device therapy; and advances in the technology of devices to treat, delay, and even prevent morbidity and mortality from bradyarrhythmias, tachyarrhythmias, and heart failure. Learn more.
Heart Rhythm Society/Pediatric and Congenital Electrophysiology Society Clinical Competency Statement: Training pathways for implantation of cardioverter-defibrillators and cardiac resynchronization therapy devices in pediatric and congenital heart patients (May 14, 2008)
This clinical document details the training for ICD/CRT implants in patients who are either in the pediatric age range (0–18 years of age) with or without congenital heart disease, or adults with congenital heart disease. The health care team involved in the care of these patients should have knowledge and expertise about the implantation indications, implantation techniques, complications, programming and follow-up for these devices, as well as the non-technical issues relevant to children. Learn more.
HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs): Description of Techniques, Indications, Personnel, Frequency and Ethical Considerations (May 14, 2008)
This international document represents expert consensus concerning the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs). The document includes the monitoring of CIEDs with a description of the technology, indications for use, personnel involved in monitoring and the frequency and types of monitoring events. Also covered are issues in regard to data management, regulatory environments, reimbursement and ethical considerations in respect to device inactivation. Learn more.
HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up (May 9, 2007)
Developed in partnership with the European Heart Rhythm Association (EHRA) and the European Cardiac Arrhythmia Society (ECAS)
Download full text, (PDF, 1.3MB) or the executive summary (PDF, 138K)
Inter-Association Task Force Recommendations on Emergency Preparedness and Management of Sudden Cardiac Arrest in High School and College Athletic Programs (March 2007)
This statement was written by an Inter-Association Task Force to assist high school and college athletic programs to prepare and respond to sudden cardiac arrest for this population. The Heart Rhythm Society endorsed this document. Download consensus statement (PDF, 441K)
AHA/ACC/HRS SCIENTIFIC STATEMENT: Recommendations for the Standardization and Interpretation of the Electrocardiogram, Part I and Part II (March 2007)
Part I: The Electrocardiogram and its Technology (PDF, 195K) — This statement examines the relation of the resting ECG to its technology. Its purpose is to foster understanding of how the modern ECG is derived and displayed and to establish standards that will improve the accuracy and usefulness of the ECG in practice.
Part II: Electrocardiography Diagnostic Statement List (PDF, 62K) — This statement provides a concise list of diagnostic terms for ECG interpretation that can be shared by students, teachers, and readers of electrocardiography.
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Arrhythmias, CRM Devices and Leads
AHA/HRS Addendum to Personal and Public Safety Issues Related to Arrhythmias that May Affect Consciousness: Implications for Regulation and Physician Recommendations (February 7, 2007)
This addendum to a 1996 advisory addresses driving restrictions in patients who receive an ICD for primary prevention. Learn more.
A Practical Guide for Clinicians Who Treat Patients with Amiodarone (2007)
Amiodarone is commonly used to treat supraventricular and ventricular arrhythmias in various inpatient and outpatient settings. Because of adverse drug reactions, proper use is essential to deriving optimal benefits from the drug with the least risk. Download guide (PDF, 116K)
Recommendations from the Heart Rhythm Society Task Force on Device Performance Policies and Guidelines (September 2006)
This report offers the first comprehensive recommendations for the surveillance, analysis and performance reporting of pacemakers and ICDs; changes that will help patients continue to have confidence and trust in these lifesaving treatments. Learn more.
ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (October 2006)
A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines.
The purpose of this document, developed with and endorsed by the Heart Rhythm Society, is to update and combine the previously published recommendations into one source approved by the major cardiology organizations in the United States and Europe. Learn more.
Report on Device Performance from the Independent Panel of Guidant Corporation (2006)
Following the recall event in 2005, Guidant decided to commission an independent panel charged with the responsibility of studying, analyzing, and evaluation the policies and procedure of the CRM business in regard to the post-market device surveillance. This report summarizes the findings and recommendations of the panel. Download report (PDF, 727K)
Proceedings Document from the Policy Conference on Pacemaker and ICD Performance (September 16, 2005)
Conference presented by the Heart Rhythm Society and the Food and Drug Administration. Learn more.
The Relation Between Patients' Outcomes and the Volume of Cardioverter-Defibrillator Implantation Procedures Performed by Physicians Treating Medicare Beneficiaries (2005)
This is the first study designed to look at the relation between patient outcomes and physicians/hospitals volume cardioverter-defibrillator implantation to determine if implantation should be limited to physicians with high procedural volume. Download report (PDF, 171K)
Expert Consensus Statement: Resynchronization Therapy for Heart Failure (2005)
Publication covers mechanisms and consequences of mechanical and electrical remodeling in HF; controlled trials of CRT alone or combined with Implantable Cardioverter Defibrillator, expanding indications for electrical heart failure devices, and much more. Download consensus statement (PDF, 2.1M)
ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices (2002)
Summary Article from the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (updating 1998 pacemaker guidelines). Download executive summary (PDF, 83K)
The Role(s) of the Industry Employed Allied Professional (March 2001)
Task force developed policy statement to clarify the role Industry employed allied professionals (IEAPs) should play in the clinical environment, with the objective of maintaining and improving high quality and cost-effective care to patients with implanted cardiac rhythm devices. Download policy statement (PDF, 51K)
Recommendations for Extraction of Chronically Implanted Transvenous Pacing and Defibrillator Leads: Indications, Facilities, Training (April 2000)
Standard definitions and recommendations for the clinical practice of lead extraction were discussed in a Policy Conference held on May 11, 1997 in New Orleans, LA. The conclusions of that conference were supplemented in this summary paper; the purpose is to elucidate the consensus of the Conference in the form of standardizing language and forward-looking recommendations. Download recommendations (PDF, 64K)
Practical Guidelines for Clinicians Who Treat Patients with Amiodarone (2000)
These Guidelines were created as an approach to the use of Amiodarone in clinical practice. They review the indication for use of Amiodarone and method of initiation therapy, suggest strategies for follow-up of patients receiving Amiodarone and outline the adverse effects of the therapy. Download guidelines (PDF, 202K)
NASPE/AHA: Personal and Public Safety Issues Related to Arrhythmias That May Affect Consciousness: Implications for Regulation and Physician Recommendations (1996)
This Statement, which is based on the two conferences held in 1994 and 1995, addresses the issues related to activities in patient with arrhythmias that may result in impaired consciousness. Download policy statement (PDF, 199K)
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Ablation / EP Studies / Personnel
ACC/AHA/HRS 2006 Key Data Elements and Definitions for Electrophysiological Studies and Procedures
The electrophysiolgy field has evolved into one in which therapeutic ventures have displaced diagnosis as the major focus. Therapies directed by electrophysiologists encompass two major types: catheter-based, for cure or palliation of tachyarrhythmias, and device-based, for both bradyarrhythmias as well as tachyarrhythmias. These guidelines serve as the basis for databases employed in clinical research as well as practice, and providing standard definitions of terms relevant to the care of patients with arrhythmias and implanted rhythm management devices. Download guidelines (PDF, 212K)
American College of Cardiology/American Heart Association 2006 Update of the Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion (October 2006)
Developed in Collaboration With the Heart Rhythm Society, this competence statement was designed to assist in the assessment of physicians’ competence on a procedure-specific basis. The minimum education, training, experience, and cognitive and technical skills necessary for the competent performance of invasive cardiac EPS, catheter ablation, and cardioversion are specified. Learn more.
International Consensus on Nomenclature and Classification of Atrial Fibrillation (2003)
The Consensus Statement, which is a Collaborative Project of the Working Group on Arrhythmias and the Working Group of Cardiac Pacing of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, provides a simple way to characterize an episode of Atrial Fibrillation. Download consensus statement (PDF,50K )
NASPE Policy Statement on Catheter Ablation: Personnel, Policy, Procedures, and Therapeutic Recommendations (2003)
The Policy Statement provides updates about the rationale and indications for catheter ablative procedures and recommendations regarding EP laboratory personnel and facilities. Download policy statement (PDF, 114K)
NASPE Expert Consensus Statement: Radiofrequency Catheter Ablation in Children With and Without Congenital Heart Disease (2002)
The Consensus Statement, which is based on the Consensus Conference held during the 21st Annual Scientific Sessions of NASPE, is covering the issues of specific cardiac arrhythmias in children with or without CHDC, the special needs of children and patients with CHDC and how best to meet these needs. Download consensus statement (PDF, 223K)
NASPE Position Statement: Classification of Atrial Flutter and Regular Atrial Tachycardia According to Electrophysiologic Mechanism and Anatomic Bases (2001)
A Joint Expert Group from the Working Group of Arrhythmias of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology wrote this Position Statement which proposes a new classification of the electrophysiologic atrial tachycardias based on EP mechanisms which are defined by mapping and entrainment. Download position statement (PDF, 584K)
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Training Statements
Task Force 6: Training in Specialized Electrophysiology, Cardiac Pacing, and Arrhythmia Management The following training statement
This document is the result of a close collaboration between the American College of Cardiology (Adult Cardiovascular Medicine Core Cardiology Training [COCATS] Task Force 6) and the Heart Rhythm Society. This Task Force 6 Report is 1 of 13 COCATS 3 Task Force Reports, which encompass training recommendations for the fellowship programs in adult cardiovascular medicine. Download guidelines (PDF, 80K)
The Heart Rhythm Society Requirements for the Alternate Training Pathway for Non-Electrophysiologists to Implant ICD and CRT devices
This Clinical Competency Statement and Addendum along with the additional listed resources were developed to provide training guidance and a list of requirements for non-electrophysiologists who have an interest in ICD and CRT device implantation. Learn more.
ACCF 2006 Update for Training in Adult Cardiovascular Medicine (Focused Update of the 2002 COCATS 2 Training Statement)
This limited update to the 2002 COCATS 2 Task Force 6 was endorsed by the Heart Rhythm Society, which was represented by Cynthia Tracy, MD. Download update (PDF, 88K)
NASPE Policy Statement: NASPE Training Requirements for Cardiac Implantable Electronic Devices: Selection, Implantation, and Follow Up (2003)
The original policy statement on training guidelines originated from a conference held in 1992 and was published as a policy statement in 1994. Download policy statement (PDF, 73K)
NASPE Position Paper: Clinical Cardiac Electrophysiology Fellowship Teaching Objectives for the New Millennium (2001)
This updated fellowship teaching objectives outline the basic science, clinical component sand procedural aspect of Electrophysiology; they give relevant references that can be used as an educational guide. Download report (PDF, 191K)
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Endorsed / Sponsored Documents
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery (2007)
These guidelines are intended for physicians and nonphysician caregivers who are involved in the preoperative, operative, and postoperative care of patients undergoing noncardiac surgery. They provide a framework for considering cardiac risk of noncardiac surgery in a variety of patient and surgical situations. Download guidelines (PDF, 876K)
ACC/AHA/ESC 2006 Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: (2006)
The Guidelines, jointly created by the American College of Cardiology, American Heart Association and the European Society of Cardiology has been endorsed by the Heart Rhythm Society Board of Trustees, is giving you an update and combining the previously published recommendations regarding the management of patients with Ventricular arrhythmias into one source. Download full text (PDF, 945K ), Download executive summary (PDF, 688k)
ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation
A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation)
These guidelines were developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Learn more.
ACC/AHA 2006 Guideline Update on Perioperative Cardiovascular Evaluation for Noncardiac Surgery: Focused Update on Perioperative Beta-Blocker Therapy
A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
This update was developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society for Vascular Medicine and Biology. Download update (PDF, 197K)
ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult (August 2005)
A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure)
This update was developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation. Learn more.
Practice Advisory for the Perioperative Management of Patients with Cardiac Rhythm Management Devices: Pacemakers and Implantable Cardioverter-Defibrillators (2004)
The Report , written by the American Society of Anesthesiologists Task Force has been endorsed by the Heart Rhythm Society in 2004. It provides a synthesis and analysis of expert opinion on the perioperative management of patients with pacemakers and implantable cardioverter-defibrillators (ICDs). Download advisory report (PDF, 238K)
Guidelines on Management (Diagnosis and Treatment) of Syncope — Update 2004
The Task Force on Syncope, European Society of Cardiology. Download executive summary (PDF, 336K)
ACC/AHA/ESC Guidelines for the Management of Patients with Atrial Fibrillation (2001)
NASPE endorsed ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation. Download executive summary (PDF, 942K)
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Other
NASPE Position Statement: The Revised NASPE/BPEG Generic Code for Antibradycardia, AdaptiveRate, and Multisite Pacing (2002)
This Statement gives the revised NBG code, endorsed by BPEC and NASPE in 2001, which is more compatible with contemporary and emerging pacing technology with particular attention to the issue of multisite pacing. Download position statement (PDF, 105K)
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