Clinical Resources

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 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.

A briefing with Hugh Calkins, MD, FACC, FAHA, FHRS, available on Heart Rhythm 365, highlights the most important modifications to the guidelines and their impact on patient management.  

The Heart Rhythm Society endorsed the document on November 28, 2018. 

January 2, 2019—This document is the second of two companion appropriate use criteria (AUC) documents developed by the American College of Cardiology, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. The first document addresses the evaluation and use of multimodality imaging in the diagnosis and management of valvular heart disease, whereas this document addresses this topic with regard to structural (nonvalvular) heart disease. While dealing with different subjects, the two documents do share a common structure and feature some clinical overlap. The goal of the companion AUC documents is to provide a comprehensive resource for multimodality imaging in the context of structural and valvular heart disease, encompassing multiple imaging modalities.

The Heart Rhythm Society endorsed the document on October 12, 2018.

December 20, 2018—In the past 5 years, there have been several initiatives in pediatric cardiology, specifically in the heart failure and interventional cardiology domains, to develop and market devices that have been designed for the pediatric patient. PACES developed a task force in 2016 to specifically address comprehensive device development issues for the pediatric/congenital heart disease arrhythmia patient, ranging from cardiovascular implantable electronic devices to ablation catheters.

November 15, 2018—The purpose of this project was to develop a minimum set of standardized outcome measures that could be collected in atrial fibrillation (AF) patient registries and clinical practice. The harmonized measures represent a minimum set of outcomes that are relevant in AF research and clinical practice. Routine and consistent collection of these measures in registries and in other systems would support creation of a research infrastructure to efficiently address new questions and improve patient outcomes.

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 ACCF/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.

The Heart Rhythm Society endorsed the document on June 20, 2018.

August 16, 2018—The 2018 adult congenital heart disease (ACHD) guideline is a full revision of the 2008 ACC/AHA Guidelines for the Management of Adults with Congenital Heart Disease, which was the first US guideline to be published on the topic. This revision uses the 2008 ACHD guideline as a framework and incorporates new data and growing ACHD expertise to develop recommendations.

The Heart Rhythm Society endorsed the document on June 20, 2018.

July 21, 2018—In recognizing advances since the 2014 consensus document, the European Heart Rhythm Association (EHRA), the European Society of Cardiology Working Group on Thrombosis, the European Association of Percutaneous Cardiovascular Interventions (EAPCI), and the European Association of Acute Cardiac Care (ACCA) developed a focused update to include the new data, with the remit of comprehensively reviewing the available evidence and publishing a focused update consensus document on the management of antithrombotic therapy in patients with atrial fibrillation presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions (e.g., transcatheter aortic valve replacement), and providing up-to-date consensus recommendations for use in clinical practice.

The Heart Rhythm Society endorsed the document on March 22, 2018.

June 28, 2018—The aim of this consensus document is to provide an overview of sex differences in the pathophysiology, epidemiology, and management of cardiac arrhythmias, to highlight factors limiting the access to contemporary therapies, and to develop the pathways that may improve quality of medical care in women with cardiac arrhythmias. Suggestions for the design of future clinical trials in women are also provided.

The Heart Rhythm Society endorsed the document on February 7, 2018.

June 13, 2018—The aim of this document is to involve experts in the field of arrhythmias and devices, as well as experts in acute critical care, in order to focus all the aspects that are specific to these acute settings, highlighting the main drivers of clinical decision making and providing some advice to be considered for improved patient management.

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.