Heart Rhythm Society Scientific and Clinical Documents Committee Viewpoint

2022 HRS expert consensus statement on evaluation and management of arrhythmic risk in neuromuscular disorders.

HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices.

Evaluation of the implementation of International Classification of Diseases, 11th revision for morbidity coding: Rationale and study protocol

Pulsed field ablation has emerged as a novel non-thermal treatment modality with a distinct safety profile for the interventional treatment of atrial fibrillation. By inducing irreversible electroporation, pulsed field ablation achieves myocardial ablation while preserving surrounding structures such as nerves, vasculature, and the esophagus. This European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC) scientific statement, endorsed by major international societies, reviews the biophysics, technology, clinical evidence, workflow, safety, and training aspects of pulsed field ablation. Randomized trials demonstrate comparable efficacy to radiofrequency and cryoballoon ablation, with advantages in safety and efficiency. The statement provides practical advice for clinical implementation, operator training, and identifies key gaps in evidence and priorities for future research and innovation.

2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch

HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs): Description of Techniques, Indications, Personnel, Frequency and Ethical Considerations: Developed in partnership with the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA); and in collaboration with the American College of Cardiology (ACC), the American Heart Association (AHA), the European Society of Cardiology (ESC), the Heart

In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017. Seven years after the last consensus, an updated document was considered necessary to define a contemporary framework for selection and management of patients considered for or undergoing catheter or surgical AF ablation. This consensus is a joint effort from collaborating cardiac electrophysiology societies, namely the European Heart Rhythm Association, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society .

Transparent sharing of digital health data: A call to action

Current Opinion in Cardiology was launched in 1985. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of cardiology is divided into 14 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Editor and Section Editors for this issue. EDITOR Robert RobertsRobert RobertsDr Roberts is an Executive Director of the Heart and Vascular Institute for Dignity Health at St Joseph’ Hospital and Medical Center in Phoenix, Arizona, USA. He is Professor of Medicine at the University of Arizona School of Medicine Phoenix and holds the Chair in ISCTR. He was the President and CEO of the University of Ottawa Heart Institute, Canada, (2004–2014) and the Founder and Director of The Ruddy Canadian Cardiovascular Genetics Centre, Canada. He received his M.D. from Dalhousie University, Canada, and completed his residency in internal medicine and fellowship in cardiology at the University of Toronto, Canada. Funded by a Canadian Heart Foundation Scholarship, he pursued research in heart disease at the University of California, USA, followed by a faculty position at Washington University and Director of the CCU at Barnes Hospital, St Louis, USA. In 1982 he became Chief of Cardiology at Baylor College of Medicine in Houston, Texas, USA. Dr Roberts developed the MBCK Test, the standard used to diagnose heart attacks for three decades. Dr Roberts’ research led him to molecular biology and genetics, during which time he discovered many genes responsible for single gene disorders of the heart including FHCM, FDCM, atrial fibrillation, WPW and ARVG. In the past 10 years, he has pursued a major effort, which resulted in discovery of 9p21, the first genetic risk variant for CAD. In collaboration with an international consortium he has been involved with the discovery of over 100 genetic risk variants for CAD. Dr Roberts is generally regarded as one of the founders of molecular cardiology. He has been the Associate Editor of Hurst's the Heart for more than two decades and co-authored the section on Cardiovascular Genetics. He is Senior Guest Editor for JACC: Basic Translational Science and Section Editor for Genomics and Genetics for the parent journal, JACC. He is Associate Editor of Trends in Cardiovascular Medicine, authors Gene of the Month for Cardiology Today and is on the Editorial Board for multiple other cardiovascular journals. Dr Roberts has had a distinguished and prolific career as a Cardiologist, Educator and Scientist having published over 960 scientific articles. In recognition of his scientific contributions he was elected a Fellow of Academy of Science of the Royal Society of Canada in 2013, received the Distinguished Scientist Award of the American College of Cardiology in 1998 and the Award of Meritorious Achievement from the American Heart Association in 2001. He has received many other awards including the 2012 Research Achievement Award from the Canadian Cardiovascular Society; the 2012 Distinguished Fellowship Award from the International Academy of Cardiology; the McLaughlin Medal from the Royal Society of Canada; the Albrecht Fleckenstein Memorial Award from the International Academy of Cardiology in 2008; Citation for Highly Cited Researcher from ISI Thomson Scientific in 2002. SECTION EDITORS Wilber W. SuWilber W. SuDr Wilber W. Su is the Director of Cardiac Electrophysiology Banner-University Medical Center and Associate Professor of Medicine at the University of Arizona, USA, as well as Stanford University Medical Center, USA. He has a biomedical engineering degree from Massachusetts Institute of Technology, and received his training at Mayo Clinic Rochester, Minnesota, for medicine, cardiology, clinician investigator fellowship and cardiac electrophysiology. He has been a high-volume operator and has served as a training physician in both implantable cardiac devices and complex ablation, notably in atrial fibrillation. He is also active in research with multiple important clinical trials and is the national primary investigator for several research trials. He is recognized as a key opinion and thought leader around the world in cryoballoon ablation and has personally performed over 3000 cryoballoon ablation procedures for atrial fibrillation, the highest volume world-wide. He has also taught, presented, and published on various cryoballoon techniques. His latest publication highlights his leadership in the field of cryoballoon ablation, and is titled “Best Practice Guide for Cryoballoon Ablation in Atrial Fibrillation: The compilation experience of over 3000 Procedures” as well as “Best Practice Guide II-Focus on Dosing” and book chapters on Cryoballoon Ablation. He is also a member of the writing committee for the American Heart Association and Heart Rhythm Society national guidelines. Mitchell I. CohenMitchell I. CohenMitchell I. Cohen MD FACC FHRS is the current Co-Director of the Heart Center and Chief of Pediatric Cardiology at Inova Children's Hospital. Dr Cohen graduated from Temple University School of Medicine, USA, and then completed a pediatric internship, residency, cardiology fellowship, and subspecialty training in pediatric electrophysiology at the Children's Hospital of Philadelphia, USA. Dr Cohen remained on faculty at the Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, USA. In 2017, Dr Cohen relocated to Northern Virginia and became the Co-Director of the Heart Center and Chief of Pediatric Cardiology at Inova Children's Hospital. Dr Cohen's clinical and research interests address long-term outcomes of children with cardiovascular implantable electronic devices, genotype specific therapies for patients with channelopathies, Wolff-Parkinson-White syndrome, and late arrhythmic outcomes in adults with congenital heart disease. Dr Cohen has lectured at over 280 national and international scientific meetings and has over 1000 published papers and book chapters. He has been a visiting professor at Primary Children's Hospital, Children's Mercy Hospital, and Duke Children's Hospital. Dr Cohen's advocacy interests extend to sudden cardiac death prevention and awareness for all high-school students. He is the Past-President of the Pediatric and Congenital Electrophysiology Society (PACES) and is a scientific advisor to the Sudden Arrhythmia Death Syndromes Foundation (SADS). Dr Cohen served on the Scientific Clinical Documents Committee for the Heart Rhythm Society and been the lead or co-author on more than 5 nationally published guidelines by the American College of Cardiology and the American Heart Association. He is the current pediatric representative of the Clinical Arrhythmia Committee for the American College of Cardiology. He is the current pediatric program representative for the 2021 Heart Rhythm Society (HRS) scientific sessions and the Scientific Program Chair for the 2023 World Congress in Pediatric Cardiology and Cardiothoracic Surgery. Dr Cohen is board certified in pediatric cardiology and adult congenital heart disease. He is certified in electrophysiology, pacemakers, and defibrillators by the International Board of Heart Rhythm Examiners (IBHRE). Dr Cohen is currently Professor of Pediatrics at Virginia Commonwealth University (VCU) School of Medicine, USA.

Inclusion and exclusion criteria for CRT

This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/ Heart Rhythm Society/ European Heart Rhythm Association/ Asia Pacific Heart Rhythm Society describes the current status of mobile health ("mHealth") technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self‐management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.

Patients with the Wolff-Parkinson-White electrocardiographic pattern (WPW) are at risk for sudden cardiac death (SCD), but disagreement exists about the magnitude of the risk and prevention of SCD in these patients. A committee convened by the Pediatric and Congenital Electrophysiology Society and the Heart Rhythm Society has now reviewed the literature and published a consensus document endorsed by multiple other governing bodies. The recommendations concern young (aged …

We aim to provide a critical appraisal of basic concepts underlying signal recording and processing technologies applied for (i) atrial fibrillation (AF) mapping to unravel AF mechanisms and/or identifying target sites for AF therapy and (ii) AF detection, to optimize usage of technologies, stimulate research aimed at closing knowledge gaps, and developing ideal AF recording and processing technologies. Recording and processing techniques for assessment of electrical activity during AF essential for diagnosis and guiding ablative therapy including body surface electrocardiograms (ECG) and endo- or epicardial electrograms (EGM) are evaluated. Discussion of (i) differences in uni-, bi-, and multi-polar (omnipolar/Laplacian) recording modes, (ii) impact of recording technologies on EGM morphology, (iii) global or local mapping using various types of EGM involving signal processing techniques including isochronal-, voltage- fractionation-, dipole density-, and rotor mapping, enabling derivation of parameters like atrial rate, entropy, conduction velocity/direction, (iv) value of epicardial and optical mapping, (v) AF detection by cardiac implantable electronic devices containing various detection algorithms applicable to stored EGMs, (vi) contribution of machine learning (ML) to further improvement of signals processing technologies. Recording and processing of EGM (or ECG) are the cornerstones of (body surface) mapping of AF. Currently available AF recording and processing technologies are mainly restricted to specific applications or have technological limitations. Improvements in AF mapping by obtaining highest fidelity source signals (e.g. catheter-electrode combinations) for signal processing (e.g. filtering, digitization, and noise elimination) is of utmost importance. Novel acquisition instruments (multi-polar catheters combined with improved physical modelling and ML techniques) will enable enhanced and automated interpretation of EGM recordings in the near future.

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

Rationale, considerations, and goals for atrial fibrillation centers of excellence: A Heart Rhythm Society perspective