Atrial Fibrillation
Education – Clinical: This Foundational EP education video will cover the Diagnosis of SVT in the EP Lab usually for the purpose of catheter ablation. Additional videos created by Joshua M. Cooper, MD, FACC, FHRS include:
Read MoreEducation – Clinical: In this Foundational EP education video, learn the importance of understanding in detail how unipolar and bipolar signals are recorded, and how they should be interpreted in order to maximize the safety and success of EP studies in catheter ablation procedures. Additional videos created by Joshua M. Cooper, MD, FACC, FHRS include:
Read MoreCatheter ablation of atrial fibrillation is an important treatment option for maintaining a normal heart rhythm and reducing arrhythmia-related symptoms. This consensus statement provides healthcare providers with clinical practice standards and advice on which patients should receive ablation, how to perform the procedure, and how to manage patients before, during, and afterwards.
Read MoreWorkflows: In collaboration with Anesthesia, Urology, PACU and EP, here is the bladder management workflow for ablation patients from the EP Lab.
Read MoreVideo: In this breaking news episode, #HRStv host Mehak Dhande, MD, is joined by Joshua Silverstein, MD, FHRS, and Jennifer Wright, MA, MD, FHRS, Co-chairs of the CardiQ Steering Group. They delve into the benefits of CardiQ, a digital platform committed to enhancing quality of care, specifically for patients with AFib. The platform provides a wealth of carefully curated tools and resources to support heart rhythm care specialists, hospitals, health systems and the broader medical community in quality improvement initiatives.
Read MoreVideo: Introducing, CardiQ! Roderick Tung, MD, FHRS, talks with Thomas Deering, MD, MBA, FHRS, CCDS, about CardiQ.org, the Heart Rhythm Society’s new digital platform dedicated to quality improvement in AFib care. CardiQ offers a step-by-step framework for QI initiatives, a curated library of tools and resources, and a growing community sharing practical insights and experiences.
Read MoreJournal Articles: The last expert consensus document on cardiac catheterization laboratory standards was published in 2001 (1). Since then, many changes have occurred as the setting has evolved from being primarily diagnostic based into a therapeutic environment. Technology has changed both the imaging and reporting systems. The lower risk of invasive procedures has seen the expansion of cardiac catheterization laboratories to sites without onsite cardiovascular surgery backup and even to community hospitals where primary percutaneous coronary intervention (PCI) is now being performed. This has increased the importance of quality assurance (QA) and quality improvement (QI) initiatives. At the same time, the laboratory has become a multipurpose suite with both diagnostic procedures to investigate pulmonary hypertension and coronary flow and with therapeutic procedures that now include intervention into the cerebral and peripheral vascular systems as well as in structural heart disease. These new procedures have impacted both the adult and pediatric catheterization laboratories. The approaches now available allow for the treatment of even very complex heart disease and have led to the development of hybrid cardiac catheterization laboratories where a team of physicians (including invasive cardiologists, cardiovascular surgeons, noninvasive cardiologists, and anesthesiologists) is required.
Read MoreJournal Articles: Clinical electrophysiology (EP) and catheter ablation of arrhythmias are rapidly evolving in recent years. More than 50 000 catheter ablations are performed every year in Europe. Emerging indications, an increasing number of procedures, and an expected high quality require national and international standards as well as trained specialists. The purpose of this European Heart Rhythm Association (EHRA) survey was to assess the practice of requirements for EP personnel, equipment, and facilities in Europe. Responses to the questionnaire were received from 52 members of the EHRA research network. The survey involved high-, medium-, and low-volume EP centres, performing >400, 100–399, and under 100 implants per year, respectively. The following topics were explored: (i) EP personnel issues including balance between female and male operators, responsibilities within the EP department, age profiles, role and training of fellows, and EP nurses, (ii) the equipments available in the EP laboratories, (iii) source of patient referrals, and (iv) techniques used for ablation for different procedures including sedation, and peri-procedural use of anticoagulation and antibiotics. The survey reflects the current EP personnel situation characterized by a high training requirement and specialization. Arrhythmia sections are still most often part of cardiology departments and the head of cardiology is seldom a heart rhythm specialist. Currently, the vast majority of EP physicians are men, although in the subgroup of physicians younger than 40 years, the proportion of women is increasing. Uncertainty exists regarding peri-procedural anticoagulation, antibiotic prophylaxis, and the need for sedation during specific procedures.
Read MoreGuidelines/Clinical Documents: 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. To this end, the Heart Rhythm Society (HRS) convened a multidisciplinary team to review EP laboratory design, ergonomics, personnel, equipment, occupational hazards, and patient safety, as well as clinical and ethical issues related to diagnostic and therapeutic EP procedures. The goal is to provide physicians, administrators, and regulatory personnel with the recommended requirements for building, staffing, and running a modern EP laboratory to optimize patient outcomes, minimize patient risk, and provide a safe and positive environment for physicians and staff.
The writing committee was formed by the Scientific and Clinical Documents Committee of the HRS, with approval by the President of the HRS and the HRS Executive Committee. The composition of the committee was meant to represent the range of stakeholders in the EP laboratory. The choice of the writing committee members was in accordance with the HRS Relationships With Industry policy.1 All members of the writing committee were required to fully disclose all potential conflicts of interest (see Appendix 1).
Relatively little published literature addresses the EP laboratory environment, staffing, and processes. Therefore, many of the statements in this document are the product of expert consensus by the writing committee and reviewers. For cases in which there were divergent opinions on a statement, a vote among writing committee members was taken, and if a two-third majority supported the statement, it was adopted in the document. The sections pertaining to pediatric and adult congenital heart disease were reviewed and approved by the Pediatric and Congenital Electrophysiology Society (PACES), a nonprofit organization dedicated to the treatment of arrhythmia disorders in children and individuals with congenital heart disease (CHD). The final document was approved by the Board of Trustees of the HRS. This document is directed to all health care professionals who design, manage, and/or work in the EP laboratory environment.
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