Time for Practical Clinical Tools

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The entire field of cardiovascular medicine is witnessing an era of rapid scientific progress that occurs against a backdrop of increasing emphasis on the importance of evidence-based practice. In this context, there has been a rapid development of guidelines, scientific statements and position papers by major professional societies, such as the American College of Cardiology/American Heart Association, the European Society of Cardiology and their numerous specialty divisions and working groups. A quick survey of 2016–2017 in the field of arrhythmias and related clinical entities, for example, reveals 10 such documents aimed at guiding clinicians in decision making.1–10 Explosive scientific developments and evolving, exciting, new clinical information necessitate fresh guidance. However, with such prolific production, it is a tall order to expect busy clinicians to notice, let alone read and embrace, all this continually emerging information, even in our interconnected digitised world.

It is time that learned societies, as well as editors of cardiology journals, undertake the task of guiding, standardising and coordinating these activities. This effort should prevent overproduction of overlapping documents and contribute towards the generation of user-friendly practical clinical tools that summarise evidence-based practice under the auspices of established organisations.


  1. Katritsis DG, Boriani G, Cosio FG, et al. European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardiaca y Electrofisiologia (SOLAECE). Europace 2017;19(3):465–511.
    Crossref | PubMed
  2. Philip Saul J, Kanter RJ, Writing Committee, et al. PACES/HRS expert consensus statement on the use of catheter ablation in children and patients with congenital heart disease: developed in partnership with the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Heart Rhythm 2016;13(6):e251–89.
    Crossref | PubMed
  3. Patton KK, Ellinor PT, Ezekowitz M, et al. Electrocardiographic early repolarization: a scientific statement from the American Heart Association. Circulation 2016;133(15):1520–9.
    Crossref | PubMed
  4. Antzelevitch C, Yan GX, Ackerman MJ, et al. J-Wave syndromes expert consensus conference report: emerging concepts and gaps in knowledge. Europace 2017;19(4):665–94.
    Crossref | PubMed
  5. Halvorsen S, Storey RF, Rocca B, et al. ESC Working Group on Thrombosis. Management of antithrombotic therapy after bleeding in patients with coronary artery disease and/or atrial fibrillation: expert consensus paper of the European Society of Cardiology Working Group on Thrombosis. Eur Heart J 2017;38(19):1455–62.
    Crossref | PubMed
  6. Shen WK, Sheldon RS, Benditt DG, et al. 2017 ACC/AHA/ HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. J Am Coll Cardiol 2017; epub ahead of press.
    Crossref | PubMed
  7. Niessner A, Tamargo J, Morais J, et al. Reversal strategies for non-vitamin K antagonist oral anticoagulants: a critical appraisal of available evidence and recommendations for clinical management-a joint position paper of the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy and European Society of Cardiology Working Group on Thrombosis. Eur Heart J 2017;38(22):1710–6.
    Crossref | PubMed
  8. Doherty JU, Gluckman TJ, Hucker WJ, et al. 2017 ACC Expert Consensus Decision Pathway for Periprocedural Management of Anticoagulation in Patients With Nonvalvular Atrial Fibrillation: a report of the American College of Cardiology Clinical Expert Consensus Document Task Force. J Am Coll Cardiol 2017;69(7):871–98.
    Crossref | PubMed
  9. Raval AN, Cigarroa JE, Chung MK, et al. Management of patients on non-vitamin k antagonist oral anticoagulants in the acute care and periprocedural setting: a scientific statement from the American Heart Association. Circulation 2017;135(10):e604–33.
    Crossref | PubMed
  10. Peberdy MA, Gluck JA, Ornato JP, et al. Cardiopulmonary resuscitation in adults and children with mechanical circulatory support: a scientific statement from the American Heart Association. Circulation 2017;135(24):e1115–34.
    Crossref | PubMed