March 16, 2012 — The Heart Rhythm Society (HRS) issued an international consensus statement on indications, techniques and outcomes of catheter and surgical ablation of atrial fibrillation (AF). The statement was written in joint partnership with European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS).
The HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of AF is an update to the first AF consensus document released in 2007, and is published in the March edition of HeartRhythm, the official journal of the Heart Rhythm Society. The new statement was written in collaboration with the American College of Cardiology (ACC), the American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS) and the Society of Thoracic Surgeons (STS).
AF is one of the most common heart rhythm disorders affecting more than 2.5 million Americans and millions more around the world. Today, catheter and surgical ablation of AF are common, rapidly evolving procedures. The HRS/EHRA/ECAS expert consensus statement includes recommendations for patient selection, procedure techniques, management and follow-up, new definitions and research trial design, among other updates.
“It is without question that AF is a growing heart health issue requiring state-of-the-art treatment to ensure the best possible outcome,” stated co-lead author of the statement, Hugh Calkins, M.D., FHRS, CCDS, first vice president of the Heart Rhythm Society, professor of medicine at the Johns Hopkins University School of Medicine and director of cardiac arrhythmia services and the electrophysiology laboratory at The Johns Hopkins Hospital. “As we continue to learn more about the treatment of AF, it is important to update our resources accordingly, and in this case, our document is intended to improve patient care by providing the most current foundation of knowledge for those involved in catheter and surgical ablation of AF.”
HRS convened a diverse panel of 45 experts representing seven international organizations to focus on the most recent advancements in the field of catheter and surgical ablation. The expert consensus statement includes 11 topic areas:
- AF definitions, mechanisms and rationale for ablation
- Indications for catheter and surgical ablation of AF
- Techniques and endpoints for AF ablation
- Technologies and tools
- Other technical aspects; anticoagulation, anesthesia and esophageal monitoring
- Follow-up considerations
- Outcomes and efficacy of AF ablation
- Complications
- Training requirements and competencies
- Surgical ablation of AF
- Clinical trial considerations and definitions
Specifically, the statement provides notable updates in the areas of indications and techniques. These updates include, but are not limited to, the following:
- The addition of class and level of grades of indications for catheter and surgical ablation of AF when performed by an electrophysiologist or surgeon who has received the proper training and/or has a certain level of experience.
- The specific recommendations regarding the management of anticoagulation strategies before, during and post-ablation, including information on newer anticoagulants.
- A list of 53 definitions intended to guide clinical research.
“It is important to note the highly collaborative nature of this document and the comprehensive recommendations that have been put forth by an international panel of experts in our field,” stated Bruce L. Wilkoff, M.D., FHRS, CCDS, president of HRS. “This statement, along with other consensus documents issued on an annual basis, is intended to provide a uniformed standard of care with the goal of improving the overall safety and efficacy of patient care around the world.”
For a more information: www.heartrhythmjournal.com
October 10, 2023 
