Full report from the first annual Heart Rhythm Society Research Forum: a vision for our research future, "dream, discover, develop, deliver".

The Heart Rhythm Society (HRS) organized a research forum held on December 14–15, 2010, to develop a vision for future arrhythmia research and to design practical approaches to ensure these visions are realized. The goal of the present communication is to summarize the discussions and recommendations of this research forum. The core purpose of the HRS is to improve the health of patients with heart rhythm disorders.1 In addition to the ability to end death and suffering due to bradycardia by implanting cardiac pacemakers, members of this society were largely responsible for the invention and refinement of implantable cardioverter-defibrillators (ICDs), radiofrequency catheter ablation techniques, surgical treatment of cardiac arrhythmias and improved strategies of drug therapy. Multiple clinical trials have been performed by Society members to evaluate and document the effectiveness of therapeutic approaches to various cardiac arrhythmias. Despite these advances, heart rhythm disorders remain a major cause of mortality and morbidity in United States and in other parts of the world. Sudden cardiac death (SCD) continues to claim more than 250,000–400,000 U.S. lives annually,2,3 accounting for 15–20 percent of all deaths.4,5 Over 50 percent of all of coronary heart disease deaths are sudden, occurring out-of-hospital and in the emergency room,6 and survival rates from cardiac arrest remain poor.7 At the same time, the percentage of the population afflicted with atrial fibrillation (AF) is growing exponentially.8,9 An estimated 5.1 million people are diagnosed with AF in the United States at present, and this number is expected to rise to 7.5 million by 2020 and to 12.1 million by 2050.10 The population afflicted with AF is further affected by the clinical sequelae of AF, which include thromboembolic stroke,11 heart failure (HF),12 cognitive dysfunction,13 increased mortality,2 and a lower quality of life.14 Therefore, despite our best current efforts, heart rhythm disorders remain major public health problems. In 2009, HRS embarked upon a bold strategic plan with the “big audacious goal” of “ending death and suffering due to heart rhythm disorders.” To achieve this ambitious goal, fundamental advances in our understanding of arrhythmia mechanisms are needed to facilitate the effective treatment and/or prevention of arrhythmias in our patients. Thus, research was identified as a top priority.1,15 Several HRS initiatives were proposed, including efforts to establish a more robust research funding portfolio targeting early stage and transitional investigators, expanding the research focus during the Annual Scientific Sessions and more complete integration of biomedical investigation into the fabric of the Society—in short, to establish a sustainable research culture. To ensure that heart rhythm research receives sufficient attention from its membership, the Society organized a research forum held on December 14–15, 2010. The goal of the forum was to develop a vision for future arrhythmia research and to design practical approaches to ensure these visions are realized. Attendees included HRS members and stakeholders in arrhythmia research, as well as representatives from the National Institutes of Health (NIH), National Heart, Lung and Blood Institute (NHLBI), the American Heart Association (AHA), Food and Drug Administration (FDA), Centers for Medicare & Medicaid Services (CMS), industry, patient care organizations, patient advocacy groups and affiliated scientists. Representatives from the European and Asian Pacific Heart Rhythm Associations also participated in the discussion. The attendees reaffirmed that “Ending death and suffering due to heart rhythm disorders” is the goal of HRS, and that this audacious goal can only be achieved through collaborative efforts between scientists and clinicians interested in heart rhythm research. While the forum was mainly convened to address American research, many of the issues raised cross geographic and political boundaries and the recommendations may also be readily transportable to other jurisdictions. In his opening remarks, 2010–2011 Heart Rhythm Society President Douglas L. Packer, MD, emphasized how creating a research culture within the Society will require the participation of all Society members in each step of the research process. While research scientists play a paramount role in this process, each individual clinician must embrace the concepts critical to progress in research. The following is a summary of the discussions in the Research Forum.