Cardiology groups share new recommendations for performing safe, effective cardiac ablations in ASCs
Two leading cardiology groups, the Heart Rhythm Society (HRS) and American College of Cardiology (ACC), have published a new scientific statement on how to safely, effectively perform cardiac catheter ablation procedures in an ambulatory surgical center (ASC). The full document is available in both Heart Rhythm and the Journal of the American College of Cardiology.[1, 2]
“The evidence shows that when teams implement the right safety standards and workflows, appropriately selected patients can receive high-quality care in a more convenient environment without compromising outcomes,” HRS President Mina K. Chung, MD, a cardiologist with Cleveland Clinic, said in a statement. “These guiding principles aim to help clinicians and health systems adopt this model thoughtfully, safely and responsibly.”
Document follows a key policy update
The timing of the scientific statement could not have been better—it went live on the same day the Centers for Medicare and Medicaid Services (CMS) finalized coverage for cardiac ablations performed in ASCs as part of its 2026 Hospital Outpatient Prospective Payment System and ASC Payment System final rule.
Groups such as HRS, ACC and Heart Rhythm Advocates (HRA), a new advocacy arm of HRS focused on electrophysiology (EP) policies, have been pushing for these procedures to be covered for quite some time. While other cardiovascular procedures were already on the ASC covered procedures list (ASC-CPL), CMS had previously resisted adding cardiac ablation due to safety concerns. As one might expect, those groups—and many others in the EP community—were ecstatic about this update.
“This CMS decision is a tremendous victory for our field and the patients we serve,” HRA Board Co-Chair Kenneth Ellenbogen, MD, said when the news was announced. “Adding EP ablations to the ASC-CPL is the clearest recognition yet of just how far electrophysiology has come—in safety, in quality and innovation. This is a moment our community has worked toward for years, and it reflects the dedication of countless clinicians, advocates and partners who believed this progress was possible.”
Scientific statement co-chair Amit Shanker shares his perspective
“This paper, three years in the making, was developed to analyze available global clinical data, provide a framework for recommended best clinical practices and characterize the evolving reimbursement and regulatory landscape in the context of ASC market dynamics and U.S. fiscal policy,” Amit Shanker, MD, first author and co-chair of this scientific statement, told Cardiovascular Business. “Emerging real-world data from thousands of ASC-based ablations demonstrate complication and transfer rates comparable to or lower than hospital outpatient departments.”
Shanker—who is also an attending physician with the St. Lawrence Health System, an HRA board member, an FDA advisor and chair of the HRS Health Policy and Regulatory Affairs Committee—emphasized that performing ablations in ASCs is associated with lower out-of-pocket costs for patients and shorter wait times. Clinicians, he added, benefit from “high operational efficiency” and “predictable scheduling” that come with working in an ASC.
“However, the successful scalability of this model is currently hindered by regulatory fragmentation, workforce recruitment challenges and existing reimbursement disparities,” Shanker said. “Moreover, in select regions in the United States, a rapid and sustained shift in procedural volumes could paradoxically reduce healthcare access by creating economic and workforce strain on local hospitals. To mitigate any unintended harm to vulnerable communities, our statement calls for collaborative, data-driven policies that expand access and efficiency while safeguarding system-wide capacity for complex and emergent cardiac care.”
Click here to read the full document in Heart Rhythm. Click here to read it in the Journal of the American College of Cardiology.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.