Key points to remember when performing cardiac ablations in ASCs

May 14, 2026 - 03:38

When the Centers for Medicare and Medicaid Services finalized coverage for cardiac ablations performed in ambulatory surgery centers, experts from the Heart Rhythm Society and the American College of Cardiology stepped in with guidance on how to do these procedures safely. One of the cardiologists behind that official advice recently shared some critical takeaways.

First, patient selection is everything. Not every patient is a good candidate for an ASC setting. The ideal patient has a straightforward arrhythmia, like typical atrial flutter or a simple supraventricular tachycardia. Complex cases, such as those involving ventricular tachycardia or patients with significant heart failure, should stay in a hospital.

Second, the facility must have a clear plan for emergencies. Even in a simple ablation, there is a risk of cardiac tamponade or stroke. The ASC needs immediate access to a pericardial drain, a defibrillator, and a code cart. Staff must drill on emergency protocols regularly. If a patient needs urgent transfer to a hospital, the route and transport team should be prearranged.

Third, anesthesia matters. Deep sedation is common, but the team must avoid agents that could trigger arrhythmias. Communication between the electrophysiologist and the anesthesiologist is key, especially when mapping the heart.

Finally, follow-up care cannot be an afterthought. Patients should be monitored for at least two hours after the procedure, and they need clear instructions on what symptoms warrant a call to the doctor or a trip to the ER. The bottom line is that ASCs can offer convenience and lower costs, but only if the team sticks to strict safety protocols.