November 24, 2025—The Heart Rhythm Society (HRS) and the American College of Cardiology (ACC) partnerd to develop the HRS/ACC Scientific Statement: Guiding Principles on the Performance of Intracardiac Ablation Procedures in Ambulatory Surgical Centers.
As advances in electrophysiology (EP) technology, procedural safety, and care delivery models continue to evolve, ambulatory surgical centers (ASCs) are emerging as a potential setting for selected intracardiac ablation procedures.
This scientific statement reviews clinical evidence and real-world experience supporting the performance of intracardiac ablation procedures in ASCs. Available data demonstrate low complication and transfer rates, with outcomes comparable to hospital-based procedures when patients are appropriately selected.
The document emphasizes that successful implementation of ASC-based ablation programs requires a structured approach to case selection, procedural planning, and facility readiness, with patient safety as the primary consideration.
Figure 3 illustrates key considerations for case selection in ambulatory surgical centers, including patient, procedural, operator, and facility factors that influence whether a case is most or less favorable.
Key elements include:
- Careful patient and case selection based on clinical complexity and comorbidities
- Facility requirements, including equipment, staffing, and proximity to hospital-based care
- Standardized protocols for periprocedural management, monitoring, and discharge
- Emergency preparedness and defined transfer pathways for managing complications
- Quality assurance processes, including outcomes tracking and continuous improvement
A central theme throughout the statement is the importance of maintaining high standards of care while adapting to evolving care delivery environments. The document emphasizes shared decision-making and patient-centered care, ensuring that clinical decisions remain driven by patient safety rather than operational or financial considerations. In addition, the statement highlights broader system-level considerations, including regulatory variability, reimbursement challenges, and the need for continued data collection to inform best practices.
Overall, this document provides a practical framework for clinicians and institutions seeking to safely integrate intracardiac ablation procedures into ambulatory surgical center settings.
