In January, CMS put cardiac ablation on the ASC Covered Procedures List. By summer, Medtronic reported 137% U.S. growth in ablation, Boston Scientific and Abbott raised guidance, and pulsed field ablation was tracking toward a $6 billion market by 2031.
I wrote about this a few months ago and the response from cardiologists, EPs, anesthesiologists, cath lab leaders, and operators sharpened the thesis. Here is what the first year of outpatient ablation has taught us.
Patients were always going to take a definitive treatment for their arrhythmia at half the cost, outside a hospital. What held it back was two decades of payment policy that pulled roughly 90% of U.S. cardiologists into hospital employment, constrained access, and raised prices. That policy is reversing, and volume is moving the moment it does.
Outpatient ablation is flowing to centers built by, or in partnership with, independent cardiologists who saw this coming. Device companies are now partnering with physician-led GPOs to put next-generation technology in independent ASCs. Self-funded employers are starting to contract directly with those centers. The vendors and the payers are following the volume.
In Certificate of Need states, new cardiac ASCs are rare and often majority hospital-owned. The cost lands on communities where patients wait months, drive two hours, or sit in a hospital bed waiting for an open cath lab slot. Care this essential should live close to the patients who need it. Added capacity in these markets is the whole point.
The right question we heard: is there still room for careful patient selection? Yes, and it is everything. Early multicenter data show complication rates in cardiac ASCs comparable to hospitals, and that result comes from disciplined selection criteria built in from day one. Our ASC Director, Christine Hagan, described the approach in Becker’s ASC Review. Cheaper and more accessible only matters if it is also equally safe and effective.
Clinical teams go where their skills are valued, and physician-led ASCs offer exactly that. On technology, build lean and around the clinical workflow; do not import the hospital’s legacy hardware footprint into a setting designed to escape it. Both expand capacity safely. Neither creates demand. The demand was already there.
The outpatient shift is the biggest structural tailwind independent EP groups have seen in years. The question now is who builds the operational and capital infrastructure to capture it. That is what Atria does: we partner with independent, physician-owned cardiology groups and supply that infrastructure, so the physicians who saw this coming are the ones who benefit.
The EP market just got a lot more interesting.
