HRS/ACC scientific statement: Guiding principles on the performance of intracardiac ablation procedures in ambulatory surgical centers.

Ambulatory surgical centers (ASC) in the United States have emerged as an innovative model in health care delivery, potentially serving as a cost-effective, patient-centric alternative to traditional hospital-based care. Supported by Centers for Medicare & Medicaid Services policy expansions, ASCs accommodate procedures across specialties from orthopedics to interventional cardiology. By leveraging technological/procedural advancements and same-day discharge protocols, appropriately selected procedures in the field of cardiac electrophysiology (such as intracardiac ablation procedures and cardiac implantable electronic device implants) could increasingly shift to an ASC setting. This transition aligns with a growing clinical need for arrhythmia interventions and a broader push for operational efficiency. A mounting body of evidence supports the feasibility of performing intracardiac ablation procedures in the ASC setting, with an ongoing need for clinical investigation to track outcomes. Additional barriers to scalable clinical adoption exist, such as regulatory fragmentation, workforce challenges, and heterogeneity in reimbursement. As such, performance of intracardiac ablation procedures in the ASC setting will require collaboration among stakeholders (clinicians, policymakers, payers, and advocacy groups) to investigate and ensure safety and effectiveness, harmonize payment policies, prioritize equitable access, and embed rigorous quality assurance frameworks. By integrating data-driven protocols, clinical excellence, and ethical practices, ASCs could fulfill a defined adjunctive role in a value-based health care system, assuring high-quality care without compromising patient safety while improving access.