The Centers of Medicare and Medicaid Services (CMS) closed for public comment the proposed list of topics for potential National Coverage Determinations (NCD) on September 28, 2008. The list of potential NCDs, released in July, included a range of procedures, drugs, biologic and medical device products, one of which was catheter ablation for treatment of atrial fibrillation (AF).

CMS invited comments from a wide variety of stakeholders to determine if there is adequate evidence to demonstrate health benefits in the patients who receive catheter ablation therapy for the treatment of AF because they have either failed pharmacologic treatment or are intolerant to anti-arrhythmic drugs.

In response to this request, the Society submitted a comment letter signed by Society President N.A. Mark Estes, III, MD, FHRS. The letter details health benefits in the patients who received an ablation for AF, supported by five randomized controlled clinical trials that compared pulmonary vein isolation with an anti-arrhythmic medication, and the ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation, as well as the HRS/EHRA/ESC Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: "For selected patients with AF in whom medication is not effective or not tolerated, catheter ablation is the preferred management option. The substantial body of completed and published observational data and randomized trails supports this position...Consequently, continued Medicare coverage for this procedure is essential."

» Download Heart Rhythm Society comment letter(PDF, 125K)