There is major market movement underway in the cardiac ablation space, with huge implications for MedTech. In late November, CMS released their CY 2026 OPPS/ASC Final Rule, which adds cardiac catheter ablation to the ASC Covered Procedures List, allowing Medicare to reimburse atrial fibrillation (AF) ablations performed in the ASC setting starting Jan 1, 2026.

At the very same time, the market is experiencing a wave of new pulsed field ablation (PFA) technologies that deliver improved safety, shorter procedure times, and strong atrial fibrillation (AF) efficacy. Together, these two forces are poised to unlock a new growth phase in cardiac ablation.

These shifts won’t just expand the market; they will also reshape competitive dynamics, pressure pricing, and redefine what “winning” looks like for companies in the EP space.

What We’re Hearing From Big PFA Players: Growth Is Accelerating

Across recent earnings calls, the three major PFA players — Boston Scientific, Medtronic, and Johnson & Johnson (Biosense Webster) — signaled strong confidence in PFA as a long-term growth engine.
While each company has its own positioning, the themes are consistent:

• Boston Scientific continues to see strong global uptake of FARAPULSE™, with EP sales reaching $865M in Q3 (up 64% year-over-year), driven by physician enthusiasm and expanding indications. Analysts now consider PFA one of the company’s highest-growth cardiovascular platforms for the decade ahead.
• Medtronic highlighted PulseSelect™ as a strategic pillar of its EP franchise, with double-digit gains in their cardiac ablation portfolio on the strength of their PFA products and underscoring PFA’s safety profile as a key driver of wider adoption and increasing procedure volumes.
• J&J (Biosense Webster) underscored PFA as a major competitive frontier, emphasizing integration with CARTO™ mapping and long-term expansion into broader AF segments.

The message is clear: PFA is not just a new tool — it’s a platform shift with multi-year growth momentum behind it.

Implications for the Market

1. More total ablations, not just re-shuffled ones
EP capacity is constrained in many hospital labs. Allowing AF ablations in ASCs now introduces new procedure capacity, not just new locations. With a lower-acuity site of care and a safer technology, referring cardiologists may be more willing to send symptomatic AF patients earlier, representing a huge growth opportunity.

2. Low-risk AF procedures will shift to ASCs, creating a two-speed market
The market could begin to bifurcate into:

• High-Throughput, Cost-Sensitive ASC EP Labs
  • Focused on straightforward paroxysmal AF and redo cases
  • Prioritizing speed, efficiency, and predictable outcomes
  • Highly sensitive to pricing, staffing efficiency, and room turnover
• High-Acuity Hospital EP Labs
  • Handling persistent AF, complex mapping, VT, and patients with significant comorbidities
  • Maintaining broader EP capabilities but feeling margin pressure as lower-acuity volume shifts out

3. Downward pressure on facility & device economics
ASC reimbursement is typically lower than hospital OPPS, with tighter margins, shorter recovery windows, and more scrutiny on supply costs. This creates natural pricing pressure:

• Lower device ASPs
• More intense evaluation of disposables
• Demand for streamlined workflows and predictable outcomes

This environment favors new PFA tech, which provides shorter procedures, lower complication rates, and fewer repeat procedures. In an ASC, shaving 20–30 minutes off a procedure can be the difference between 3 vs. 4 cases per day per room, directly driving revenue.

As these dynamics intensify, the market will likely see the rise of “focus factories”—high-throughput, highly specialized ASCs designed specifically for AF and simple EP ablations. These centers will prioritize speed, standardization, and predictable PFA workflows, creating even stronger pressure on device pricing, staffing efficiency, and procedural turnover.

What PFA Companies Must Do to Win

1. Build a true ASC value proposition
A compelling ASC value proposition starts with real numbers, not generalities. Companies must move beyond “safer and faster” and quantify the impact of their technology, translating those metrics into ASC-specific economic models and clear selling stories that show why their solution wins in a high-efficiency environment.

2. Adjust pricing & contracting models
New incentives and buyer types require new structures. Consider volume-based pricing tiers for ASC chains, generator leasing + per-procedure disposable bundles, or risk-sharing tied to complication or redo-rates.

3. Re-map the commercial model
Decision-making in ASCs looks different, with new stakeholders involved in the deal. Sales teams need new tools, messaging, and call patterns that speak the ASC language: room turnover, staff utilization, cash flow, capital ROI.

As other specialties have shown, ASC migration can rapidly reshape competition. When orthopedics moved to ASCs, it enabled lower-cost entrants to gain ground, intensifying pricing pressure and causing established players to see meaningful share disruption. EP is likely to experience a similar dynamic, making it critical for companies to adapt their commercial models early.

How S2N Helps MedTech Companies Win in the New Market Reality

1. Build the right go-to-market strategy for an ASC-driven EP market

• Map real-time shifts into ASCs using procedure, referral, and facility-level data.
• Custom dashboards to pinpoint where ablations are occurring now, which geographies are seeing volume migration to ASCs first, and which markets are bottlenecked by ASC availability or Certificate of Need regulations.
• Size the true incremental opportunity so teams know where to invest.
• Map physician–ASC affiliations and identify the early adopter EPs who are most likely to anchor new ASC ablation programs.

2. Quantify the economic advantage of your tech

• Model ASC-specific procedural economics: case throughput, staffing efficiency, device utilization, and per-case contribution margin vs RF/cryo.
• Test & refine evidence-backed value stories that resonate with ASC administrators and physicians.

3. Target the right physicians, sites, and ownership groups

• EPs performing high volumes of paroxysmal AF and redo cases (prime ASC candidates).
• Physicians with strong private-practice referral networks, and high innovation receptivity.
• Sites at risk of leakage that are ready for PFA investment.

5. Optimize resource deployment and messaging

• Redesign territory alignment around ASC clusters and multi-site EP ownership patterns.
• Equip sales with ASC-ready messaging frameworks: throughput, transfer likelihood, complication rates.
• Build ROI calculators, economic models, and in-context pre-call insights that make reps immediately effective.

Ready to capture the opportunity?

See how S2N can help you target the right sites, build ASC-ready economic stories, and deploy a commercial model built for this next era of EP. Book a demo today.