Question · Q3 2025
Peter Chickering inquired about the proposed reimbursement for AF ablation in Ambulatory Surgical Centers (ASCs) for next year, asking what proportion of AF ablations could shift to ASCs and how this increased capacity might fuel additional market growth.
Answer
Chairman and CEO Mike Mahoney noted strong interest in ASCs in states without certificate of need, such as Arizona and Florida, which he believes will help address hospital backlogs for Therapulse. He anticipates an increasing trend in 2026 and over the LRP, estimating that 40% of U.S. AF ablations are in states not requiring a certificate of need. Mahoney emphasized Boston Scientific's unique position to succeed in this market due to Therapulse's reliability, favorable COGS/gross margin profile, and complementary cardiovascular products. Chief Medical Officer Dr. Ken Stein added that while ASC build-out will be a slow ramp, the Therapulse ecosystem is well-suited for these procedures. Mike Mahoney concluded that the PFA journey is still in early innings, with opportunities for new account openings, deeper physician penetration, and increased Watchman training for electrophysiologists, making ASCs crucial for managing future volume demands.