Catheter ablation procedures for supraventricular tachyarrhythmia (SVTA) including atrial flutter, atrial fibrillation

Policy context

Catheter ablation is a procedure used to treat some types of heart arrhythmias (variations from a normal heartbeat). The HCA has selected ablation therapies for supraventricular tachyarrhythmia including atrial flutter and atrial fibrillation for review. The topic was nominated based on high levels of concern around efficacy and cost, and on medium levels of concern around safety.

Status: Decision completed

Primary criteria ranking

  • Safety = Medium
  • Efficacy = High
  • Cost = High

Assessment timeline

  • Draft key questions published: August 15, 2012
  • Public comment period: August 15 to August 31, 2012
  • Draft report published: March 5, 2013
  • Public comment period: March 5 to April 5, 2013
  • Final report published: April 15, 2013
  • HTCC public meeting: May 17, 2013


Catheter ablation is a procedure used to treat some types of heart arrhythmias. The procedure is typically performed in a catheter lab and involves guided insertion of catheters from the arm, groin, or neck through the blood vessel and into the heart. In radiofrequency catheter ablation, radiofrequency energy is sent through the catheters to a focal point in the heart that is believed to be the source of the arrhythmia; this energy ablates (destroys) very small areas of the heart to disrupt conduction of abnormal electrical activity. Other types of catheter ablation are becoming available, such as cryoablation. Cryoablation is cooling and freezing of the targeted tissue to alter abnormal electrical activity. Catheter ablation is most commonly used to treat tachyarrhythmias that originate above the ventricles.