Cardiac Catheter Ablation and Radioablation

Aetna considers cardiac catheter ablation medically necessary for specified atrial tachyarrhythmias when criteria are met—including survivors of sudden cardiac death from atrial flutter/fibrillation without an accessory pathway; dual‑chamber pacemaker patients with pacemaker‑mediated tachycardia not amenable to drugs or reprogramming; symptomatic atrial tachyarrhythmias that are drug‑resistant, drugs are not tolerated, or the patient declines drugs (even if ventricular rate can be controlled), symptomatic tachyarrhythmias with inadequately controlled ventricular rates, and symptomatic non‑paroxysmal junctional tachycardia that is drug‑resistant/intolerant/declined. All other indications are considered experimental/investigational and not covered (examples: benign non‑sustained VT without symptoms, hypertrophic cardiomyopathy, multifocal atrial tachycardia, and AV junction ablation with pacemaker for drug‑refractory AF) due to insufficient evidence.

"Documentation that member is symptomatic (when applicable) and that symptoms are attributable to the arrhythmia"