Response to Comments: Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease

The policy for Non-Invasive Fractional Flow Reserve for Ischemic Heart Disease was revised after the release of the 2021 AHA/ACC/ASE/CHEST/SAEM/ SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain. It was presented at Open Meeting 2/22/22 and comments received are addressed in this article. Policy L38771 will be in notice period 07/07/2022 to 08/20/2022 and be effective 08/21/2022. References: Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. 2021:CIR. 0000000000001030. Maron DJ, Hochman JS, O'Brien SM, et al. International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial: Rationale and design. Am Heart J. 2018;201:124-135. Vavere AL A-ZA, Rochitte CE, et al. Coronary artery stenoses: accuracy of 64detector row CT angiography in segments with mild, moderate, or severe calcification–a subanalysis of the CORE-64 trial. . Radiology 2011;261:100-108. Collet C, Miyazaki Y, Ryan N, et al. Fractional Flow Reserve Derived From Computed Tomographic Angiography in Patients With Multivessel CAD. Journal of the American College of Cardiology. 2018;71(24):2756-2769. De Bruyne B, Pijls NH, Kalesan B, et al. Fractional flow reserve–guided PCI versus medical therapy in stable coronary disease. J New England Journal of Medicine. 2012;367(11):991-1001. Michail M, et al. CAST-FFR study, Feasibility and Validity of Computed Tomography - Derived Fractional Flow Reserve in Patients with Severe Aortic Stenosis: Circulation. Cardiovascular Interventions. 2021;14(1). Collet C, Miyazaki Y, Ryan N, et al. Fractional Flow Reserve Derived From Computed Tomographic Angiography in Patients With Multivessel CAD. J Am Coll Cardiol. 2018;71(24):2756-2769.