Feature | May 16, 2013

Multiple Studies Show Promise for Innovative FIRM Rotor Mapping Method

New mapping method could greatly improve and shorten AFib ablation procedures, but debate persists over question of rotor mobility

May 16, 2013 — New research presented at Heart Rhythm 2013 continues to show promising results for focal impulse and rotor modulation (FIRM) mapping to effectively target atrial fibrillation (AF) sources and improves ablation therapy outcomes. The novel diagnostic real-time mapping system helps target ablation therapy to patient-specific drivers of AF rather than to anatomical targets, which can improve patient outcomes.

More than 2 million people in the United States have AF, a common heart rhythm disorder which causes an irregular and rapid heartbeat. Although it is not life threatening, AF can lead to other problems including chronic fatigue, congestive heart failure and stroke.

“This new procedure has the potential to dramatically change how we treat patients with atrial fibrillation,” said Vijay Swarup, M.D., FHRS, director of cardiac electrophysiology at Arizona Heart Hospital. “New findings help us better understand that small electrical spinning tops – rotors – or focal sources drive AF, the stability of these sources and exactly where to treat them.”

New research builds on the CONFIRM trial findings from 2011 that first showed AF was acutely terminated or substantially slowed with less than 10 minutes of FIRM-guided ablation per identified source.

A new study, led by Robert Kowal, M.D., and presented at Heart Rhythm 2013, provides more information on how FIRM-guided ablation effectively treats AF. FIRM mapping was performed in 210 patients at 11 U.S. centers. Ablation was targeted prospectively at rotors or focal sources in 132 consecutive patients, of whom 25 percent had paroxysmal AF and 75 percent had persistent AF. FIRM-guided ablation achieved an acute endpoint in 82.9 percent of patients with ten minutes of total ablation. This included terminating AF and rendering it noninducible in 55.8 percent of patients, in whom the majority (69 percent) terminated to sinus rhythm and 31 percent terminated to atrial tachycardia.

A second study, led by Swarup, used FIRM to map where electrical rotors or focal sources are located in the heart and found that sources exist in diverse stable locations throughout the atria. The 11-multicenter prospective trial mapped AF in 210 consecutive patients, of whom 132 had FIRM-guided ablation at rotor or focal sources of AF. Sources were revealed in 99.2 percent of patients, and more than half of the AF sources were located away from pulmonary veins. These results further confirm the importance of mapping AF sources in each patient compared to traditional pulmonary vein isolation therapy. In FIRM guided patients, AF termination or 10 percent slowing was achieved.

FIRM rotor mapping has spurred some debate in EP because it is believed by some that these rotors move. If they are stationary, the ablations can be very successful, but if they move, as some believe, relief from AF might only be temporary following a FIRM procedure. 

For more information: www.HRSonline.org

Related Content

Alere, INRatio PT/INR Monitor, voluntary recall, FDA
News | Blood Testing| July 12, 2016
July 12, 2016 — Following a collaborative process with the U.S. Food and Drug Administration (FDA), Alere Inc.
anticoagulants, dabigatran, Pradaxa, novel oral anticoagulants, NOACs, rivaroxaban, Xarelto, apixaban, Eliquis
Feature | Antiplatelet and Anticoagulation Therapies| July 12, 2016 | Heidi Olsen, Pharm.D
With the recent introduction of several novel oral...
Abbott, FIRM-guided rotor ablation, atrial fibrillation, clinical studies, Cardiostim 2016
News | EP Mapping and Imaging Systems| July 07, 2016
July 7, 2016 — Abbott recently announced positive results from three clinical studies investigating the benefits asso
AtriCure, FROST cryoanalgesia study, William Beaumont Hospital Michigan, cryoICE system
News | Left Atrial Appendage (LAA) Occluders| July 07, 2016
AtriCure Inc. announced the first patient has been enrolled in the FROST study at William Beaumont Hospital, Dearborn,...
AtriCure, AtriClip PRO2 LAA Exclusion System, CE Mark, left atrial appendage occlusion
News | Left Atrial Appendage (LAA) Occluders| July 05, 2016
AtriCure Inc. announced that it has received CE Mark for the AtriClip PRO2 Left Atrial Appendage (LAA) Exclusion System...
News | Heart Failure| July 05, 2016
A research team has developed a new electric mesh device that can be wrapped around the heart to deliver electrical...
anabolic steroid abuse, ARVC, arrhythmia, stroke, British Cardiovascular Society conference
News | Cardiac Diagnostics| July 01, 2016
Research has already shown that taking anabolic steroids is associated with high blood pressure and an increased risk...
St. Jude Medical, CE Mark, SyncAV CRT, MultiPoint Pacing, CardioStim 2016
Technology | Cardiac Resynchronization Therapy Devices (CRT)| June 28, 2016
St. Jude Medical Inc. announced CE Mark approval and launch of SyncAV CRT software, designed to build upon the company’...
U.K., NHS studies, weekend effect, hospital admission, atrial fibrillation, heart failure
News | Clinical Study| June 28, 2016
New research shows patients admitted to National Health Service (NHS) hospitals in the United Kingdom for atrial...
atrial fibrillation, stroke risk, aspirin vs blood thinners, JACC study
News | Antiplatelet and Anticoagulation Therapies| June 24, 2016
More than 1 in 3 atrial fibrillation (AF) patients at intermediate to high risk for stroke are treated with aspirin...
Overlay Init