FIRM for A-Fib

Monday, November 28, 2016
SAN FRANCISCO. (KFSN) -- Atrial fibrillation is the most common heart rhythm ailment, affecting more than two million people in the U.S.

It's an electrical problem that prevents the heart from pumping blood correctly. Doctors often treat it by ablating, or zapping, the trouble spot, but that doesn't always work. Now a new technique is pinpointing the exact source of the problem and improving the treatment odds.

Sixty-six-year-old Bob Westlund couldn't have done this a year and a half ago.

"When I've been in AFib, my energy levels are terrible," detailed Westlund.

Sanjiv Narayan, M.D., a professor of medicine at Stanford Arrhythmia Center in San Francisco, California, used a new mapping technique on Westlund: focal impulse and rotor modulation, or FIRM. Atrial fibrillation appears to send out chaotic waves, but Dr. Narayan's FIRM electrical mapping software shows there is actually a pattern, kind of like the eye of a hurricane.

Dr. Narayan and his team use FIRM mapping to zero in on the rotors, the centers of those spirals, which are sending out electrical waves, then zaps them with heat.

"What we have seen is if you take a standard PVI ablation procedure, often quoted as having a success rate of 50-60 percent, we can add 20 percent to that," Dr. Narayan told Ivanhoe. (Read Full Interview)

Westlund, who's a retired engineer, appreciates the cutting edge science, but mostly, he's glad he feels well enough to garden and walk with his dog.

"Heart rate keeps up with me. It doesn't accelerate madly," said Westlund.

After decades of living with AFib, Westlund is optimistic it's gone for good.

FIRM mapping does add about an hour to the ablation process and Dr. Narayan said the firm technique is not perfect. His team is still working on ways to improve the outcome.
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