Long-term Follow-up of FIRM-guided Ablation of Atrial Fibrillation: A Single-center Experience 1
This is a large 80 patient study with 2 years of follow-up. The majority of patients had persistent AF (75% persistent, with 18% being long-standing persistent) and other high-risk co-morbidities such as sleep apnea and heart failure.
The location and distribution of rotors identified and long-term results were consistent with those identified with previously published results of FIRM-guided ablation.234
A large percentage of LA rotors were identified outside the PVs and the posterior wall.
A much lower incidence of focal sources were identified (~4%) which is consistent with the results reported in the Multicenter Registry.3
RA rotors were identified in a high percentage of patients, thereby reinforcing the importance of the right atrium in the treatment of atrial fibrillation.
Finally, the results indicate that the elimination of rotors is an effective endpoint.
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- Gery Tomassoni, MD, Sandeep Duggal, DO, Melody Muir, RN, Lynn Hutchins, RN, Keri Turner, CCS, Ann Marie Mcloney, RN and Aaron Hesselson, MD. Long-term Follow-up of FIRM-guided Ablation of Atrial Fibrillation: A Single-center Experience. Journal of Innovations Cardiac Rhythm Management. (2015), 2145–2151.
- Narayan SM, Krummen DE, Shivkumar K, Clopton P, Rappel W-J, Miller J. Treatment of atrial fibrillation by the ablation of localized sources: The Conventional Ablation for Atrial Fibril-lation With or Without Focal Impulse and Rotor Modulation: CONFIRM Trial. JAmCollCardiol.2012;60(7):628–636.
- Narayan SM, Clopton P, Krummen DE, Shivkumar K, Miller J. Direct or coincidental ablation of localized sources may
explain the success of atrial fibrillation ablation. On-treat-ment analysis from the CONFIRM trial. J Am Coll Cardiol.
- Miller JM, Kowal RC, Swarup V, et al. Initial independent outcomes from focal impulse and rotor modulation ablation for
atrial fibrillation: Multicenter FIRM registry. J Cardiovasc Electrophysiol. 2014;25(9):921–929.