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Get your rhythm back.

Serious heart rhythm disorders called arrhythmias, affect the lives of millions of people daily. Unfortunately, most treatments for these conditions are generic and one-size-fits-all, with mixed results.


But there’s hope.


We believe there is a better way to address serious heart rhythm disorders such as atrial fibrillation and ventricular tachycardia. Using Abbott Electrophysiology’s technology, doctors can identify the sources of arrhythmias that are unique to each person. Now treatment can be tailored to your individual needs.


Find Your Source.
Get Tailored Therapy.
Get Your Rhythm Back.

Find a doctor near you who is using the Topera Rotor Mapping System

The most common heart rhythm disorder, atrial fibrillation (AF, or afib) is a serious global public health problem which affects millions of people around the world. If left untreated, AF doubles the risk of heart-related deaths and also increases stroke risk by up to 500%. Unfortunately, although it is such a serious health problem, AF has historically been difficult to treat with an acceptable degree of success.

In response to this unaddressed need, Abbott, Inc. has developed a unique 3D analysis and mapping solutions (the Abbott 3D Mapping System), which consists of the RhythmView Workstation and FIRMap diagnostic catheter. The Abbott 3D Mapping System has been designed to enable physicians to view the electrical activity of the heart, thereby supporting the diagnosis and patient-specific treatment planning for a variety of heart arrhythmias including atrial fibrillation, atrial flutter, atrial tachycardia and ventricular tachycardia.

The Abbott 3D Mapping System received FDA Clearance in 2013 band is now in routine use at several leading medical centers throughout the United States.

On-Treatment Analysis

On-Treatment Analysis of CONFIRM1


study2FIRM-guided therapy has demonstrated success at eliminating rotors and reducing the need for additional Afib treatments including multiple heart ablation procedures.

Objective

The study authors hypothesized that ablation of stable atrial fibrillation (AF or Afib) sources, either directly by focal impulse and rotor modulation (FIRM) or coincidentally when anatomical ablation passes through AF sources, may explain long-term freedom of AF.

Background

It is unclear why conventional anatomical AF ablation can be very effective in some patients yet ineffective in others with similar profiles.

Methods

The CONFIRM trial2 prospectively showed stable AF rotors or focal sources in 98 of 101 subjects with Afib at 107 consecutive ablation cases. In a 1:2 fashion, subjects received targeted source ablation (FIRM-guided therapy) then conventional ablation, or conventional ablation alone. The authors determined if ablation lesions on electroanatomic maps passed through AF sources on FIRM maps. The only exclusion was a patient’s inability or refusal to provide specific, written informed consent.

Key Findings

  • More than half of rotors were outside of the areas typically ablated with traditional PVI (pulmonary vein isolation)
  • The successful elimination of rotors was directly correlated with success, namely single-procedure freedom from AF

Conclusions

The eradication of stable AF rotors and focal sources may explain freedom from AF after diverse approaches to heart ablation procedures. Patient-specific AF source distributions are consistent with the reported success of specific anatomical lesion sets, and of widespread ablation. These results support targeting AF sources to reduce unnecessary ablation, and motivate studies on FIRM-only ablation.


  1. Narayan SM, Krummen DE, Clopton P, Shivkumar K, and Miller JM. Direct or Coincidental Elimination of Stable Rotors or Focal Sources May Explain Successful AF Ablation: On-Treatment Analysis of the CONFIRM Trial. J Am Coll Cardiol. 2013; 60(2):138-47.
  2. Narayan SM, Krummen DE, Shivkumar K, Clopton P, Rappel W-J, and Miller JM. Treatment of Atrial Fibrillation by the Ablation of Localized Sources-CONFIRM (Conventional Ablation for Atrial Fibrillation With or Without Focal Impulse and Rotor Modulation) Trial. J Am Coll Cardiol 2012; 60(7):628-3

 

These trials were supported by grants to the lead author from the National Institutes of Health and the Doris Duke Charitable Foundation. Please refer to the study citations to review all reported author conflicts of interest.