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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.

Healthcare Providers

Afib Treatment Challenges & Solutions

Effectively managing patients with atrial fibrillation (AF or Afib) is one of the biggest challenges facing cardiac medicine. For many years, treatment for Afib was limited to anticoagulant and anti-arrhythmic agents. Despite the recent development of new pharmacologic treatments, these options have not reduced complications.1,2

Ablation & Atrial Fibrillation

Over the past 15 years, cardiac ablation has been established as a treatment option and is often used by cardiac electrophysiologists. The current treatment strategy is to isolate the pulmonary veins (PVs) of the left atrium. Ablation for atrial fibrillation targets isolation of the foci firing from the PVs and triggers the abnormal activity during an Afib episode.

Three-Dimensional Mapping

Cardiologist using a medical interface

Today’s ablation for atrial fibrillation also requires a good representation of the left atrial anatomy and the PVs. This is achieved by utilizing mapping systems that are capable of integrating pre-acquired images from either a CT or MRI. Ablation technologies have also improved by using either radiofrequency-irrigated catheters or cryogenic balloons.

However, isolation of PVs alone is often suboptimal as many Afib patients require multiple ablations.6-8 Most physicians agree that an additional ablation strategy is required. The most common of these strategies include:

  • Roof line ablation
  • Left sided (mitral) isthmus
  • Isolation of the superior vena cava
  • Isolation of left atrial appendage
  • Cavo-tricuspid line
  • Complex fractionated electrograms or CFAE

Electrophysiologists generally choose a strategy based on an individual patient’s needs and the type of atrial fibrillation. Despite the increase in the number of ablation options and their frequency, outcomes have not significantly improved.6-8 Two questions remain: Is anatomical ablation enough for treatment of Afib and how important is a better understanding of mechanisms that cause Afib?

Identifying Afib at the Source

A new mechanistic approach to treating Afib has emerged. In contrast to the common anatomical strategy of PVI, it offers diagnostic capabilities that are individualized to each patient. Patients are selected for ablation only if the diagnostic or mechanistic part indicates and presents personalized targets.

The Topera® Rotor Mapping Solution

This new approach is achieved using the Topera Rotor Mapping Solution, which includes FIRMap®, a diagnostic basket catheter that is connected to the RhythmView® Workstation. FIRMap has 64 evenly spaced electrodes, distributed between 8 splines and is inserted into the right and then left atrium sequentially, in order to identify rotational waves (rotors) creating surrounding disorganized electrical activity or fibrillation. Once FIRMap collects the electrical activity, it transfers the information to the RhythmView Workstation for signal processing and provides a visual representation of the electrical maps, allowing the identification of rotors. Physicians then use this information in combination with other systems in the EP lab to determine the appropriate treatment. If cardiac ablation is indicated, they may use any ablation device to address the selected locations. Additional diagnostic electrical maps are acquired and the process repeated until the elimination of all rotors is confirmed. This new technology is capable of identifying rotors but most importantly, confirms elimination of rotors.9-11

  1. Van Gelder IC, Groenveld HF, Crijns HJ et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med 2010;362:1363-73.
  2. Roy D, Talajic M, Nattel S et al. Rhythm control versus rate control for atrial fibrillation and heart failure. N Engl J Med 2008;358:2667-77.
  3. Oral H, Pappone C, Chugh A et al. Circumferential Pulmonary-Vein Ablation for Chronic Atrial Fibrillation. N Engl J Med 2006;354:934-941.
  4. Wilber DJ, Pappone C, Neuzil P et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA 2010;303:333-40.
  5. Morillo C, Verma A, Kuck KH et al. Radiofrequency Ablation Vs Antiarrhythmic Drugs As First-line Treatment Of Symptomatic Atrial Fibrillation: (RAAFT 2): A Randomized Trial (Late Breaking Abstract). Heart Rhythm 2012;9.
  6. Nademanee K, McKenzie J, Kosar E et al. A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate. J Am Coll Cardiol 2004a;43:2044-2053.
  7. Tanner H, Hindricks G, Kobza R et al. Trigger activity more than three years after left atrial linear ablation without pulmonary vein isolation in patients with atrial fibrillation. J Am Coll Cardiol 2005;46:338-43.
  8. Yao Y, Zheng L, Zhang S et al. Stepwise linear approach to catheter ablation of atrial fibrillation. Heart Rhythm 2007;4:1497-504.
  9. Narayan SM, Krummen DE, Shivkumar K, et al. 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 Cardiovasc Electrophysiol. 2012; 60(7):628-636.
  10. Narayan SM, Baykaner T, Clopton P, Schricker A, Lalani G, Krummen DE, Shivkumar K, Miller JM, Ablation of Rotor and Focal Sources Reduces Late Recurrence of Atrial Fibrillation Compared to Trigger Ablation Alone, Journal of the American College of Cardiology (2014), doi: 10.1016/j.jacc.2014.02.543.
  11. 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.