Mapping and ablation of electrical rotor and focal sources for atrial fibrillation: A patient-tailored mechanistic approach

Junaid A.B. Zaman, Siva K. Mulpuru, David E. Krummen, Sanjiv M. Narayan

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

This chapter illustrates electrical rotors in human atrial fibrillation (AF) and differences from atrial flutter on focal impulse and rotor mapping (FIRM) mapping. It displays the clinical characteristics of the patient group. Persistent AF was present in 81% of the FIRM-guided group, and in 66% of the FIRM-blinded group.It presents the nomenclature of FIRM maps, in which the left atrium is opened at its "equator" and the right atrium is opened along a meridian. Mapping analyzes contact electrograms, which are the reference standard for signal fidelity, using recently reported human rate-response properties of atrial repolarization and regional conduction. In FIRM-guided subjects, ablation commenced with the elimination of AF rotors or focal sources using various radiofrequency sources. CONFIRM and recent confirmatory multicenter studies of FIRM were not randomized, although subjects were enrolled and treated prospectively for prespecified end points.

Original languageEnglish (US)
Title of host publicationPractical Guide to Catheter Ablation of Atrial Fibrillation
Subtitle of host publicationSecond Edition
PublisherWiley-Blackwell
Pages271-282
Number of pages12
ISBN (Electronic)9781118658369
ISBN (Print)9781118658505
DOIs
StatePublished - Dec 5 2015

Keywords

  • Atrial fibrillation
  • Electrical rotors
  • Electrogram
  • FIRM ablation
  • FIRM mapping

ASJC Scopus subject areas

  • Medicine(all)

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