New targeting technology improves outcomes for patients with atrial fibrillation

As a comparison, conventional catheter procedures were performed in a second group of patients. Since this approach is less targeted, it involved hours of treatment over larger regions in the heart and often did not shut down the atrial fibrillation.

To track outcomes, patients received an implanted ECG monitor that very accurately assessed their heart rhythms over time. The researchers found that after two years, the FIRM-guided group had an 82.4 percent freedom from atrial fibrillation episodes, compared with only 44.9 percent freedom in the group that received standard therapy.

"We are very excited by this trial, which for the first time shows that atrial fibrillation is maintained by small electrical hotspots, where brief FIRM guided ablation can shut down the arrhythmia and bring the heart back to a normal rhythm after only minutes of ablation," said lead author Sanjiv Narayan, a professor of medicine at UC San Diego, visiting professor at the UCLA Cardiac Arrhythmia Center, and director of electrophysiology at the San Diego Veterans Affairs Medical Center.

"The results of this trial, with an 80 percent ablation success rate after a single procedure, are very gratifying," said study author Kalyanam Shivkumar, director of the UCLA Cardiac Arrhythmia Center and a professor of medicine and radiological sciences at UCLA. "This is the dawn of a new phase of managing this common arrhythmia that is mechanism-based."

The science behind
From UC San Diego: These discoveries, owned by the Regents of the University of California, were then licensed to a startup company, Topera Medical, which has recently obtained clearance from the Food and Drug Administration for the mapping system it developed from this early science, called RhythmView.

Narayan is a co-founder with equity interest in Topera. Study author Wouter-Jan Rappel from the UC San Diego Department of Theoretical Biological Physics holds equity interest in Topera. Study author Shivkumar of UCLA is an unpaid advisor to Topera. John Miller, chief of electrophysiology at Indiana University, has received modest consulting fees from Topera.
Additional study authors included David Krummen, associate professor of medicine and associate director of electrophysiology fellowship training at the UC San Diego School of Medicine and associate director of the San Diego Veterans Affairs Medical Center, and Paul Clopton from the San Diego Veterans Affairs Medical Center Department of Statistics. They have no financial disclosures.