Cardiology
Breakthrough Mapping
Technology Helps Target
Treatment of Atrial Fibrillation
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Atrial fibrillation is a heart rhythm disorder where a person’s heart veers unpredictably from its usual rhythm. For those it affects, the condition can be both terrifying and dangerous. When left untreated, it can cause heart failure and stroke.
A minimally invasive treatment called ablation can help but, until recently, doctors had no way to locate for certain the areas in the heart that cause the unsteady rhythm. Patients often had to undergo multiple procedures before they could get relief.
Now, a breakthrough mapping technology called FIRM ablation, developed by Stanford cardiologist Sanjiv Narayan, MD, PhD, has addressed this challenge by enabling doctors to locate and neutralize the precise source of a patient’s arrhythmia.
Paul J. Wang, MD, professor of cardiovascular medicine
Under the leadership of Paul Wang, MD, Stanford’s Cardiac Arrhythmia Physicians have completed more than 400 FIRM procedures, more than any other medical center in the world.
When patient Susan Klein first felt her heart stop, she was terrified. Her initial research into available treatments discouraged her– until she learned about FIRM ablation.
Benefits of FIRM-Guided Ablation
FIRM ablation is now a common procedure at Stanford. It is often used to treat routine and severe cases of atrial fibrillation. The advantages of FIRM ablation over traditional ablation include:
- Faster treatment - FIRM streamlines the ablation procedure so it can be done quickly and more efficiently.
- Faster recovery - The ability to pinpoint and neutralize the problem provides more precise and effective treatment, protecting nearby healthy tissue. Focused treatment can reduce the recovery time.
- Better outcomes - FIRM ablation increases the odds that Afib symptoms will be corrected with just one procedure and reduces the likelihood of repeat procedures.
Computerized map of the electrical sources of a patient's arrhythmia
Physician’s Research Advances Standard of Care for AFib
Sanjiv Narayan, MD, PhD, professor of cardiovascular medicine
As a physician and software engineer, Sanjiv Narayan, MD, PhD, was intrigued by an important question — Was it possible to map the chaos of atrial fibrillation?
Starting in 2001, Narayan began using engineering and software modeling to explore ways to track the sources of atrial fibrillation.
His analyses and patient studies revealed patterns pointing to small, localized areas driving the disruptive electrical activity behind Afib. Dr. Narayan’s research confirmed that these spots, called rotors, were the origins of the chaotic electrical activity causing Afib. Though experimental studies had shown evidence of such sites, his work was the first to confirm their existence in patients with the actual disorder.
Drawing on his expertise in computers and neurophysiology, Dr. Narayan collaborated with colleagues to develop the FIRM mapping software and the elegant electric signal analysis used for FIRM ablation.
In 2009, his team performed the first FIRM-guided ablation of atrial fibrillation, using the technology he invented.
Today Dr. Narayan and his colleagues at the Stanford Cardiac Arrhythmia Service continue to improve this technology by collaborating with bioengineers and other scientists at Stanford University.
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