Long-term clinical outcomes of focal impulse and rotor modulation for treatment of atrial fibrillation: A multicenter experience.


BACKGROUND:New approaches to ablation of atrial fibrillation (AF) include focal impulse and rotor modulation (FIRM). Studies of this technology with short-term follow-up have shown favorable outcomes. OBJECTIVE:The purpose of this study was to characterize the long-term results of FIRM ablation in a cohort of patients treated at 2 academic medical centers. METHODS:All FIRM-guided ablation procedures (n = 43) at UCLA Medical Center and Virginia Commonwealth University Medical Center performed between January 2012 and October 2013 were included for analysis. During AF, FIRM software constructed phase maps from unipolar atrial electrograms to identify putative AF sources. These sites were targeted for ablation, along with pulmonary vein isolation in 77% of patients. RESULTS:AF was paroxysmal in 56%, and 67% had prior AF ablation. All patients had rotors identified (mean 2.6 ± 1.2 per patient, 77% in LA). Prespecified acute procedural end-point was achieved in 47% of patients (n = 20): AF termination in 4, organization in 7, >10% slowing of AF cycle length in 9. Acute complications occurred in 4 patients (9.3%). At 18 ± 7 months of follow-up, 37% were free from documented recurrent AF after a 3-month blanking period; 21% were free from documented atrial tachyarrhythmias and off antiarrhythmic drugs. Multivariate analysis did not reveal any significant predictors of AF recurrence, including pattern of AF, acute procedural success, or prior failed ablation. CONCLUSION:Long-term clinical results after FIRM ablation in this cohort of patients showed poor efficacy, different from previously published studies. Randomized studies are needed to evaluate the efficacy and clinical utility of this ablation approach for treating AF.


Heart Rhythm


Heart rhythm


Buch E,Share M,Tung R,Benharash P,Sharma P,Koneru J,Mandapati R,Ellenbogen KA,Shivkumar K




Has Abstract


2016-03-01 00:00:00














  • Comparison of longevity and clinical outcomes of implantable cardioverter-defibrillator leads among manufacturers.

    abstract:BACKGROUND:An early failure of the Biotronik Linox S/SD implantable cardioverter-defibrillator (ICD) lead has been reported. We have also experienced several cases with early failure of Linox leads. OBJECTIVE:Our aim was to assess the longevity of Linox S/SD (Biotronik, Berlin, Germany) compared with Sprint Fidelis (M...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Kawada S,Nishii N,Morimoto Y,Miyoshi A,Tachibana M,Sugiyama H,Nakagawa K,Watanabe A,Morita H,Ito H

    更新日期:2017-10-01 00:00:00

  • The effect of reverse remodeling on long-term survival in mildly symptomatic patients with heart failure receiving cardiac resynchronization therapy: results of the REVERSE study.

    abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) reduces mortality, improves functional status, and induces reverse left ventricular remodeling in selected populations with heart failure (HF). The magnitude of reverse remodeling predicts survival with many HF medical therapies. However, there are few studies assessin...

    journal_title:Heart rhythm

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Gold MR,Daubert C,Abraham WT,Ghio S,St John Sutton M,Hudnall JH,Cerkvenik J,Linde C

    更新日期:2015-03-01 00:00:00

  • Perioperative electrophysiology study in patients with tetralogy of Fallot undergoing pulmonary valve replacement will identify those at high risk of subsequent ventricular tachycardia.

    abstract:BACKGROUND:Ventricular tachyarrhythmias are the most common cause of death in patients with repaired tetralogy of Fallot (TOF), but predicting those at risk remains a challenge. An electrophysiology study (EPS) has been proposed to risk stratify patients with TOF. OBJECTIVE:We sought to evaluate a perioperative EPS-gu...

    journal_title:Heart rhythm

    pub_type: 杂志文章,多中心研究


    authors: Sandhu A,Ruckdeschel E,Sauer WH,Collins KK,Kay JD,Khanna A,Jaggers J,Campbell D,Mitchell M,Nguyen DT

    更新日期:2018-05-01 00:00:00

  • The influence of varying energy settings on efficacy and safety of endoscopic pulmonary vein isolation.

    abstract:BACKGROUND:The optimal energy setting for endoscopic pulmonary vein (PV) isolation (PVI) has not yet been determined. OBJECTIVE:To assess the influence of varying energy settings on the efficacy and safety of endoscopic PVI. METHODS:In the current prospective study, 30 patients with paroxysmal atrial fibrillation wer...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Metzner A,Wissner E,Schoonderwoerd B,Burchard A,Tilz R,Fürnkranz A,Rillig A,Mathew S,Ouyang F,Kuck KH

    更新日期:2012-09-01 00:00:00

  • Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome.

    abstract:BACKGROUND:There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs). OBJECTIVE:The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between white and Asian patients with BrS an...

    journal_title:Heart rhythm

    pub_type: 杂志文章,多中心研究


    authors: Milman A,Andorin A,Postema PG,Gourraud JB,Sacher F,Mabo P,Kim SH,Maeda S,Takahashi Y,Kamakura T,Aiba T,Conte G,Juang JJM,Leshem E,Michowitz Y,Fogelman R,Hochstadt A,Mizusawa Y,Giustetto C,Arbelo E,Huang Z,Corrad

    更新日期:2019-10-01 00:00:00

  • Prospective, randomized comparison of two biphasic waveforms for the efficacy and safety of transthoracic biphasic cardioversion of atrial fibrillation.

    abstract:OBJECTIVES:The purpose of this study was to determine if there is a difference in commercially available biphasic waveforms. BACKGROUND:Although the superiority of biphasic over monophasic waveforms for external cardioversion of atrial fibrillation (AF) is established, the relative efficacy of available biphasic wavef...

    journal_title:Heart rhythm

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Alatawi F,Gurevitz O,White RD,Ammash NM,Malouf JF,Bruce CJ,Moon BS,Rosales AG,Hodge D,Hammill SC,Gersh BJ,Friedman PA

    更新日期:2005-04-01 00:00:00

  • T-wave alternans phase following ventricular extrasystoles predicts arrhythmia-free survival.

    abstract:OBJECTIVE:The purpose of this study was to assess the value of T-wave alternans (TWA) following ventricular extrasystoles in predicting arrhythmia-free survival. BACKGROUND:Stratifying risk for sudden death in patients with coronary disease and moderate left ventricular (LV) dysfunction remains a challenge. We hypothe...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Narayan SM,Smith JM,Schechtman KB,Lindsay BD,Cain ME

    更新日期:2005-03-01 00:00:00

  • Amiodarone treatment in atrial fibrillation and the risk of incident cancers: A nationwide observational study.

    abstract:BACKGROUND:In observational studies, case reports, and animal studies, amiodarone has been associated with incident cancer. OBJECTIVE:The purpose of this study was to examine whether a dose-response relationship between amiodarone use and the risk of cancer could be ascertained in a large nationwide study cohort. MET...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Rasmussen PV,Dalgaard F,Hilmar Gislason G,Torp-Pedersen C,Piccini J,D'Souza M,Ruwald MH,Pallisgaard JL,Hansen ML

    更新日期:2020-04-01 00:00:00

  • P wave duration is associated with cardiovascular and all-cause mortality outcomes: the National Health and Nutrition Examination Survey.

    abstract:BACKGROUND:P wave indices are an intermediate phenotype modulated by atrial conduction and electrophysiology. Their clinical correlates and association with all-cause mortality have received limited scrutiny. OBJECTIVE:To determine the relationship between P wave indices and cardiovascular and all-cause mortality in t...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Magnani JW,Gorodeski EZ,Johnson VM,Sullivan LM,Hamburg NM,Benjamin EJ,Ellinor PT

    更新日期:2011-01-01 00:00:00

  • Cloning, functional characterization, and remodeling of K2P3.1 (TASK-1) potassium channels in a porcine model of atrial fibrillation and heart failure.

    abstract:BACKGROUND:Effective treatment of atrial fibrillation (AF) remains an unmet need. Human K2P3.1 (TASK-1) K(+) channels display atrial-specific expression and may serve as novel antiarrhythmic targets. In rodents, inhibition of K2P3.1 causes prolongation of action potentials and QT intervals. We used a porcine model to f...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Schmidt C,Wiedmann F,Langer C,Tristram F,Anand P,Wenzel W,Lugenbiel P,Schweizer PA,Katus HA,Thomas D

    更新日期:2014-10-01 00:00:00

  • Outcomes of His-bundle pacing upgrade after long-term right ventricular pacing and/or pacing-induced cardiomyopathy: Insights into disease progression.

    abstract:BACKGROUND:His-bundle pacing (HBP) is a physiological alternative to right ventricular pacing (RVP). The outcomes of HBP in patients with longstanding atrioventricular block (AVB) and RVP are unknown OBJECTIVE: The purpose of this study was to retrospectively assess the feasibility of HBP in patients with chronic RVP a...

    journal_title:Heart rhythm

    pub_type: 杂志文章,多中心研究


    authors: Vijayaraman P,Herweg B,Dandamudi G,Mittal S,Bhatt AG,Marcantoni L,Naperkowski A,Sharma PS,Zanon F

    更新日期:2019-10-01 00:00:00

  • Novel mechanism for sudden infant death syndrome: persistent late sodium current secondary to mutations in caveolin-3.

    abstract:BACKGROUND:Sudden infant death syndrome (SIDS) is one of the leading causes of death during the first year of life. Long QT syndrome (LQTS)-associated mutations may be responsible for 5% to 10% of SIDS cases. We recently established CAV3-encoded caveolin-3 as a novel LQTS-associated gene with mutations producing a gain...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Cronk LB,Ye B,Kaku T,Tester DJ,Vatta M,Makielski JC,Ackerman MJ

    更新日期:2007-02-01 00:00:00

  • Validation of a defibrillation lead ventricular volume measurement compared to three-dimensional echocardiography.

    abstract:BACKGROUND:There is increasing evidence that using frequent invasive measures of pressure in patients with heart failure results in improved outcomes compared to traditional measures. Admittance, a measure of volume derived from preexisting defibrillation leads, is proposed as a new technique to monitor cardiac hemodyn...

    journal_title:Heart rhythm

    pub_type: 临床试验,杂志文章


    authors: Haines DE,Wong W,Canby R,Jewell C,Houmsse M,Pederson D,Sugeng L,Porterfield J,Kottam A,Pearce J,Valvano J,Michalek J,Trevino A,Sagar S,Feldman MD

    更新日期:2017-10-01 00:00:00

  • Safety and efficacy of epicardial cryoablation in a canine model.

    abstract:OBJECTIVES:The purpose of this study was to evaluate the safety and efficacy of cryoablation in a closed chest canine epicardial ablation model. BACKGROUND:Limitations of radiofrequency energy in the epicardial space warrants investigation of alternative energy sources. METHODS:A linear-tip catheter with a 3-cm freez...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Lustgarten DL,Bell S,Hardin N,Calame J,Spector PS

    更新日期:2005-01-01 00:00:00

  • The Canadian experience with Durata and Riata ST Optim defibrillator leads: a report from the Canadian Heart Rhythm Society Device Committee.

    abstract:BACKGROUND:The St. Jude Medical Riata family of implantable cardioverter-defibrillator (ICD) leads has demonstrated a high rate of externalized conductors and electrical failure. OBJECTIVE:Given similar design elements of Durata to Riata, the purpose of this study was to assess the rates of failure of the Riata ST Opt...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Bennett MT,Ha AC,Exner DV,Tung SK,Parkash R,Connors S,Coutu B,Crystal E,Champagne J,Philippon F,Yee R,Stephenson EA,Nery PB,Essebag V,Sanatani S,Redfearn D,Krahn AD,Healey JS

    更新日期:2013-10-01 00:00:00

  • The role of atrial natriuretic peptide in modulating cardiac electrophysiology.

    abstract::Since the discovery of atrial natriuretic peptide (ANP) in 1981, significant progress has been made in understanding the mechanism of its release and its role in salt and water balance in the body. It has also become clear that ANP plays a key role in cardiac electrophysiology, modulating the autonomic nervous system ...

    journal_title:Heart rhythm

    pub_type: 杂志文章,评审


    authors: Perrin MJ,Gollob MH

    更新日期:2012-04-01 00:00:00

  • Clinical predictors and relationship between early and late atrial tachyarrhythmias after pulmonary vein antrum isolation.

    abstract:BACKGROUND:Several studies have reported early (EAT) and late (LAT) atrial tachyarrhythmias following atrial fibrillation (AF) ablation, but the factors associated with them and their clinical significance are not well known. OBJECTIVE:The purpose of this study was to investigate the predictors and the relationship be...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Themistoclakis S,Schweikert RA,Saliba WI,Bonso A,Rossillo A,Bader G,Wazni O,Burkhardt DJ,Raviele A,Natale A

    更新日期:2008-05-01 00:00:00

  • Automatic measurement of atrial pacing thresholds in dual-chamber pacemakers: clinical experience with atrial capture management.

    abstract:BACKGROUND:The Medtronic EnPulse pacemaker incorporates the new atrial capture management (ACM) algorithm to automatically measure atrial capture thresholds and subsequently manage atrial pacing outputs. OBJECTIVES:The purpose of this study was to evaluate the clinical performance of ACM. METHODS:Two hundred patients...

    journal_title:Heart rhythm

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Sperzel J,Milasinovic G,Smith TW,Mead H,Brandt J,Haisty WK,Bailey JR,Roelke M,Simonson J,Englund J,Farges E,Compton S

    更新日期:2005-11-01 00:00:00

  • Potential interference of small neodymium magnets with cardiac pacemakers and implantable cardioverter-defibrillators.

    abstract:BACKGROUND:Magnetic fields may interfere with the function of cardiac pacemakers and implantable cardioverter-defibrillators (ICDs). Neodymium-iron-boron (NdFeB) magnets, which are small in size but produce strong magnetic fields, have become widely available in recent years. Therefore, NdFeB magnets may be associated ...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Wolber T,Ryf S,Binggeli C,Holzmeister J,Brunckhorst C,Luechinger R,Duru F

    更新日期:2007-01-01 00:00:00

  • Outcomes after repeat ablation of ventricular tachycardia in structural heart disease: An analysis from the International VT Ablation Center Collaborative Group.

    abstract:BACKGROUND:Data evaluating repeat radiofrequency ablation (>1RFA) of ventricular tachycardia (VT) are limited. OBJECTIVE:The purpose of this study was to determine the safety and outcomes of VT >1RFA in patients with structural heart disease. METHODS:Patients with structural heart disease undergoing VT RFA at 12 cent...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Tzou WS,Tung R,Frankel DS,Di Biase L,Santangeli P,Vaseghi M,Bunch TJ,Weiss JP,Tholakanahalli VN,Lakkireddy D,Vunnam R,Dickfeld T,Mathuria N,Tedrow U,Vergara P,Vakil K,Nakahara S,Burkhardt JD,Stevenson WG,Callans DJ

    更新日期:2017-07-01 00:00:00

  • Respiratory cycle-dependent atrial tachycardia: prevalence, electrocardiographic and electrophysiologic characteristics, and outcome after catheter ablation.

    abstract:BACKGROUND:Little is known about the tachyarrhythmias relating to respiration. Case reports presented patients with respiratory cycle-dependent atrial tachycardias (RCATs), which cyclically emerge after starting inspiration and cease during expiration. OBJECTIVE:The aim of the present study was to elucidate the preval...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Yamamoto T,Hayashi M,Miyauchi Y,Murata H,Horie T,Igawa O,Kato T,Mizuno K

    更新日期:2011-10-01 00:00:00

  • Bidirectional ventricular tachycardia: ping pong in the His-Purkinje system.

    abstract:BACKGROUND:Bidirectional ventricular tachycardia (BVT), which is characterized by an alternating beat-to-beat ECG QRS axis, is a rare but intriguing arrhythmia associated with digitalis toxicity, familial catecholaminergic polymorphic ventricular tachycardia (CPVT), and several other conditions that predispose cardiac ...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Baher AA,Uy M,Xie F,Garfinkel A,Qu Z,Weiss JN

    更新日期:2011-04-01 00:00:00

  • Real-time electrogram analysis for monitoring coronary blood flow during human ventricular fibrillation: implications for CPR.

    abstract:BACKGROUND:Effective chest compressions during prolonged ventricular fibrillation (VF) have been shown to increase the chances of successful defibrillation to a rhythm associated with a sustainable cardiac output. There is currently no effective method of recording the degree of antegrade coronary artery flow during ch...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Umapathy K,Foomany FH,Dorian P,Farid T,Sivagangabalan G,Nair K,Masse S,Krishnan S,Nanthakumar K

    更新日期:2011-05-01 00:00:00

  • Probability and magnitude of response to cardiac resynchronization therapy according to QRS duration and gender in nonischemic cardiomyopathy and LBBB.

    abstract:BACKGROUND:QRS morphology and QRS duration (QRSd) determine cardiac resynchronization therapy (CRT) candidate selection but criteria require refinement. OBJECTIVE:To assess CRT effect according to QRSd, treated by dichotomization vs a continuous function, and modulation by gender. METHODS:Patients selected were those...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Varma N,Manne M,Nguyen D,He J,Niebauer M,Tchou P

    更新日期:2014-07-01 00:00:00

  • Comparative spatial resolution of 12-lead electrocardiography and an automated algorithm.

    abstract:BACKGROUND:The spatial resolution of pacemapping using 12-lead electrocardiography (ECG) or PaSo software is unknown. OBJECTIVE:The purpose of this study was to determine the spatial resolution of traditional ECG pacemapping and pacemapping using the PaSo coefficients. METHODS:Seventeen patients undergoing ablation o...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Dharmaprani D,Lahiri A,Ganesan AN,Kyriacou N,McGavigan AD

    更新日期:2020-02-01 00:00:00

  • Of founder populations, long QT syndrome, and destiny.

    abstract::Founder populations, characterized by a single ancestor affected by long QT syndrome (LQTS) and by a large number of individuals and families who all are related to the ancestor and thereby carry the same disease-causing mutation, represent the ideal human model for studying the role of "modifier genes" in LQTS. This ...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Brink PA,Schwartz PJ

    更新日期:2009-11-01 00:00:00

  • Acute defibrillation performance of a novel, non-transvenous shock pathway in adult ICD indicated patients.

    abstract:OBJECTIVES:The purpose of this study was to evaluate the efficacy of a totally subcutaneous, anteroposterior defibrillation shock pathway using a long time-constant shock waveform that emulates a proposed device having approximately twice the capacitance and thus twice the available energy of traditional transvenous de...

    journal_title:Heart rhythm

    pub_type: 临床试验,杂志文章


    authors: Lieberman R,Havel WJ,Rashba E,DeGroot PJ,Stromberg K,Shorofsky SR

    更新日期:2008-01-01 00:00:00

  • Mechanisms for the initiation of human atrial fibrillation.

    abstract::Understanding of the mechanisms underlying atrial fibrillation (AF) remain limited. However, both persistent and paroxysmal AF likely initiate via the interaction of triggers such as premature atrial beats with 'substrate', that includes static components such as fibrosis and scar, as well as dynamic alterations that ...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Krummen DE,Narayan SM

    更新日期:2009-08-01 00:00:00

  • Complications arising from catheter ablation of atrial fibrillation: temporal trends and predictors.

    abstract:BACKGROUND:The reported complication rate of catheter ablation of atrial fibrillation (AF) varies. OBJECTIVE:Our goal was to assess temporal trends and the effect of both institutional and individual operators' experience on the incidence of complications. METHODS:All patients undergoing AF ablation at Johns Hopkins ...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Hoyt H,Bhonsale A,Chilukuri K,Alhumaid F,Needleman M,Edwards D,Govil A,Nazarian S,Cheng A,Henrikson CA,Sinha S,Marine JE,Berger R,Calkins H,Spragg DD

    更新日期:2011-12-01 00:00:00

  • Epicardial course of the septopulmonary bundle: Anatomical considerations and clinical implications for roof line completion.

    abstract:BACKGROUND:Gaps in the roof line have been ascribed to epicardial conduction using the septopulmonary bundle. OBJECTIVES:We sought to evaluate the frequency of septopulmonary bundle bypass during roof line ablation, to describe anatomical conditions favoring this epicardial gap, and to propose an alternative strategy ...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Pambrun T,Duchateau J,Delgove A,Denis A,Constantin M,Ramirez FD,Chauvel R,Tixier R,Welte N,André C,Nakashima T,Nakatani Y,Kamakura T,Takagi T,Krisai P,Cheniti G,Vlachos K,Bourier F,Takigawa M,Kitamura T,Frontera A

    更新日期:2020-11-11 00:00:00