Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2012 Sep;9(9):1436-9.
doi: 10.1016/j.hrthm.2012.03.055. Epub 2012 Mar 28.

Focal impulse and rotor modulation ablation of sustaining rotors abruptly terminates persistent atrial fibrillation to sinus rhythm with elimination on follow-up: a video case study

Sanjiv M Narayan  1 , Jigar Patel, Siva Mulpuru, David E Krummen
Affiliations
Case Reports

Focal impulse and rotor modulation ablation of sustaining rotors abruptly terminates persistent atrial fibrillation to sinus rhythm with elimination on follow-up: a video case study

Sanjiv M Narayan et al. Heart Rhythm. 2012 Sep.
No abstract available

PubMed Disclaimer

Figures

Figure 1
Figure 1
Right atrial FIRM mapping and ablation during AF. A: Basket and ablation catheters in the right atrium during AF (anteroposterior fluoroscopy). B: Counterclockwise rotor in posterolateral right atrium centered over C3, with collision beyond the spiral arms (indicated by white double lines; supplementary movie). C: Electrograms around the RA rotor site, indicating counterclockwise rotation with variability at CL ≈ 177 ms. D: FIRM ablation at RA rotor terminates AF to sinus rhythm within 30 seconds. ABL = ablation electrogram; AF = atrial fibrillation; CL = cycle length; CSP = proximal coronary sinus; FIRM = focal impulse and rotor modulation; RA = right atrial.
Figure 2
Figure 2
Left trial FIRM mapping and ablation of reinduced AF. This AF required vigorous reinduction to be sustained after right atrial FIRM. A: Basket and ablation catheters in the left atrium during AF (right anterior oblique 30o fluoroscopy). B: Counterclockwise rotor in midposterior left atrium, with collision beyond spiral arms (indicated by double lines). Pulmonary vein ostia indicated by dashed lines. C: Electrograms around the LA rotor showing counterclockwise rotation with variability. D: FIRM ablation at the LA rotor terminates AF to sinus rhythm (4.75 minutes). ABL = ablation electrogram; AF = atrial fibrillation; CS = coronary sinus; FIRM = focal impulse and rotor modulation; LA = left atrial.
See this image and copyright information in PMC

Comment in

References

    1. Calkins H, Kuck KH, Cappato R, et al. HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society. Heart Rhythm. 2012;2012;9:632–696.e21. - PubMed
    1. Weerasooriya R, Khairy P, Litalien J, et al. Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up? J Am Coll Cardiol. 2011;57:160–166. - PubMed
    1. Allessie MA, de Groot NM, Houben RP, et al. The electropathological substrate of longstanding persistent atrial fibrillation in patients with structural heart disease: longitudinal dissociation. Circ Arrhythm Electrophysiol. 2010;3:606–615. - PubMed
    1. Vaquero M, Calvo D, Jalife J. Cardiac fibrillation: from ion channels to rotors in the human heart. Heart Rhythm. 2008;5:872–879. - PMC - PubMed
    1. Ryu K, Shroff SC, Sahadevan J, Martovitz NL, Khrestian CM, Stambler BS. Mapping of atrial activation during sustained atrial fibrillation in dogs with rapid ventricular pacing induced heart failure: evidence for a role of driver regions. J Cardiovasc Electrophysiol. 2005;16:1348–1358. - PubMed

Publication types