"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su Cavanaugh Heart Center, Phoenix, AZ

"Your book [Beat Your A-Fib] is the quintessential most important guide not only for the individual experiencing atrial fibrillation and his family, but also for primary physicians, and cardiologists."

Jane-Alexandra Krehbiel, nurse, blogger and author "Rational Preparedness: A Primer to Preparedness"


"Steve Ryan's summaries of the Boston A-Fib Symposium are terrific. Steve has the ability to synthesize and communicate accurately in clear and simple terms the essence of complex subjects. This is an exceptional skill and a great service to patients with atrial fibrillation."

Dr. Jeremy Ruskin of Mass. General Hospital and Harvard Medical School

"I love your [A-fib.com] website, Patti and Steve! An excellent resource for anybody seeking credible science on atrial fibrillation plus compelling real-life stories from others living with A-Fib. Congratulations…"

Carolyn Thomas, blogger and heart attack survivor; MyHeartSisters.org

"Steve, your website was so helpful. Thank you! After two ablations I am now A-fib free. You are a great help to a lot of people, keep up the good work."

Terry Traver, former A-Fib patient

"If you want to do some research on AF go to A-Fib.com by Steve Ryan, this site was a big help to me, and helped me be free of AF."

Roy Salmon Patient, A-Fib Free; pacemakerclub.com, Sept. 2013

More FIRM Research: Mapping System Falls Short (Again)

Background: FIRM stands for ‘Focal Impulse and Rotor Modulation’; The FIRM mapping and ablation system uses a basket catheter, a panoramic contact-mapping tool by Topera/Abbott Laboratories. Rotors (rotational circuits or focal sources) are underlying drivers that sustain or perpetuate an A-Fib signal after it has been triggered (like an echo).
The FIRMap basket Catheter from Topera/Abbott Laboratories

The FIRMap basket catheter

A three-center 2015 study (Gianni) used FIRM-guided only ablation on 29 patients with persistent or long-standing persistent A-Fib. The centers were:

• The Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin, TX, USA
• The Heart Center Bad Neustadt, Bad Neustadt, Germany
• Baptist Health, Lexington, KY, USA

Undergoing FIRM mapping, 20 patients had persistent A-Fib and 9 patients had long-standing persistent. Doctors found 4 rotors (on average) per patient (with 62% coming from the left atrium) and 1 focal impulse. All these signal sources were successfully ablated.

Follow-up Ablation Results

After a mean of 5.7 months of follow-up, single procedure freedom from A-Fib/Flutter without antiarrhythmic drugs was a low 17%.

Researchers concluded that the FIRM system was not effective in returning patients to normal sinus rhythm (or alternatively moving from the chaotic A-Fib rhythm to a more regular rhythm such as A-Flutter). And only ablating FIRM-identified rotors did not prevent recurrence (i.e., return of A-Fib).

Other Research on the FIRM System

AF Symposium logo

AF Symposium reports

This study confirms the January 2015 AF Symposium presentation, Critical Analysis of the FIRM Mapping System, by Dr. Ravi Mandapati of Loma Linda University,

From a different perspective, Dr. Vivek Reddy offers a real world application of the FIRM system (advantages and problems). See the 2016 AF Symposium presentation: Two Challenging, Difficult Catheter Ablation Cases.

Bottom line for Patients

Even though the FIRM mapping and ablation system seems to currently have built-in limitations, master EPs still use the FIRM basket mapping catheter because it provides a great deal of important information very quickly. It is especially useful in cases of Persistent A-Fib.

Note: The developer of FIRM, Topera/Abbott Laboratories, is working to address shortcomings by developing its own line of mapping basket catheters.
References for this article

Related Posts

Follow Us
facebook - A-Fib.comtwitter - A-Fib.comlinkedin  - A-Fib.compinterest  - A-Fib.comYouTube: A-Fib Can be Cured!  - A-Fib.com

A-Fib.com is a
501(c)(3) Nonprofit

Your support is needed. Every donation helps, even just $1.00.

We Need You
A-Fib.com Mission Statement
BYA - Alerts ad Green

A-Fib.com top rated by Healthline.com for the third year.
A-Fib.com top rated by Healthline.com for the third year. 2014  2015  2016

Mug - Seek your cure - Beat Your A-Fib 200 pix wide at 300 resEncourage others
with A-Fib
click to order

Home | The A-Fib Coach | Help Support A-Fib.com | A-Fib News Archive | Tell Us What You think | Media Room | GuideStar Seal | HON certification | Disclosures | Terms of Use | Privacy Policy