Left panel shows the eye of a hurricane. Right panel shows the striking similarity of the rotor or localized source of an arrhythmia in a patient with atrial fibrillation. Ablation targeted at these rotors or “eyes of the storm” successfully terminated and eliminated atrial fibrillation in the CONFRIM trial. Photo credit: UCSD/UCLA.
New Technology Improves Heart Rhythm Treatment
CONFIRM study results point to a doubling of success in treating heart rhythm disorder
Researchers from UC San Diego, the University of California Los Angeles and Indiana University report having found, for the first time, that atrial fibrillation or irregular heart rhythms is caused by small electrical sources within the heart, in the form of electrical spinning tops (“rotors”) or focal beats. Importantly, they found a way of detecting these key sources, then precisely targeting them for therapy that can shut them down in minutes with long lasting results.
The team, which included cardiologists, physicists and bioengineers, report the findings in the July issue of the Journal of the American College of Cardiology as the CONFIRM trial (Conventional Ablation for Atrial Fibrillation
With or Without Focal Impulse and Rotor Modulation).
Currently, many patients treated for atrial fibrillation with standard therapies will experience a recurrence due to the difficulty of finding the source of the arrhythmia. The new findings will help cardiologists better target and treat arrhythmias.
The CONFIRM study examined 107 patients with atrial fibrillation referred for a non-surgical catheter ablation procedure. During this procedure, doctors thread a wire with a metal-tipped catheter inside the body, from a vein in the groin, to apply heat to the area of the heart that is producing the arrhythmia to stop it.
In one group of patients, the team used the new technique to help perform precise burns, called Focal Impulse and Rotor Modulation (FIRM) that were aimed directly at the fundamental source of the arrhythmia – tiny electrical disturbances in the heart called rotors or focal sources that look like mini tornadoes or spinning tops.
Remarkably, this new procedure shut down atrial fibrillation or very significantly slowed it in 86 percent of patients in an average of only 2.5 minutes.