Understanding Focal Impulse and Rotor Modulation

​A professor at Stanford University, Dr. Sanjiv Narayan has developed innovative therapies such as focal impulse and rotor modulation (FIRM). In fact, Dr. Sanjiv Narayan's cardiology insights led to the founding of a start-up company called Topera, which was later purchased by Abbott. He has also lectured on matters related to cardiology during grand rounds at Abbott Northwest Hospital and other medical facilities.

Before looking at the FIRM therapies, it’s important to understand atrial fibrillation and its consequences for heart health. Classified as an arrhythmia, atrial fibrillation occurs when the atria, the two upper chambers of the heart, behave abnormally, contracting rapidly but ineffectively. This problem can result in blood gathering in the atria because they are unable to pump all the blood out. In some cases, atrial fibrillation leads to stroke and even heart failure.

FIRM addresses atrial fibrillation by locating the tissues that are sending the electrical signals that give rise to the arrhythmia. Doctors then ablate, or destroy, those tissues with the hope of eliminating the cause of atrial fibrillation. FIRM is more precise than other ablation methods in that it is able to hone in on the particular tissues responsible, meaning that doctors need not destroy as much heart tissue when they perform ablations. 

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