Evidence map›Paper›PMID 33351076›Full record

Trial reportEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2021

Focal Impulse and Rotor Modulation Ablation vs. Pulmonary Vein isolation for the treatment of paroxysmal Atrial Fibrillation: results from the FIRMAP AF study.

Roland R Tilz, Corinna Lenz, Philipp Sommer, Meyer-Saraei Roza, Anne E Sarver, Christopher G Williams, Christian Heeger, Gerhard Hindricks, Julia Vogler, Charlotte Eitel

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 3 pooled it
3.4field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Guideline
  4. Randomized evaluation of redo ablation procedures of atrial fibrillation with focal impulse and rotor modulation-guided procedures: the REDO-FIRM study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Trial
  5. Trial
  6. Review
  7. Review
  8. Review
  9. Article
  10. Review
  11. Catheter ablation for non-paroxysmal atrial fibrillation. A review.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2024
    Review
  12. Article
  13. Article
  14. Functional mapping to reveal slow conduction and substrate progression in atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  15. Review
  16. Review
  17. Treatment of pathophysiologic propagation outside of the pulmonary veins in retreatment of atrial fibrillation patients: RECOVER AF study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  18. Rotor mechanism and its mapping in atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Review
  19. Personalized ablation vs. conventional ablation strategies to terminate atrial fibrillation and prevent recurrence.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  20. [New mapping tools for catheter ablation of atrial fibrillation].Herzschrittmachertherapie & Elektrophysiologie · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Roland R TilzUniversity Heart Center Lübeck, Medical Clinic II, Department of Electrophysiology, Lübeck, Germany.
Corinna LenzUnfallkrankenhaus Berlin, Klinik für Innere Medizin/Kardiologie, Berlin, Germany.
Philipp SommerHeart Center Leipzig, Department of Electrophysiology, Leipzig, Germany.ORCID 0000-0002-3037-8704
Meyer-Saraei RozaUniversity Heart Center Lübeck, Medical Clinic II, Department of Electrophysiology, Lübeck, Germany.
Anne E SarverAbbott, Plymouth, MN, USA.
Christopher G WilliamsAbbott, Plymouth, MN, USA.
Christian HeegerUniversity Heart Center Lübeck, Medical Clinic II, Department of Electrophysiology, Lübeck, Germany.
Gerhard HindricksHeart Center Leipzig, Department of Electrophysiology, Leipzig, Germany.
Julia VoglerUniversity Heart Center Lübeck, Medical Clinic II, Department of Electrophysiology, Lübeck, Germany.
Charlotte EitelUniversity Heart Center Lübeck, Medical Clinic II, Department of Electrophysiology, Lübeck, Germany.ORCID 0000-0002-8733-6791
University of Lübeck · DEAbbott (United States) · USLeipzig Heart Institute · DEUnfallkrankenhaus Berlin · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPulmonary vein isolation (PVI) is the gold standard for atrial fibrillation (AF) ablation. Recently, catheter ablation targeting rotors or focal sources has been developed for treatment of AF. This study sought to compare the safety and effectiveness of Focal Impulse and Rotor Modulation (FIRM)-guided ablation as the sole ablative strategy with PVI in patients with paroxysmal AF. METHODS AND

resultsWe conducted a multicentre, randomized trial to determine whether FIRM-guided radiofrequency ablation without PVI (FIRM group) was non-inferior to PVI (PVI group) for treatment of paroxysmal AF. The two primary efficacy end points were (i) acute success defined as elimination of AF rotors (FIRM group) or isolation of all pulmonary veins (PVI group) and (ii) long-term success defined as single-procedure freedom from AF/atrial tachycardia (AT) recurrence 12 months after ablation. The study was closed early by the sponsor. At the time of study closure, any pending follow-up visits were waived. A total of 51 patients (mean age 63 ± 10.6 years, 57% male) were enrolled. All PVs were successfully isolated in the PVI group and all rotors were successfully eliminated in the FIRM group. Single-procedure effectiveness was 31.3% (5/16) in the FIRM group and 80% (8/10) in the PVI group at 12 months. Three vascular access complications occurred in the FIRM group.

conclusionThese partial study effectiveness results reinforce the importance of PVI in paroxysmal AF patients and indicate that FIRM-guided ablation alone (without PVI) is not an effective strategy for treatment of paroxysmal AF in most patients.

Indexed as

Atrial FibrillationCatheter AblationPulmonary VeinsAgedFemaleHumansMaleMiddle AgedRecurrenceTreatment OutcomeAtrial fibrillationCatheter ablationFocal Impulse and Rotor ModulationRotor

Identifiers

PMID33351076
PMCPMC8139814
OpenAlexW3117957182

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.