Treating Atrial Fibrillation

atrial fibrillation (AF)
atrial fibrillation (AF)


In his goal to deliver good patient outcomes in the treatment of atrial fibrillation (AF), Dr. Sanjiv Narayan led the development of an innovative therapy known as Focal Impulse and Rotor Modulation (FIRM). Dr. Sanjiv Narayan also founded a start-up company that was eventually bought by Abbott Laboratories. The company, Topera, Inc., enabled Abbott to enter the field of treating individuals with AF.

Topera created a rotor identification system using mapping software and an innovative diagnostic catheter. This system assists physicians in finding and targeting the definitive locations of an individual’s heart that are causing atrial fibrillation. An independent study has shown that the system with catheter ablation results in better long-term outcomes and requires fewer procedures than other methods of treatment.

In an ablation procedure, a catheter is positioned in a targeted area of the heart. Energy is then used to disturb the unusual electrical activity in that area associated with AF.

AF is the most prevalent cardiac arrhythmia (abnormal heart rhythm). Around 2.7 million to 6.1 million adult Americans are estimated to have AF. Individuals having this condition are three times more likely to experience heart failure.


The Computational Arrhythmia Research Laboratory at Stanford

Stanford University Image:
Stanford University


Dr. Sanjiv Narayan cofounded medical device startup Topera, Inc., which was later purchased by Abbott Laboratories. The acquisition enabled Abbott to enter the large and expanding catheter-based electrophysiology market. A professor of medicine at Stanford University, Dr. Sanjiv Narayan is also the director of the Computational Arrhythmia Research Laboratory based at the same academic institution.

The research laboratory seeks to improve the treatment of patients with cardiac arrhythmias, focusing on atrial fibrillation (AF), as well as on ventricular fibrillation. It develops bioengineering solutions to raise the mechanistic understanding of the disorder, as well as enhance its clinical treatment.

Mapping cardiac fibrillation through the creation of clinical tools has been a major development of the laboratory. This form of mapping is computationally close to the optical mapping yardstick, which at present is not yet available to patients.

Focal Impulse and Rotor Mapping (FIRM) was pioneered by the laboratory, which led to the discovery that localized circuits (rotors) perpetuate human AF. The FIRM approach is increasingly utilized in treating AF, and its results have been supported by many other clinical techniques and by basic science studies in many human and and animal models .

The research program receives funding from the National Institutes of Health.

Types of Arrhythmia

Arrhythmia pic

Dr. Sanjiv Narayan, founder of an Abbott Laboratories company, leads as director of the atrial fibrillation program and of electrophysiology research at Stanford University. Also involved in developing a new arrhythmia center, Dr. Sanjiv Narayan is committed to furthering understanding of abnormal heart rhythms and developing new treatments to improve patient diagnosis and care.

By definition, an arrhythmia is any heartbeat that deviates from the norm. The most common variety is the premature ventricular contraction, a typically harmless occurrence in which the heart generates an extra beat. Often asymptomatic, they often require no treatment, particularly in otherwise healthy patients.

Other cases of arrhythmia are classified as tachycardia, or an abnormally fast heartbeat. Examples of such presentations include paroxysmal supraventricular tachycardia and ventricular tachycardia, both of which present with a very fast but regular beat. The former comes on quickly and the latter is particularly short-lived, though neither is generally dangerous. One therapy developed by Dr. Narayan is now Abbott-affiliated.

Patients with heartbeats that are too slow, by contrast, have what is known as a bradycardia. These include bradyarrhythmias, which often result from a condition or medication that alters electrical activity in the body.

The heart may also generate an abnormally irregular rhythm, such as an atrial or ventricular fibrillation. Very quick but irregular, the cardiac muscles tremble rather than beat, and thus cannot properly pump blood. These conditions are potentially dangerous and require immediate medical attention.