Atrial Fibrillation Study Builds on Mapping of Rotors, Focal Drivers

Sanjiv Narayan Abbott pic
Sanjiv Narayan

A professor of cardiovascular medicine at Stanford University, Dr. Sanjiv M. Narayan is working to develop the Stanford Arrhythmia Center, which focuses on creating innovative bioengineering-based treatments for complex heart rhythm disorders. As a bioengineer, Sanjiv Narayan also applies his background in neural networks, machine learning, and artificial intelligence to the field of cardiology at the Computational Arrhythmia Research Laboratory.

After extensive work that resulted in discovery of the role of focal drivers and rotors in heart fibrillation, Dr. Narayan coauthored a paper on what independent mapping techniques showed about the presence of rotational activation. The paper was published in the January 29, 2018, issue of the Journal of Cardiovascular Electrophysiology.

The authors of the paper worked with the goal of finding out how, during the process of ablation, atrial fibrillation terminates close to the pulmonary veins prior to pulmonary vein isolation. This research represents the first full study of that phenomenon, as well as the first study of how patients with pulmonary vein reconnection can be free of arrhythmias.

The study involved patients with atrial fibrillation who had been scheduled for ablation. The researchers examined specific electrograms from these patients using two distinct mapping methods. In all patients studied, ablation at locations close to the pulmonary veins resulted in a termination of atrial fibrillation before the isolation of the pulmonary veins.

The researchers concluded that surgeons may be able to use these mapping techniques to create pulmonary vein lesion groups and lessen the occurrence of atrial fibrillation.

Study Examines Relationship between AT and AF


Sanjiv Narayan Abbott pic
Sanjiv Narayan

Dr. Sanjiv M. Narayan is a cardiac research scientist and a professor of medicine at Stanford University, where he founded the Stanford Arrhythmia Center. In his research for new treatment methods, Dr. Sanjiv Narayan participates in leading research projects.

Atrial fibrillation (AF) and atrial tachycardia (AT) often convert to and from one another, but little research has been performed on whether the two conditions are related on a mechanistic basis. Dr. Narayan and other researchers recently conducted a trial in which they hypothesized that critical areas related to AT may have a correlation to regional sources of AF in patients who experience both conditions.

The researchers tested their hypothesis with spatial mapping techniques on 26 different patients who experience AF to AT conversion. The researchers concluded that overlap may exist in atrial regions related to the mechanisms that cause both AF and AT. The researchers suggest that future studies should examine the rate at which accelerated AT causes AF.