{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T04:56:58Z","timestamp":1774155418498,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,11,6]],"date-time":"2019-11-06T00:00:00Z","timestamp":1572998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The role of focal impulse and rotor modulation (FIRM)\u2010guided ablation for the treatment of atrial fibrillation (AF) remains unclear. Previous studies on the FIRM\u2010guided ablation outcomes have been limited by a focus on AF termination as an endpoint and by patient population heterogeneity. We sought to determine differences in rates of AF termination, inducibility, and recurrence in patients with persistent AF undergoing first\u2010time ablation with a FIRM\u2010guided approach compared with patients undergoing conventional ablation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Eight\u2010five consecutive patients (38 FIRM, 47 conventional) with persistent AF undergoing first\u2010time ablation were retrospectively analyzed. There were no significant differences in the rates of AF termination in the FIRM group compared to the conventional group (26% vs 15%; <jats:italic>P<\/jats:italic>\u2009=\u2009.15). Rates of inducible AF after ablation were 37% in the FIRM group and 30% in the conventional group (<jats:italic>P<\/jats:italic>\u2009=\u2009.32). Over a median follow\u2010up of 2.4 years, the rates of freedom from AF were similar between the FIRM and conventional groups (1\u2010year freedom from AF 65% vs 50%, respectively; <jats:italic>P<\/jats:italic>\u2009=\u2009.18). Procedural termination of AF with either FIRM ablation or conventional ablation was not associated with any significant reduction in AF recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A FIRM\u2010guided approach was not associated with a significant difference in freedom from AF when compared to conventional ablation. Termination of AF with ablation was not associated with increased freedom from AF. While AF termination using substrate\u2010based ablation may have mechanistic implications for understanding AF rotor physiology, its impact on clinical outcomes remains unclear.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14240","type":"journal-article","created":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T14:10:10Z","timestamp":1571407810000},"page":"2773-2781","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effects of focal impulse and rotor modulation\u2010guided ablation on atrial arrhythmia termination and inducibility: Impact on outcomes after treatment of persistent atrial fibrillation"],"prefix":"10.1111","volume":"30","author":[{"given":"Jared M.","family":"Kirzner","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine New York\u2010Presbyterian Hospital  New York New 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