Conditions Treated
Our Approach to FIRM Ablation
At Stanford, our doctors are pioneering a new, more effective treatment for advanced atrial fibrillation, known as FIRM ablation.
Focal Impulse and Rotor Modulation, or FIRM, is a mapping technology that allows doctors to precisely target the electrical sources of AFib. FIRM is a more accurate treatment, providing long-term relief of AFib and its symptoms.
WHAT WE OFFER YOU FOR FIRM ABLATION
- Nationally recognized expertise, with electrophysiologists who have decades of experience in treating atrial fibrillation (AFib) and other types of arrhythmias
- Advanced treatment options as one of the first U.S. hospitals to offer FIRM ablation, a new technology for mapping and treating AFib more precisely
- Ongoing clinical trials to study the effectiveness of FIRM in treating all types of AFib, whether it occurs occasionally (paroxysmal), frequently (persistent) or continuously (permanent)
- Pioneering research among Stanford doctors, bioengineers and other scientists to improve the FIRM mapping technology
To request an appointment with one of our arrhythmia specialists, call: 650-723-7111.
What Is FIRM Ablation?
What to Expect
Your doctor will perform the procedure with assistance by a trainee – typically a board certified cardiologist who is learning advanced procedures and is more than six years out of medical school.
Before
After
Before the Procedure
Diagnostic Tests
Before FIRM ablation is performed, you may need addititional tests like echocardiogram, rhythm monitor, special CT scan or cardiac MRI. Your doctor will discuss the need for additional tests with you.
Medical Records
Bring the following medical records (if available):
- Echocardiograms
- Stress tests
- Electrocardiograms (ECG)
- Cardiac monitor results
- Cardiac history
- Medical history
- Medication list
- Imaging studies of your heart
- Prior ablation records
Medication Management
Blood thinners (anticoagulants): As with any other atrial fibrillation ablation procedure, our team will discuss anti-coagulant management on a case-by-case basis with you beforehand.
Anti-arrhythmic medications: We recommend that patients discontinue anti-arrhythmic medications 72 hours before the FIRM ablation procedure, or as much as one month for patients on amiodarone. However, adjustments can be made on a case-by-case basis. Discuss details with your doctor.
After the Procedure
If you are traveling from out of town, we recommend you come with a family member or friend who can help you travel home.
Your Hospital Stay
You can expect to be discharged the day after the procedure. If you are from out of town, then we recommend that you stay nearby for another two days before returning home on day five.
Browse our list of recommendations of where to stay near Stanford.
Normal Activity
In the first week after ablation, you should take it easy. For one week, do not lift, push, or pull anything heavier than 10 pounds, or a jug of milk. Avoid sex, driving, straining to have a bowel movement, or climbing stairs.
You may return to normal activities one week after the procedure.
Going Home
If somebody else drives you, then you can travel as a passenger in a car on the return trip.
AFib Recurrence
Atrial fibrillation can re-occur in all patients who undergo this ablation for up to 3 months after the procedure. The ablation itself can cause inflammation (pericarditis) in the atria and this can cause atrial fibrillation. Some patients will have an increase in atrial fibrillation episodes early after ablation. In many cases these episodes of atrial fibrillation will prove self limited.
In approximately 30% of patients, post-ablation arrhythmias do not resolve with waiting. In these patients, a repeat ablation could be considered after a waiting period of 3 to 6 months to be sure that spontaneous resolution of the post-ablation arrhythmia has not occurred.
Medication Management after FIRM Ablation
Blood thinners (anticoagulants): We recommend patients continue to take anticoagulants based upon their stroke risk assessment score, instead of the presence or absence of atrial fibrillation.
In certain cases, your doctor may discontinue oral anticoagulants after successful FIRM ablation, typically at 2 to 3 months. This is decided on a case-by-case basis.
Anti-arrhythmic medications: Talk to your doctor about taking anti-arrhythmic medications after FIRM ablation. Typically, you should continue taking anti-arrhythmic agents for the next 2 to 3 months.
Precautions
If you develop any problems with swallowing, heartburn, vomiting, or abdominal pain within the first month after your ablation, call us immediately. It may be a sign of esophageal irritation. which requires immediate attention.
Common symptoms after FIRM Ablation:
- Minor bruising and soreness near groin or neck access sites
- Bruising may ocassionally extend down the leg
- Minor chest pain is common for a week or so after the procedure. Pain will often worsen with a deep breath or when you lean forward. This should resolve within a week although it might increase the day after the procedure
- Low grade fever
When to Call Your Doctor
- If severe swelling or more significant pain occurs at or near access sites, please call your doctor so we can evaluate you
- If you develop a fever over 100 degrees anytime within the first three week after the procedure, please contact your doctor.
Call 911 if you develop any of the following neurological symptoms:
- Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
- Sudden confusion, slurred speech or understanding
- Sudden difficulty walking, dizziness, or loss of balance or coordination
- Sudden and severe headache with unknown cause
Before the Procedure
Diagnostic Tests
Before FIRM ablation is performed, you may need addititional tests like echocardiogram, rhythm monitor, special CT scan or cardiac MRI. Your doctor will discuss the need for additional tests with you.
Medical Records
Bring the following medical records (if available):
- Echocardiograms
- Stress tests
- Electrocardiograms (ECG)
- Cardiac monitor results
- Cardiac history
- Medical history
- Medication list
- Imaging studies of your heart
- Prior ablation records
Medication Management
Blood thinners (anticoagulants): As with any other atrial fibrillation ablation procedure, our team will discuss anti-coagulant management on a case-by-case basis with you beforehand.
Anti-arrhythmic medications: We recommend that patients discontinue anti-arrhythmic medications 72 hours before the FIRM ablation procedure, or as much as one month for patients on amiodarone. However, adjustments can be made on a case-by-case basis. Discuss details with your doctor.
close Before
After the Procedure
If you are traveling from out of town, we recommend you come with a family member or friend who can help you travel home.
Your Hospital Stay
You can expect to be discharged the day after the procedure. If you are from out of town, then we recommend that you stay nearby for another two days before returning home on day five.
Browse our list of recommendations of where to stay near Stanford.
Normal Activity
In the first week after ablation, you should take it easy. For one week, do not lift, push, or pull anything heavier than 10 pounds, or a jug of milk. Avoid sex, driving, straining to have a bowel movement, or climbing stairs.
You may return to normal activities one week after the procedure.
Going Home
If somebody else drives you, then you can travel as a passenger in a car on the return trip.
AFib Recurrence
Atrial fibrillation can re-occur in all patients who undergo this ablation for up to 3 months after the procedure. The ablation itself can cause inflammation (pericarditis) in the atria and this can cause atrial fibrillation. Some patients will have an increase in atrial fibrillation episodes early after ablation. In many cases these episodes of atrial fibrillation will prove self limited.
In approximately 30% of patients, post-ablation arrhythmias do not resolve with waiting. In these patients, a repeat ablation could be considered after a waiting period of 3 to 6 months to be sure that spontaneous resolution of the post-ablation arrhythmia has not occurred.
Medication Management after FIRM Ablation
Blood thinners (anticoagulants): We recommend patients continue to take anticoagulants based upon their stroke risk assessment score, instead of the presence or absence of atrial fibrillation.
In certain cases, your doctor may discontinue oral anticoagulants after successful FIRM ablation, typically at 2 to 3 months. This is decided on a case-by-case basis.
Anti-arrhythmic medications: Talk to your doctor about taking anti-arrhythmic medications after FIRM ablation. Typically, you should continue taking anti-arrhythmic agents for the next 2 to 3 months.
Precautions
If you develop any problems with swallowing, heartburn, vomiting, or abdominal pain within the first month after your ablation, call us immediately. It may be a sign of esophageal irritation. which requires immediate attention.
Common symptoms after FIRM Ablation:
- Minor bruising and soreness near groin or neck access sites
- Bruising may ocassionally extend down the leg
- Minor chest pain is common for a week or so after the procedure. Pain will often worsen with a deep breath or when you lean forward. This should resolve within a week although it might increase the day after the procedure
- Low grade fever
When to Call Your Doctor
- If severe swelling or more significant pain occurs at or near access sites, please call your doctor so we can evaluate you
- If you develop a fever over 100 degrees anytime within the first three week after the procedure, please contact your doctor.
Call 911 if you develop any of the following neurological symptoms:
- Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
- Sudden confusion, slurred speech or understanding
- Sudden difficulty walking, dizziness, or loss of balance or coordination
- Sudden and severe headache with unknown cause
close After
Our Clinics
Our nationally recognized electrophysiologists provide leading-edge care with compassion for people with all types of arrhythmias. Our team includes experts from several heart specialties with decades of experience in patient-centered care.
