Sanjiv M. Narayan, MD, PhD
This page provides information about a featured electrophysiologist, cardiologist, cardiothoracic surgeon, hospital, heart hospital, arrhythmia center, or atrial fibrillation center.
On this page you will find an overview of this atrial fibrillation patient services provider's atrial fibrillation treatments and background, as well as information about this provider's specialized afib procedures, such as catheter ablation, maze surgery, or the mini maze procedure, and the provider's treatment results, when available. There are also reviews by other afib patients, when available.
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300 Pasteur Dr
Stanford, California 94305
United States
Phone: 858-449-3252
About
Dr. Narayan is Co-Director of the Stanford Arrhythmia Center at Stanford Health Care, a leading center for patient care and innovation recognized both nationally and worldwide. He is also a Professor of Medicine and Director of the Atrial Fibrillation Program and Director of Research in the Electrophysiology service at Stanford University. More information about Dr. Narayan can be found on the Stanford Health Care website.
See Dr. Narayan's professional and academic profile.
FIRM-guided ablation is a promising approach to therapy that targets rotors and focal sources that drive AF and other complex heart rhythm disorders, without the use of widespread destruction of heart tissue. The treatment is FDA-cleared, and is used by the Electrophysiology group at Stanford for a wide range of patients.
The Electrophysiology service at the Stanford Arrhythmia Center has nine physicians. Our goal is to work closely with you and your primary healthcare team to ensure that you understand your condition and the best treatment options for you. We specialize in treating patients with all types of heart rhythm disorder, including atrial fibrillation, ventricular tachycardia, supraventricular arrhythmias, those who require pacemaker or defibrillator device therapy, and those with inherited heart rhythm disorders. We are committed to developing new therapies for these conditions, and offering them as part of clinical trials or approved therapy for our patients.
See the Stanford Arrhythmia Center Website for more information.
For patients in other geographical locales, several other U.S. and International Centers are now performing FIRM ablation. The closest sites to you can be obtained by emailing Eve Zheng at [email protected].
Eve Zheng, RN
Stanford Cardiovascular Clinic
300 Pasteur Drive
Stanford, CA 94305
Office: (650) 497-4937
Fax: (650) 498-4531
[email protected]
Atrial Fibrillation Procedures
- FIRM (Focal Impulse and Rotor Mapping/Modulation) Faculty co-invented
- Cryoballoon therapy for AF. Faculty co-invented
- Hybrid surgical therapy for AF
- Left atrial appendage occlusion
- Ablation for Paroxysmal and Persistent AF
- Comprehensive care of patients with heart rhythm disorders
Specialized Procedures
Dr. Narayan’s group developed the Focal Impulse and Rotor Mapping (FIRM) approach to ablate AF after more than a decade of research funded by the National Institutes of Health, American Heart Association and Doris Duke Charitable Foundation.
FIRM identifies rotors and focal sources that drive AF, that differ from triggers in the pulmonary veins. Importantly, AF sources can lie in different regions of the heart in each patient, including the right atrium in a third of individuals. FIRM-guided ablation is therefore personalized to each patient. In the CONFIRM trial and many studies by experienced independent groups (Miller et al., 2014, Sommer et al. 2015; Tomassoni et al. 2015, Rashid et al. 2015, Foreman et al. 2015, Spitzer et al. 2016), FIRM guided ablation improved the success rate over that expected by PVI alone to over 70% for a single procedure (higher in some independent studies). Randomized clinical trials are underway (as of 2016) and are anticipated.
FIRM-guided ablation is FDA-cleared. More than 3000 patients have been treated worldwide with this approach. Dr. Narayan is co-inventor of patents licensed to Topera Inc, and held equity in Topera on this technology. Details of his consulting and other relationships may be found on his academic website.
Dr. Narayan, Dr. Wang and their collaborators are working to further improve ablation success through clinical trials funded by the National Institutes of Health and other agencies. These trials including performing FIRM mapping and ablation without ablation of the pulmonary veins, strategies to use FIRM-guided ablation with pulmonary vein isolation in different patient populations, and the use of FIRM-guided ablation to treat ventricular arrhythmias. These protocols can be discussed with any member of Dr. Narayan’s team.
Links to some other information on this topic can be found below:
Press:
- The New York Times, "With A-Fib Rhythms, Higher Odds of Stroke"
Videos:
Short List of Publications:
- Narayan SM, Krummen DE, Shivkumar K, Clopton PS, Rappel WJ, Miller JM. Treatment of Atrial Fibrillation by the Ablation of Localized Sources: The CONventional Ablation for Atrial Fibrillation With and Without Focal Impulse and Rotor Modulation (CONFIRM) Trial, Journal of the American College of Cardiology 2012; 60(7): 628-36.
- Shivkumar K, Ellenbogen KA, Hummel JD, Miller JM, Steinberg JS, Acute Termination of Human Atrial Fibrillation by Identification and Catheter Ablation of Localized Rotors and Sources: First Multicenter Experience of Focal Impulse and Rotor Modulation (FIRM) Ablation, Journal of Cardiovascular Electrophysiology 2012; 23(12): 1277-85.
- Miller JM, Kowal RC, Swarup V, Daubert JP, Daoud EG, Day JD, et al. (2014). Initial Independent Outcomes from Focal Impulse and Rotor Modulation Ablation for Atrial Fibrillation: Multicenter FIRM Registry. J Cardiovasc Electrophys 25(9): 921-929.
- Sommer P, Kircher S, Rolf S, John S, Arya A, Dinov B, et al. (2016). Successful Repeat Catheter Ablation of Recurrent Longstanding Persistent Atrial Fibrillation with Rotor Elimination as the Procedural Endpoint: A Case Series. J Cardiovasc Electrophysiol 27(3): 274-280.
- Tomassoni G, Duggal S, Muir M, Hutchins L, Turner K, McLoney AM, et al. (2015). Long-term Follow-up of FIRM-guided Ablation of Atrial Fibrillation: A Single-center Experience. J Innovations in Cardiac Rhythm Management: 2145-2151.
- Rashid H, Sweeney A (2015). Approaches for Focal Impulse and Rotor Mapping in Complex Patients: A US Private Practice Perspective. J Innovations in Cardiac Rhythm Management 6: 2193–2198.
- Spitzer SG, Karolyi L, Rammler C, Scharfe F, Weinmann T, Zieschank M, et al. (2016). Treatment of Recurrent Non-Paroxysmal Atrial Fibrillation Using Focal Impulse and Rotor Mapping (FIRM)-Guided Rotor Ablation: Early Recurrence and Long-Term Outcomes. J Cardiovasc Electrophysiol. 2016
Patient Reviews
Several patients who have received FIRM ablation have offered to speak about their experiences. Please contact Eve Zheng, RN at [email protected] if you would like to speak to one of them.
Testimonials
Several patients who have received FIRM ablation have offered to speak about their experiences. Please contact Eve Zheng, RN at [email protected] if you would like to speak to one of them.