New Approaches To AF Ablation And Mapping

 
• By Jenny Blair
  
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The market for atrial fibrillation catheter ablation devices continues to grow even as the field wrestles with basic questions and as new study results may dampen enthusiasm for some technologies. Though strategics dominate this sector, innovators with new approaches to ablation and mapping hope to help resolve unknowns and take a piece of this vast and underpenetrated market.

Atrial fibrillation (AF or Afib), a condition in which the heart’s atria receive disorganized, irregular electrical signals that cause them to essentially twitch rather than beat, is on the rise worldwide. Catheter ablation of the heart and/or pulmonary veins is a useful treatment for some types of atrial fibrillation, but the procedure carries significant relapse rates, particularly in patients with more severe Afib. The catheter-based Afib ablation landscape is dominated by strategics including St. Jude Medical Inc., Biosense Webster Inc.(a Johnson & Johnsoncompany), Medtronic PLC, Boston Scientific Corp. and Abbott Laboratories Inc., which have made important moves recently. (Also see "Device Companies Follow New Map To Atrial Fibrillation" - Medtech Insight, 7 December, 2012.) But not everyone agrees on whether better mapping technologies or better catheters are the future of Afib ablation, and recent trial results have unsettled many insiders. Smaller companies, in the meantime, are innovating in both. (See Figure 1.) Moreover, one company is working on a completely noninvasive approach. (See sidebar below: CyberHeart Takes Noninvasive Approach To AF Ablation.)

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