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Atrial Fibrillation Innovation Center
AtriCure, Inc
Atritech, Inc
Boston Scientific Corporation
Cardiac Pathways Corporation
Cardima, Inc
CardioFocus, Inc
CryoCath Technologies, Inc
CryoCor, Inc
Endocardial Solutions, Inc
Endoscopic Technologies, Inc
Epicor Medical, Inc
Guidant Corporation
Hansen Medical, Inc
Irvine Biomedical, Inc
Johnson & Johnson
MedicalCV, Inc
Medtronic, Inc
ProRhythm, Inc
St. Jude Medical, Inc.
Stereotaxis, Inc
Symphony Medical, Inc
EXECUTIVE SUMMARY
Overview of Atrial Fibrillation
Patients and Treatments
Total Market
Catheter Ablation Technologies
Advanced Cardiac Mapping & Navigation
Surgical Ablation Technologies
Other Nonpharmacologic Therapies
Cardiac Rhythm Management Devices
Ablate and Pace Therapy
Postoperative AF Prophylaxis
Left Atrial Appendage Occlusion
Competitive Environment
Summary Exhibit 1: Atrial Fibrillation Patients by Age Group, 2005-2011
Summary Exhibit 2: AF Patients by Temporal Pattern, 2005-2011
Summary Exhibit 3: AF Patients Treated, All Modalities, 2005-2011
Summary Exhibit 4: Atrial Fibrillation Products, Market Forecast, 2005-2011
Summary Exhibit 5: AF Catheter Ablation: Patient, Procedure and Product Forecasts, 2005-2011
Summary Exhibit 6: Advanced Cardiac Mapping Systems and Catheters, Market Forecast, 2005-2011
Summary Exhibit 7: Surgical AF Ablation, Patient and Product Forecasts, 2005-2011
Summary Exhibit 8: Implantable Devices for Atrial Fibrillation, U.S. Market Forecast by Segment, 2005-2011
Summary Exhibit 9: Left Atrial Appendage Occlusion Devices, U.S. Market Forecast, 2007-2011
Summary Exhibit 10: Atrial Fibrillation Products, Supplier Shares, 2006
1.0 OVERVIEW OF ATRIAL FIBRILLATION
1.1 Cardiovascular System
1.1.1 Heart
1.1.2 Cardiac Cycle
1.1.3 Blood Vessels
1.1.4 Electrical Conduction System
1.2 Cardiac Rhythm Disorders
1.3 Atrial Fibrillation: Background
1.3.1 Description
1.3.2 Types and Classifications
1.3.2.1 Absence or Presence of Heart Disease
1.3.2.1.1 Lone AF
1.3.2.1.2 Concurrent AF
1.3.2.1.3 Secondary AF
1.3.2.2 Temporal Patterns
1.3.2.2.1 Paroxysmal AF
1.3.2.2.2 Persistent AF
1.3.2.2.3 Permanent AF
1.3.3 Risk Factors
1.3.3.1 Structural Heart Disease
1.3.3.2 Other Cardiac Arrhythmias
1.3.3.3 Endocrine and Metabolic Disorders
1.3.3.4 Surgery
1.3.3.5 Neurogenic Factors
1.3.3.6 Other Acute Events
1.3.3.7 AF Without Associated Heart Disease
1.3.4 Presentation and Sequelae
1.3.4.1 Atrial Factors
1.3.4.1.1 Pathology of Atrium in AF
1.3.4.1.2 Mechanisms of AF
1.3.4.1.3 Role of Autonomic Nervous System
1.3.4.2 Hemodynamic Consequences of AF
1.3.4.3 Thromboembolism
1.3.4.3.1 Pathophysiology of Thrombus Formation
1.3.4.3.2 Clinical Implications
1.3.4.3.3 Unmet Needs & Emerging Solutions
1.3.5 Prognosis
1.4 Atrial Fibrillation Diagnosis
1.4.1 Minimum Evaluation of the Patient with AF
1.4.2 Additional Investigations for AF
1.4.2.1 Holter Monitoring and Exercise Testing
1.4.2.2 Transesophageal Echocardiography (TEE)
1.4.2.3 Electrophysiology Study
1.5 Treatment of Atrial Fibrillation
1.5.1 Acute Management Strategies
1.5.1.1 Restoration of Sinus Rhythm
1.5.1.1.1 Spontaneous Cardioversion
1.5.1.1.2 Pharmacologic Cardioversion
1.5.1.1.3 Electrical Cardioversion
1.5.1.2 Ventricular Rate Control
1.5.2 Maintenance Strategies
1.5.2.1 Debate: Rhythm Control vs Rate Control
1.5.2.2 Maintenance of Sinus Rhythm
1.5.2.2.1 Pharmacologic Rhythm Control
1.5.2.2.2 Pacing-Based Rhythm Control
1.5.2.3 Ventricular Rate Control
1.5.2.3.1 Pharmacologic Rate Control
1.5.2.3.2 AV Node Ablation
1.5.2.3.3 AV Node Modification
1.5.2.3.4 Vagal Nerve Stimulation
1.5.3 Curative Strategies
1.5.3.1 Surgical Ablation
1.5.3.2 Catheter Ablation
1.5.3.2.1 Focal Ablation
1.5.3.2.2 Pulmonary Vein Isolation
1.5.3.2.3 Substrate Ablation
1.5.4 Thromboembolic Risk Management in AF
1.5.4.1 Acute Prevention of Thromboembolism
1.5.4.2 Reduction of Future Thromboembolic Risk
1.5.4.3 Device-Based AF Stroke Prophylaxis
1.5.5 Hybrid Therapy
1.5.5.1 Drugs and Electrical Cardioversion
1.5.5.1.1 Improved Efficacy of Cardioversion
1.5.5.1.2 Reduction of Atrial Remodeling
1.5.5.2 Drugs and Catheter Ablation
1.5.5.3 Drugs and Pacemakers
1.5.5.3.1 Drugs and Pace-Termination
1.5.5.3.2 Drugs and Pacing Prevention
1.5.5.3.3 Conclusion
Exhibit 1-1: The Heart
Exhibit 1-2: Overview of Selected Cardiac Arrhythmias
Exhibit 1-3: Classification of Atrial Fibrillation
Exhibit 1-4: Selected Risk Factors for Atrial Fibrillation
Exhibit 1-5: ATRIA Study: Baseline Characteristics of Atrial Fibrillation Patients
Exhibit 1-6: Diagnosis of Atrial Fibrillation
Exhibit 1-7: Treatment Strategies for Atrial Fibrillation
Exhibit 1-8: Cardioversion Strategies for Atrial Fibrillation
Exhibit 1-9: Maintenance Strategies for Atrial Fibrillation
Exhibit 1-10: Curative Strategies for Atrial Fibrillation
Exhibit 1-11: Stroke Rates in Relation to Age Among Patients with Atrial Fibrillation
Exhibit 1-12: Risk Factors for Ischemic Stroke and Systemic Embolism in Patients with Non-Valvular Atrial Fibrillation
Exhibit 1-13: Selected Studies of Catheter Ablation and Drug Therapy
2.0 PATIENTS AND PROTOCOLS
2.1 Atrial Fibrillation Statistics
2.1.1 Incidence
2.1.2 Prevalence
2.1.2.1 By Age
2.1.2.1.1 Epidemiological Studies
2.1.2.1.2 Conclusions
2.1.2.2 By AF Temporal Pattern
2.1.2.2.1 Epidemiological Studies
2.1.2.2.2 Conclusions
2.1.2.3 Silent AF
2.1.3 Postoperative Atrial Fibrillation
2.2 Current and Forecast AF Patient Populations
2.2.1 By Age Group
2.2.2 By Temporal Pattern
2.2.3 By Treatment
2.2.3.1 Reasons for Undertreatment
2.2.3.2 Treated Caseload
2.2.4 Postoperative Atrial Fibrillation
Exhibit 2-1: Selected Atrial Fibrillation Statistics
Exhibit 2-2: ATRIA Study: Prevalence of Atrial Fibrillation By Age
Exhibit 2-3: Overview of Selected Epidemiological Studies of Atrial Fibrillation
Exhibit 2-4: ATRIA Study: Projected Prevalence of AF in the U.S., 1995-2050
Exhibit 2-5: Outcomes of Selected Epidemiological Studies of AF Prevalence by Age
Exhibit 2-6: 2006 ACC/AHA/ESC Classification of Atrial Fibrillation
Exhibit 2-7: Selected Studies Focusing on Atrial Fibrillation Patients by Type, 2007
Exhibit 2-8: Selected Epidemiological Studies of Silent Atrial Fibrillation
Exhibit 2-9: Incidence of Postoperative Atrial Fibrillation
Exhibit 2-10: Atrial Fibrillation Patients by Age Group, 2005-2011
Exhibit 2-11: Atrial Fibrillation Patients by Temporal Pattern including First Episode, 2005-2011
Exhibit 2-12: Atrial Fibrillation Patients by Temporal Pattern, 2005-2011
Exhibit 2-13: Atrial Fibrillation Patients Treated, All Modalities, 2005-2011
Exhibit 2-14: Atrial Fibrillation Patients Undergoing Device-Based Treatments, 2005-2011
Exhibit 2-15: Postoperative Atrial Fibrillation, Patient Forecast, 2005-2011
3.0 CATHETER-BASED MANAGEMENT OF ATRIAL FIBRILLATION
3.1 Evolution of Atrial Fibrillation Mechanisms and Approaches
3.2 Catheter Ablation Procedure
3.3 Approaches and Techniques
3.3.1 Linear Ablation ("Catheter Maze")
3.3.2 Focal Ablation
3.3.3 Pulmonary Vein Isolation
3.3.3.1 Segmental Ostial Isolation
3.3.3.2 Circumferential Ostial Isolation
3.3.3.3 Pulmonary Vein Antrum Isolation
3.3.3.4 Clinical Experience
3.3.4 Substrate Ablation
3.3.5 Combined Approaches
3.4 Trends in Catheter Ablation
3.4.1 Energy Sources
3.4.1.1 Radiofrequency
3.4.1.2 Microwave
3.4.1.3 Laser
3.4.1.4 Cryoablation
3.4.1.5 High Intensity Focused Ultrasound
3.4.2 Product Refinements and Enhancements
3.5 Technologies and Products
3.5.1 Radiofrequency
3.5.1.1 Bard Electrophysiology (C.R. Bard)
3.5.1.2 Biosense Webster (Johnson & Johnson)
3.5.1.2.1 NaviStar Ablation Catheter
3.5.1.2.2 Celsius
3.5.1.2.3 EZ Steer Bi-Directional
3.5.1.2.4 Stockert 70 RF Generator
3.5.1.2.5 Clinical Experience
3.5.1.3 Boston Scientific Electrophysiology
3.5.1.3.1 Blazer Ablation Catheters
3.5.1.3.2 Chilli Cooled Ablation Catheters
3.5.1.3.3 EPT 1000 and Maestro Generators
3.5.1.4 Cardima
3.5.1.4.1 Revelation
3.5.1.4.2 Revelation Tx (RTx)
3.5.1.4.3 Revelation T-Flex
3.5.1.4.4 Revelation Helix & Helix STX
3.5.1.5 CardioOptics
3.5.1.6 CathRx
3.5.1.7 Endosense SA
3.5.1.8 Medtronic
3.5.1.9 St. Jude Medical
3.5.2 Microwave: Medwaves, Inc
3.5.3 Cryoablation
3.5.3.1 CryoCath Technologies
3.5.3.1.1 Freezor CryoAblation Catheter
3.5.3.1.2 Freezor Xtra and Freezor Max
3.5.3.1.3 Arctic Front
3.5.3.1.4 Arctic Circler
3.5.3.1.5 CryoConsole
3.5.3.2 CryoCor
3.5.4 Laser: CardioFocus
3.5.5 High Intensity Focused Ultrasound: ProRhythm, Inc
3.6 Catheter Ablation Market Analysis
3.6.1 Patient Forecast
3.6.2 Procedure Forecast
3.6.3 Catheter Market Forecast & Supplier Shares
3.6.4 Capital Equipment Market Forecast & Supplier Share
Exhibit 3-1: Catheter-Based Approaches to AF Ablation
Exhibit 3-2: Schematic of Catheter Maze Procedure
Exhibit 3-3: Advantages and Limitations of Pulmonary Vein Isolation
Exhibit 3-4: Catheter-Based Pulmonary Vein Isolation (PVI)
Exhibit 3-5: Selected Studies of Pulmonary Vein Isolation for AF Ablation
Exhibit 3-6: Selected Studies of Substrate Ablation for AF
Exhibit 3-7: Selected Studies of Combined Approaches for Catheter Ablation
Exhibit 3-8: Comparison of Major Energy Sources Used for AF Catheter Ablation
Exhibit 3-9: Selected Studies of RF Ablation Catheter Refinements
Exhibit 3-10: Selected RadioFrequency AF Catheter Ablation Systems, 2007
Exhibit 3-11: Bard Electrophysiology Stinger Ablation Catheters
Exhibit 3-12: Biosense Webster Ablation Catheters
Exhibit 3-13: Boston Scientific Catheter Ablation Products
Exhibit 3-14: Cardima Revelation Ablation Microcatheters
Exhibit 3-15: CathRx's Modular Cardiac Catheters
Exhibit 3-16: Endosense TactiCath Catheter
Exhibit 3-17: Medtronic Ablation Catheters
Exhibit 3-18: Selected St. Jude Medical AF Ablation Catheters
Exhibit 3-19 Selected AF Cryoablation Catheter Systems, 2007
Exhibit 3-20: CryoCath Technologies' AF Ablation Technologies
Exhibit 3-21: Selected Studies of CryoCath's AF Cryoablation Products
Exhibit 3-22: CryoCor Cardiac Cryoablation System (CCCS)
Exhibit 3-23: Selected Studies of the CryoCor Cardiac Cryoablation System for AF
Exhibit 3-24: CardioFocus Laser Catheter Ablation System
Exhibit 3-25: Selected Studies of CardioFocus Laser Balloon AF Ablation Catheter
Exhibit 3-26: ProRhythm HIFU Ablation System
Exhibit 3-27: Selected Studies of the ProRhythm HIFU Ablation System for AF
Exhibit 3-28: AF Catheter Ablation, Patient & Procedure Forecast, 2005-2011
Exhibit 3-29: AF Ablation Catheters, Market Forecast, 2005-2011
Exhibit 3-30: AF Ablation Catheters, Supplier Shares, 2006
Exhibit 3-31: Ablation Capital Equipment, Market Forecast, 2005-2011
Exhibit 3-32: Ablation Capital Equipment, Supplier Shares, 2006
4.0 CARDIAC ELECTROPHYSIOLOGY MAPPING & NAVIGATION
4.1 Overview of Cardiac Mapping
4.2 Mapping Functions
4.3 Design Criteria
4.4 Techniques and Approaches
4.4.1 Conventional Mapping Studies
4.4.2 Advanced 3-D Mapping
4.4.3 Sensor-Based Electroanatomic Mapping
4.4.4 Navigation Technologies
4.4.5 Image Integration Software
4.4.6 Importance for Atrial Fbrillation
4.4.7 Potential Role in Surgical AF Ablation
4.5 Technologies and Suppliers
4.5.1 Biosense Webster (Johnson & Johnson)
4.5.1.1 LASSO Circular Mapping Catheter
4.5.1.2 CARTO XP System
4.5.1.3 CARTOMERGE
4.5.1.4 CARTO RMT
4.5.1.5 NOGA XP System and NOGASTAR Catheter
4.5.2 Boston Scientific Electrophysiology
4.5.2.1 Constellation Basket Catheter
4.5.2.2 Realtime Position Management System
4.5.2.3 Astronomer Plus with SLD
4.5.3 CardioOptics
4.5.4 Hansen Medical
4.5.5 Magnetecs
4.5.6 Stereotaxis
4.5.6.1 MNS Niobe II with CardioDrive and Navigant
4.5.6.2 Catheters and Accessories
4.5.6.3 Applications
4.5.6.4 Benefits
4.5.6.5 Strategic Alliances
4.5.7 St. Jude Medical/Endocardial Solutions
4.6 Procedure Forecast
4.7 Market Analysis
4.7.1 Systems and Suppliers
4.7.2 Advanced Mapping & Navigation Catheters and Suppliers
Exhibit 4-1: Functions of Cardiac Mapping in Atrial Fibrillation
Exhibit 4-2: Design Criteria for Cardiac Mapping and Navigation System
Exhibit 4-3: Major Cardiac Mapping and Navigation Approaches
Exhibit 4-4: Selected 3D Mapping & Navigation Technologies with Application in Atrial Fibrillation, 2007
Exhibit 4-5: Biosense Webster Advanced Cardiac Mapping Products
Exhibit 4-6: Boston Scientific EP Technologies’ Constellation Catheter
Exhibit 4-7: EP Technologies’ Real Time Position Management System and Catheter
Exhibit 4-8: CardioOptics’ SiteSeekir Trans-Blood Vision System
Exhibit 4-9: Hansen Medical Sensei Robotic Catheter System
Exhibit 4-10: Stereotaxis Niobe II System
Exhibit 4-11: St. Jude Medical EnSite System
Exhibit 4-12: Advanced 3D Mapping and Navigation, U.S. Procedure Forecast, 2005-2011
Exhibit 4-13: Advanced 3D Mapping & Navigation Systems, U.S. Market Forecast, 2005-2011
Exhibit 4-14: Advanced 3D Mapping & Navigation Systems, Supplier Shares, 2006
Exhibit 4-15: Advanced 3D Mapping & Navigation Catheters, U.S. Market Forecast, 2005-2011
Exhibit 4-16: Advanced 3D Mapping & Navigation Catheters, Supplier Shares, 2006
5.0 SURGICAL MANAGEMENT OF ATRIAL FIBRILLATION
5.1 Indications for AF Surgery
5.2 Goals of AF Surgery
5.3 Surgical Approaches to Atrial Fibrillation
5.3.1 Classical Cox-Maze Procedure
5.3.1.1 Description
5.3.1.2 Complications
5.3.2 Approaches Adapting Cox-Maze Principles
5.3.2.1 Surgical Pulmonary Vein Isolation
5.3.2.2 Modified Maze Procedures
5.3.2.2.1 Challenges
5.3.2.2.2 Complications
5.3.2.2.3 Clinical Outcomes
5.3.3 Left Atrial Appendage Exclusion
5.4 Directed Energy Sources
5.4.1 Radiofrequency Energy
5.4.2 Microwave Energy
5.4.3 Cryothermal Energy
5.4.4 Laser Energy
5.4.5 High-Intensity Focused Ultrasound
5.5 Minimally Invasive Approaches
5.5.1 Endoscopic and Video-Assisted Surgical Ablation
5.5.2 Intracardiac Beating Heart Pulmonary Vein Isolation
5.5.3 Robotically-Assisted Ablation
5.6 Regulatory Issues
5.7 Reimbursement
5.8 Products and Suppliers
5.8.1 Directed Energy Ablation Devices
5.8.1.1 AtriCure
5.8.1.1.1 Ablation Systems
5.8.1.1.2 Handpieces
5.8.1.1.3 Clinical Experience
5.8.1.1.4 High Intensity Focused Ultrasound
5.8.1.2 Boston Scientific/Guidant
5.8.1.2.1 Flex Probes
5.8.1.2.2 Clinical Experience
5.8.1.3 Cardima, Inc
5.8.1.4 CooperSurgical
5.8.1.5 CryoCath Technologies
5.8.1.5.1 SurgiFrost CryoSurgical Ablation System
5.8.1.5.2 FrostByte System
5.8.1.5.3 Freezor Catheters
5.8.1.6 Edwards Lifesciences
5.8.1.6.1 Optiwave 980 Cardiac Laser Ablation System
5.8.1.6.2 Clinical Experience
5.8.1.6.3 Product History
5.8.1.7 ESTECH
5.8.1.8 MedicalCV
5.8.1.9 Medtronic
5.8.1.9.1 Cardioblate 68000 Generator Surgical Ablation System
5.8.1.9.2 Cardioblate Handpieces
5.8.1.9.3 Navigator Tissue Dissector
5.8.1.9.4 Cardioblate Clinical Experience
5.8.1.10 Messerschmidt-Bolkow-Blohn
5.8.1.11 Spectrasonics Inc
5.8.1.12 St. Jude Medical
5.8.2 Adjunctive Technologies
5.8.2.1 Enhanced Medical Systems
5.8.2.2 Innovention Technologies LLC
5.8.2.3 Intuitive Surgical, Inc
5.9 Procedure Forecast
5.10 Market Analysis
5.11 Supplier Shares
Exhibit 5-1: Major Surgical Approaches to Treatment of Atrial Fibrillation
Exhibit 5-2: The Cox-Maze III Procedure
Exhibit 5-3: Selected Studies of the Cox-Maze Procedure for AF Ablation
Exhibit 5-4: Surgical Pulmonary Vein Isolation
Exhibit 5-5: Selected Studies of Surgical Pulmonary Vein Isolation
Exhibit 5-6: Outcomes of Modified Maze Procedures, Selected Studies
Exhibit 5-7: Comparison of Directed Energy Sources for Atrial Fibrillation Ablation
Exhibit 5-8: Endoscopic Access for MiniMaze Procedures
Exhibit 5-9: Surgical AF Ablation Suppliers and Technologies, 2007
Exhibit 5-10: AtriCure: Selected AF Ablation Handpieces
Exhibit 5-11: Selected Studies of AtriCure's Surgical AF Ablation Systems
Exhibit 5-12: Boston Scientific Guidant Flex Microwave Ablation Probes
Exhibit 5-13: Selected Studies of Guidant Microwave Surgical Ablation System
Exhibit 5-14: Selected Studies of Guidant Microwave Ablation System Using Minimally Invasive Approaches
Exhibit 5-15: Cardima Surgical Ablation Probe
Exhibit 5-16: Frigitronics CCS-200 Cardiovascular Cryosurgical System
Exhibit 5-17: Selected Studies of Frigitronics CCS-200 Cardiovascular Cryosurgical System
Exhibit 5-18: Selected CryoCath Technologies' Cardiac Cryoablation Products
Exhibit 5-19: Selected Studies of SurgiFrost Cryosurgical Ablation System
Exhibit 5-20: Optiwave 980 Cardiac Laser Ablation System
Exhibit 5-21: ESTECH Cobra Surgical Systems
Exhibit 5-22: Selected Clinical Studies of the Cobra System for AF Ablation
Exhibit 5-23: MedicalCV Atrilaze Surgical Ablation System
Exhibit 5-25: Selected Studies of Cardioblate Systems for Surgical AF Ablation
Exhibit 5-26: St. Jude Medical Epicor Cardiac Ablation System
Exhibit 5-27: Selected Suppliers of Adjunctive Technologies to Support Surgical AF Ablation, 2007
Exhibit 5-28: Enhanced Medical Systems' HeartLander System
Exhibit 5-29: Innoventions LLC's Prototype HARP System
Exhibit 5-30: Clinical Application of HARP Device
Exhibit 5-31: Intuitive Surgical daVinci System
Exhibit 5-32: Surgical AF Ablation, U.S. Procedure Forecast, 2005-2011
Exhibit 5-33: Surgical AF Ablation Systems, U.S. Market Forecast by Product Type, 2005-2011
Exhibit 5-34: Surgical AF Ablation Systems, U.S. Market Forecast by Major Segment, 2005-2011
Exhibit 5-35: Surgical AF Ablation Products, Supplier Shares, 2005-2006
6.0 OTHER NONPHARMACOLOGIC THERAPIES
6.1 Rhythm Control
6.1.1 Pacing Therapies
6.1.1.1 Atrial Pacing Strategies
6.1.1.1.1 Multisite Atrial Pacing
6.1.1.1.2 Alternative Site Atrial Pacing
6.1.1.1.3 Overdrive Atrial Pacing
6.1.1.1.4 Atrial Antitachycardia Pacing
6.1.1.2 Clinical Experience
6.1.1.3 Procedure and Market Forecast
6.1.1.4 Suppliers
6.1.2 Implantable Atrial Defibrillators
6.1.2.1 Design Approaches
6.1.2.2 Patient Selection
6.1.2.3 Benefits and Limitations
6.1.2.4 Clinical Experience
6.1.2.5 Products and Suppliers
6.1.2.5.1 Boston Scientific
6.1.2.5.2 Medtronic
6.1.2.5.3 Royal Victoria Hospital
6.1.2.6 Market Analysis
6.1.3 Internal Cardioversion
6.1.3.1 Technique
6.1.3.2 Indications
6.1.3.3 Products and Suppliers
6.1.3.3.1 EP MedSystems
6.1.3.3.2 Rhythm Technologies
6.1.3.3.3 St. Jude Medical
6.1.3.4 Market Assessment
6.2 Rate Control
6.2.1 AV Nodal Ablation
6.2.1.1 Benefits and Limitations
6.2.1.2 Clinical Outcomes
6.2.1.3 Current Recommendations
6.2.1.4 Procedure Forecast
6.2.1.5 Market Analysis
6.2.2 Nondestructive AV Node Modification
6.2.2.1 Slow Pathway Ablation
6.2.2.2 Neuromodulation (Vagal Nerve Stimulation)
6.2.2.2.1 Clinical Rationale
6.2.2.2.2 Approaches
6.2.2.2.3 Products and Suppliers
6.2.2.3 Cell Therapy
6.2.2.4 Gene Therapy
6.2.2.5 Market Assessment
6.3 Management of Postoperative AF
6.3.1 Device-Based Therapies
6.3.1.1 Pacing Therapies
6.3.1.2 Hemostatic Sealant
6.3.1.3 Electrical Cardioversion
6.3.2 Market Analysis
6.4 Stroke Prevention
6.4.1 Left Atrial Appendage Exclusion
6.4.1.1 Clinical Challenges
6.4.1.2 Products and Suppliers
6.4.1.2.1 AGA Medical
6.4.1.2.2 AtriCure
6.4.1.2.3 Atritech
6.4.1.2.4 Epitek
6.4.1.2.5 ev3 (PLAATO)
6.4.1.3 Market Analysis
6.4.1.3.1 Epicardial LAA Exclusion
6.4.1.3.2 Transcatheter LAA Occlusion
6.4.2 Embolic Diversion
Exhibit 6-1: Overview of Other Nonpharmacologic Therapies for AF Management
Exhibit 6-2: Overview of Atrial Pacing Strategies for AF
Exhibit 6-3: Atrial Antitachycardia Pacing Therapies
Exhibit 6-4: Selected Clinical Studies of Pacing for AF Prevention
Exhibit 6-5: AF Suppression Pacemakers, U.S. Procedure and Market Forecast, 2005-2011
Exhibit 6-6: FDA-Approved Pacemakers Offering AF Therapies
Exhibit 6-7: AF Suppression Pacemakers, U.S. Supplier Shares, 2005-2006
Exhibit 6-8: Implantable Atrial Defibrillators: Benefits and Limitations
Exhibit 6-9: Selected Clinical Studies of Implantable Atrial Defibrillators
Exhibit 6-10: Selected Implantable Atrial Defibrillation Products, 2006
Exhibit 6-11: Atrial Defibrillators, U.S. Procedure and Market Forecast, 2005-2011
Exhibit 6-12: Atrial Defibrillators, Supplier Shares, 2005
Exhibit 6-13: Selected AF Internal Cardioversion Technologies
Exhibit 6-14: Advantages and Limitations of AV Node Ablation
Exhibit 6-15: Selected Clinical Studies of AV Nodal Ablation
Exhibit 6-16: Ablate and Pace Therapy: U.S. Procedure Forecast, 2005-2011
Exhibit 6-17: Ablate and Pace Therapy: U.S. Market Forecast, 2005-2011
Exhibit 6-18: Overview of Nondestructive Methods for AV Node Modification
Exhibit 6-18: Selected Clinical Studies of AV Node Modification
Exhibit 6-19: Selected Studies of Vagal Nerve Stimulation for Rate Control of AF
Exhibit 6-20: Selected Studies of Gene Therapy for AV Node Modification
Exhibit 6-21: Overview of Device-Based Therapies for the Management of Postoperative Atrial Fibrillation
Exhibit 6-22: Symphony Medical's Fibrisyl-AF Kit
Exhibit 6-23: SYNCRUS Internal Cardioversion System
Exhibit 6-24: Selected Clinical Studies of the SYNCRUS System
Exhibit 6-25: Postoperative AF Prophylaxis, Patient and Market Forecast, 2005-2011
Exhibit 6-26: Device-Based Approaches for Stroke Prevention in AF
Exhibit 6-27: Selected Clinical Outcomes of Surgical LAA Exclusion
Exhibit 6-28: Left Atrial Appendage (LAA) Exclusion Products and Suppliers, 2006
Exhibit 6-29: AGA Medical's Amplatzer Septal Occluder
Exhibit 6-30: AtriCure's Atrial Exclusion Device
Exhibit 6-31: Atritech's WATCHMAN System
Exhibit 6-32: Selected Clinical Studies of Atritech's WATCHMAN System
Exhibit 6-33: Epitek's Anchorage Closure System
Exhibit 6-34: ev3's PLAATO System
Exhibit 6-35: Selected Clinical Studies of the PLAATO System
Exhibit 6-36: Epicardial LAA Occlusion, U.S. Procedure and Market Forecast, 2007-2011
Exhibit 6-37: Transcatheter LAA Occlusion, U.S. Procedure and Market Forecast, 2009-2011
Exhibit 6-38: MindGuard's Diverter
7.0 COMPANY PROFILES
7.1 Atrial Fibrillation Innovation Center
7.2 AtriCure, Inc
7.3 Atritech, Inc
7.4 Boston Scientific Corporation
7.4.1 Guidant Corporation
7.4.2 Cardiac Pathways Corporation
7.5 Cardima, Inc
7.6 CardioFocus, Inc
7.7 CryoCath Technologies, Inc
7.8 CryoCor, Inc
7.9 Endoscopic Technologies, Inc
7.10 Hansen Medical, Inc
7.11 Johnson & Johnson
7.12 MedicalCV, Inc
7.13 Medtronic, Inc
7.14 Stereotaxis, Inc
7.15 St. Jude Medical, Inc.
7.15.1 Endocardial Solutions, Inc
7.15.2 Epicor Medical, Inc
7.15.3 Irvine Biomedical, Inc
7.15.4 ProRhythm, Inc
7.16 Symphony Medical, Inc