If you have a horse in the $2.4B A-fib race, hedge your bets with these 3 strategies

It’s a good time to enter the EP-mapping and ablation device market, as Millennium Research Group reports, the more and more popular A-fib ablation procedure will drive those areas toward a value of more than $2.4 billion by 2021.

The increase in atrial fibrillation ablations will drive strong growth in the electrophysiology (EP)-mapping and the ablation device market in the U.S., according to Millennium Research Group. MRG said atrial fibrillation ablations are increasing at nearly double the rate of overall EP ablations. Dr. John Mandrola of Baptist Medical in Louisville, Kentucky, whose been doing these procedures since 2004, said his practice reflects that growth.

An aging population pushing its proverbial pedal to the metal, more advanced technologies and improved operator skill are all big contributors to increase A-fib ablations, he said.

As a fellow Louisvillian, the way I best know how to chart odds are as they fly down the track. So wrap yourself in a rose blanket, don your biggest hat and apply these horse-racing tips to hedge your bets on A-fib tech market growth.

1. Don’t discount the favorite.

After all, Secretariat was a favorite. (Hoo, I just got teary.)

The MRG report suggests catheter technology, such as Medtronic’s Arctic Front Cryoballoon System, revenue will be among the fastest-growing as novel technologies continue to push the market to potential.

Medtronic’s cryo system “has experienced rapid worldwide adoption . . . with more than 55,000 patients treated in 40 countries,” said Joey Lomicky, a communications specialist for the company. The company’s A-fib program has seen steady growth, charting a 54 percent compound annual growth rate from FY08 through FY12.

But Mandrola said he and many of his colleagues have gone back to point-to-point RF rather than cryo ablations because he doesn’t see that they are any better. Plus, he said, pulmonary vein isolation requires more energy, which could increase complications.

2. Slow and steady wins the race.

This kind of horse isn’t showy, but it’s reliable. A safe bet.

As far as incremental growth is concerned, Mandrola looks forward to the development of contact force measurement.

“The notion is knowing the pressure on the heart will make better quality, more durable burns, on the heart, better quality ablations,” he said. Biosense may be particularly close with this technology, he said.

3. Just one word. Are you listening? Plastics: The quiet (but maybe risky) frontrunner.

But if you’re looking for the A-fib ablation version of “plastics” advice, the big fish, catheters aren’t the devices Mandrola foresees making leaps and bounds, technologically speaking.

If you’re feeling lucky Clint Eastwood-style and are a betting man, put your money on EP mapping, more specifically firm ablation devices.

“I believe Topera firm ablation will revolutionize everything about atrial fibrillation,” he said. “It will change everything.”

Though MRG predicts budget-conscious facilities will avoid or delay buying capital equipment and slow construction of labs will limit the EP lab system market, it’s firm ablation that has thought leaders abuzz.

“If it pans out, I would put the horizon on this (wide use of firm ablation) as a couple years,” Mandrola said. “I’m very optimistic, but it’s still early and we need more information.”

It could solve the biggest problem with A-fib ablations–that, as Mandrola puts it, you could be building fences around Los Angeles, Minneapolis and New York, when really the A-fib is coming from Texas. “With AF right now, we just ablate areas that are likely to be the problem . . . and we can’t even do that very well.”

It could show where the AF is coming from and actually target the disease, he said.

The catch? If firm ablation isn’t successful, it’s back to square one in EP-mapping innovation.

The potential payoff: not having to answer another patient’s question about how a doctor knows where to ablate with “I don’t know.”