When is FIRM considered to be a last resort in atrial fibrillation ablation?

FIRM, or Focal Impulse and Rotor Modulation, is a more advanced technique used in atrial fibrillation ablation focused on identifying and targeting the specific areas in the heart that are responsible for maintaining the arrhythmia. It is considered a last resort often because it is typically employed after other more conventional ablation techniques have not achieved desired results. Once the more standard approaches, such as pulmonary vein isolation or linear ablation, have proven ineffective in controlling the patient’s atrial fibrillation, FIRM may be utilized to potentially improve patient outcomes by addressing the underlying sources of the arrhythmia specifically.

The other options do not align with the context in which FIRM is utilized. For instance, stabilization of a patient's condition or successful ablation of initial wavelets does not imply that FIRM is necessary, nor does the minimally invasive nature of the procedure make it a first-line option. FIRM’s role is more specific to cases where first-line interventions have failed to produce the necessary therapeutic effects.