There are still EPs out there hitching their wagon to the FIRM horse and that's pretty much what they're talking about in that study, but they don't use the term FIRM. They refer to "rotational" drivers. Well, that's what FIRM was all about: this idea that there are "rotators" in the atria that sustain afib. Natale has poo-pooed the concept from the beginning and has largely been proven right. Incidentally, I had a FIRM ablation in 2014. It added hours to the procedure and accomplished nothing more than creating more burn tissue than necessary in my left atria and left me with 250 bpm flutter. Also, that was a small study and the success rates they quote don't impress me.
If I'm reading the abstract correctly, the 181 burns were across the entire study group, not a single patient.