Evolution of Physiology and iFR


DEFER, FAME, FAME II data have long shown the benefit of treating patients based on physiology. DEFINE FLAIR and iFR Swedeheart furthered physiology adoption with hyperemia-free measurements (iFR) and showed positive clinical outcomes, increased patient comfort and decreased procedural time.1,2  These results have spurred new interest in resting indices and looking to what is next for physiology.

This discussion consists of four short segments:

  1. Using physiology in evidence based practice
  2. Using iFR or FFR in practice
  3. Standards of evidence for physiological indices
  4. Advancing physiology from decision to guidance


Ajay Kirtane, MD 
Columbia University Medical Center, New York, USA



Rasha Al-Lamee, MD 
Imperial College Healthcare NHS Trust, London, UK

Hitoshi Matsuo, MD
Gifu Heart Center, Gifu, Japan

Javier Escaned, MD
Hospital Clínico San Carlos, Madrid, Spain

Supported by: Philips


Learn more: 
Philips iFR Outcome data 
Philips iFR Co-registration 

1.    Davies JE, et al., Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI. N Engl J Med. 2017 May 11;376(19):1824-1834. 
2.    Gotberg M, et al., iFR-SWEDEHEART Investigators. Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI. N Engl J Med. 2017 May 11;376(19):1813-18233.