Publications
101 results found
Zhou X, Ernst S, Lee S, 2016, Path planning for robot-enhanced cardiac radiofrequency catheter ablation, IEEE International Conference on Robotics and Automation, Publisher: IEEE
Radiofrequency Catheter Ablation (RFCA) is aprocedure used to treat cardiac arrhythmias by burning atregions of the endocardial walls to prevent the abnormalelectrical circuits causing the problem. Patients with AdultCongenital Heart Disease (ACHD) who have undergone surgicaltreatments suffer scarring within the heart that can lead to ab-normal cardiac rhythms. However, poor intraoperative cardiacgeometry recovery and incomplete Electrophysiological (EP)mapping due to limited available procedure time and complexanatomy have resulted in difficulty to detect the regions toablate and hence relatively high recurrence rates. In this paper,we present a catheter path planning algorithm to optimisecardiac EP mapping. Firstly, the optimal mapping positions aredetermined by curvature and distance weighted Quadric ErrorMetric Simplification (QEMS) to maximally recover the cardiacchamber geometry and EP mapping. Secondly, an efficient pathis designed that moves along a predetermined axis for a roboticcatheter to pass through and collect EP data at these positions.Validation is performed on retrospectively collected CARTOdata from ACHD patients.
Hebe J, Ernst SIS, 2016, Arrhythmien bei angeborenen Herzfehlern im Erwachsenenalter, Herzschrittmachertherapie + Elektrophysiologie, Vol: 27, Pages: 73-74, ISSN: 1435-1544
Ernst SIS, Ho SY, McCarthy K, 2016, Arrhythmia in adults with congenital heart defects : Atrial tachycardia, Herzschrittmacherther + Elektrophysiologie, Vol: 27, Pages: 122-130, ISSN: 0938-7412
Atriale Arrhythmien sind bei Patienten mit angeborenen Herzfehlern (AHF) mit und ohne operative Korrektur sehr häufig, und können nur mit beschränkter Erfolgsrate pharmakologisch behandelt werden. Dieser Übersichtsbeitrag beschreibt die heutzutage zur Verfügung stehenden Technologien, um in dieser extrem schwierigen Patientengruppe erfolgreiche Katheterablationen durchzuführen. Neben dem Verständnis der zugrunde liegenden Anatomie, die durch 3D-Bildgebung mithilfe von Magnetresonanztomographie oder Computertomographie ergänzt wird, wird die Auswahl der 3D-Mappingverfahren (sequenziell vs. simultan) vorgestellt. Schließlich wird die konventionelle Navigationstechnik im Vergleich zur magnetischen Navigation erläutert und die jeweiligen atrialen Arrhythmien in Bezug auf die verschiedenen AHF diskutiert.
Ernst S, 2016, Multielectrode Pulmonary Vein Isolation Versus Single Tip Wide Area Catheter Ablation-Paroxysmal Atrial Fibrillation, Circulation: Arrhythmia and Electrophysiology, Vol: 9, ISSN: 1941-3149
Roy K, Gomez-Pulido F, Ernst S, 2016, Remote Magnetic Navigation for Catheter Ablation in Patients With Congenital Heart Disease: A Review, JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol: 27, Pages: S45-S56, ISSN: 1045-3873
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- Citations: 23
Constantinescu M, Lee S, Ernst S, et al., 2016, Traversed Graph Representation for Sparse Encoding of Macro-Reentrant Tachycardia, Statistical Atlases and Computational Models of the Heart. Imaging and Modelling Challenges, Publisher: Springer, Pages: 40-50, ISSN: 0302-9743
Macro-reentrant atrial and ventricular tachycardias originatefrom additional circuits in which the activation of the cardiac chambersfollows a high-frequency rotating pattern. The macro-reentrant circuitcan be interrupted by targeted radiofrequency energy delivery with alinear lesion transecting the pathway. The choice of the optimal ablationsite is determined by the operator’s experience, thus limiting the proceduresuccess, increasing its duration and also unnecessarily extendingthe ablated tissue area in the case of incorrect ablation target estimation.In this paper, an algorithm for automatic intraoperative detection of thetachycardia reentry path is proposed by modelling the propagation as agraph traverse problem. Moreover, the optimal ablation point where thepath should be transected is computed. Finally, the proposed methodis applied to sparse electroanatomical data to demonstrate its use whenundersampled mapping occurs. Thirteen electroanatomical maps of rightventricle and right and left atrium tachycardias from patients treatedfor congenital heart disease were analysed retrospectively in this study,with prediction accuracy tested against the recorded ablation sites andarrhythmia termination points.
Kuck KH, Hoffmann BA, Ernst SIS, 2016, Impact of Complete Versus Incomplete Circumferential Lines Around the Pulmonary Veins During Catheter Ablation of Paroxysmal Atrial Fibrillation: Results From the Gap-Atrial Fibrillation-German Atrial Fibrillation Competence Network 1 Trial, Circulation: Arrhythmia and Electrophysiology, Vol: 9, ISSN: 1941-3149
Background—Ablation of atrial fibrillation (AF) is an established treatment option for symptomatic patients. It is not known whether complete pulmonary vein isolation (PVI) is superior to incomplete PVI with regard to the patients’ clinical outcome.Methods and Results—Patients with drug-refractory, symptomatic paroxysmal AF were randomly assigned to either incomplete (group A) or complete PVI (group B). In group A, a persistent gap was intentionally left within the circumferential ablation line, whereas in group B, complete PVI without any gaps was intended. At 3 months, all patients underwent invasive reevaluation to assess the rate of persistent PVI. Clinical follow-up was based on daily 30-s transtelephonic ECG transmissions. Primary study end point was the time to first recurrence of (symptomatic or asymptomatic) AF. A total of 233 patients were enrolled (116 in group A and 117 in group B). AF recurrence within 3 months was observed in a total of 161 patients (136 [84.5%] with symptomatic and 25 [15.5%] with asymptomatic AF); AF recurred in 62.2% of group B patients and 79.2% of group A patients (P<0.001), for a difference in favor of complete PVI of 17.1% (95% confidence interval, 5.3%–28.9%). Invasive restudy in 103 group A patients and 93 group B patients revealed conduction gaps in 92 (89.3%) and 65 (69.9%) patients, respectively.Conclusions—This study proves the superiority of complete PVI over incomplete PVI with respect to AF recurrence within 3 months. However, the rate of electric reconduction 3 months after PVI is high in patients with initially isolated PVs.
Rydman R, Gatzoulis MA, Ho SY, et al., 2015, Systemic Right Ventricular Fibrosis Detected by Cardiovascular Magnetic Resonance Is Associated With Clinical Outcome, Mainly New-Onset Atrial Arrhythmia, in Patients After Atrial Redirection Surgery for Transposition of the Great Arteries, CIRCULATION-CARDIOVASCULAR IMAGING, Vol: 8, ISSN: 1941-9651
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- Citations: 38
Ernst S, Saenen J, Rydman R, et al., 2015, Utility of noninvasive arrhythmia mapping in patients with adult congenital heart disease., Card Electrophysiol Clin, Vol: 7, Pages: 117-123
Arrhythmia management in patients with adult congenital heart disease (ACHD) is a challenge on many levels, as tachycardic episodes may lead to hemodynamic impairment in otherwise compensated patients even if episodes are only transient. Recently several technical advances, including 3-dimensional (3D) image integration, 3D mapping, and remote magnetic navigation, have been introduced to facilitate curatively intended ablation procedures in patients with ACHD. This review attempts to outline the role of a novel technology of simultaneous, noninvasive mapping in this patient cohort, and gives details of the authors' single-center experience.
Ernst SIS, 2014, Chapter 9: Advanced remote catheter navigation systems, Catheter Ablation of Cardiac Arrhythmias Expert Consult - Online, Publisher: Elsevier Health Sciences, ISBN: 9780323315654
The book also extensively covers the updated, basic concepts of transcatheter energy applications and currently available mapping/imaging tools for ablation.
Heidbuchel H, Wittkampf FHM, Vano E, et al., 2014, Practical ways to reduce radiation dose for patients and staff during device implantations and electrophysiological procedures, EP Europace, Vol: 16, Pages: 946-964, ISSN: 1099-5129
Patel HC, Dhillon PS, Mahfoud F, et al., 2014, The biophysics of renal sympathetic denervation using radiofrequency energy, CLINICAL RESEARCH IN CARDIOLOGY, Vol: 103, Pages: 337-344, ISSN: 1861-0684
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- Citations: 26
Keegan J, Jhooti P, Babu-Narayan SV, et al., 2014, Improved Respiratory Efficiency of 3D Late Gadolinium Enhancement Imaging Using the Continuously Adaptive Windowing Strategy (CLAWS), MAGNETIC RESONANCE IN MEDICINE, Vol: 71, Pages: 1064-1074, ISSN: 0740-3194
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- Citations: 25
Ernst SIS, 2013, Catheter ablation of atrioventricular reentry, Cardiac Electrophysiology: from Cell to Bedside Expert Consult - Online and Print, Publisher: Elsevier Health Sciences, ISBN: 9781455728565
We are pleased to publish the Sixth Edition of Cardiac Electrophysiology: From Cell to Bedside, four years after publication of the Fifth Edition. We shortened publication time by a year because of the breakneck speed of new observations, ...
Bonello B, Kempny A, Uebing A, et al., 2013, Right atrial area and right ventricular outflow tract akinetic length predict sustained tachyarrhythmia in repaired tetralogy of Fallot, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 168, Pages: 3280-3286, ISSN: 0167-5273
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- Citations: 41
Ernst S, Castellano I, 2013, Radiation Exposure and Safety for the Electrophysiologist, Current Cardiology Reports, Vol: 15, ISSN: 1523-3782
Ernst S, Pedersen M, Uebing A, et al., 2013, Successful ablation of two right atrial tachycardias on either side of the lateral tunnel patch in a patient with double inlet left ventricle and total cavopulmonary connection: Two sites and two mechanisms., Global Cardiology Science and Practice, Vol: 2013, Pages: 198-202, ISSN: 2305-7823
Ernst SIS, 2013, Gegenwärtiger Stand der Hochfrequenz-Katheterablation von Vorhoffllimmern, Vorhofflimmern Vorhofflattern Aktuelle Diagnostik und Therapie, Publisher: Springer-Verlag, ISBN: 9783662133835
Aktuelle Diagnostik und Therapie J. Neuzner, H.F. Pitschner. Dr. med. ... Die Deutsche Bibliothek – CIP-Einheitsaufnahme Vorhofflimmern, Vorhofflattern: aktuelle Diagnostik und Therapie; mit 33 Tabellen / J. Neuzner; H. F. Pitschner (Hrsg.).
Ueda A, Horduna I, Rubens M, et al., 2013, Reaching the ventricular aspect of the inferior isthmus in a Fontan patient using magnetic navigation, Heart Rhythm, Vol: 10, Pages: 1094-1095, ISSN: 1547-5271
Mantziari L, Suman-Horduna I, Babu-Narayan SV, et al., 2013, Advanced ablation strategies for management of post-surgical atrial arrhythmias., Gobal Cardiology Science and Practice, Vol: 2013, Pages: 140-148, ISSN: 2305-7823
Post-surgical arrhythmias include a wide range of arrhythmias occurring late after cardiac surgery and represent a complex substrate for catheter ablation either because of extended scar and remodeling or because of limited access to the area of interest. Novel image integration and ablation tools have made the catheter ablation in this population both feasible and successful. We review a structured approach to catheter ablation of post-surgical atrial arrhythmias in various patient cohorts including the most common congenital heart defects.
Mantziari L, Babu-Narayan SV, Suman-Horduna I, et al., 2013, Atrial arrhythmia after Fontan surgery leads to giant thrombus: Opening Pandora's box, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 166, Pages: E23-E24, ISSN: 0167-5273
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- Citations: 3
Roudijk RW, Gujic M, Suman-Horduna I, et al., 2013, Catheter ablation in children and young adults: is there an additional benefit from remote magnetic navigation?, Netherlands Heart Journal, Vol: 21, Pages: 296-303, ISSN: 1568-5888
Mantziari L, Suman-Horduna I, Gujic M, et al., 2013, Use of Asymmetric Bidirectional Catheters with Different Curvature Radius for Catheter Ablation of Cardiac Arrhythmias, PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, Vol: 36, Pages: 757-763, ISSN: 0147-8389
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- Citations: 4
Suman-Horduna I, Babu-Narayan SV, Ueda A, et al., 2013, Magnetic navigation in adults with atrial isomerism (heterotaxy syndrome) and supraventricular arrhythmias, EUROPACE, Vol: 15, Pages: 877-885, ISSN: 1099-5129
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- Citations: 20
Suman-Horduna I, Babu-Narayan SV, Ernst S, 2013, Remote Navigation for Complex Arrhythmia., Arrhythm Electrophysiol Rev, Vol: 2, Pages: 53-58, ISSN: 2050-3369
Magnetic navigation has been established as an alternative to conventional, manual catheter navigation for invasive electrophysiology interventions about a decade ago. Besides the obvious advantage of radiation protection for the operator who is positioned remotely from the patient, there are additional benefits of steering the tip of a very floppy catheter. This manuscript reviews the published evidence from simple arrhythmias in patients with normal cardiac anatomy to the most complex congenital heart disease. This progress was made possible by the introduction of improved catheters and most importantly irrigated-tip electrodes.
Suman-Horduna I, Ueda A, Mantziari L, et al., 2012, Duplication of the Conduction System in Heterotaxy Syndrome Delineated Using Remote Magnetic Navigation and Three-Dimensional Mapping, CIRCULATION, Vol: 126, ISSN: 0009-7322
Ueda A, Horduna I, Mantziari L, et al., 2012, Contribution of Remote Magnetic Navigation to Supraventricular Tachycardia Ablation in Complex Congenital Heart Diseases, CIRCULATION, Vol: 126, ISSN: 0009-7322
Camm AJ, Lip GYH, De Caterina R, et al., 2012, 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association., Eur Heart J, Vol: 33, Pages: 2719-2747
Ernst SIS, 2012, Role of Remote Navigation in Mapping and Ablation of Complex Arrhythmias, Cardiac Mapping, Publisher: John Wiley & Sons, ISBN: 9781118481516
Mohammad Shenasa, Gerhard Hindricks, Martin Borggrefe, Gunter Breithardt, Mark E. Josephson. 250 239 238 Total # of articles 200 1 50 1 00 50 219 Tables 80.1 and 80.2 summarize the milestones achieved in cardiac mapping and the ...
Verma A, Sanders P, Macle L, et al., 2012, Substrate and Trigger Ablation for Reduction of Atrial Fibrillation Trial-Part II (STAR AF II): Design and Rationale, AMERICAN HEART JOURNAL, Vol: 164, Pages: 1-+, ISSN: 0002-8703
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- Citations: 38
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