Imperial College London

DrSabineErnst

Faculty of MedicineNational Heart & Lung Institute

Professor of Practice (Cardiology)
 
 
 
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s.ernst

 
 
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Chelsea WingRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
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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.

Conference paper

Hebe J, Ernst SIS, 2016, Arrhythmien bei angeborenen Herzfehlern im Erwachsenenalter, Herzschrittmachertherapie + Elektrophysiologie, Vol: 27, Pages: 73-74, ISSN: 1435-1544

Journal article

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.

Journal article

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

Journal article

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

Journal article

Constantinescu M, Lee S, Ernst S, Yang GZet 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.

Conference paper

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.

Journal article

Rydman R, Gatzoulis MA, Ho SY, Ernst S, Swan L, Li W, Wong T, Sheppard M, McCarthy KP, Roughton M, Kilner PJ, Pennell DJ, Babu-Narayan SVet 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

Journal article

Ernst S, Saenen J, Rydman R, Gomez F, Roy K, Mantziari L, Suman-Horduna Iet al., 2015, Utility of Noninvasive Arrhythmia Mapping in Patients with Adult Congenital Heart Disease, Cardiac Electrophysiology Clinics, Vol: 7, Pages: 117-123, ISSN: 1877-9182

Journal article

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.

Book chapter

Heidbuchel H, Wittkampf FHM, Vano E, Ernst S, Schilling R, Picano E, Mont L, Jais P, de Bono J, Piorkowski C, Saad E, Femenia Fet 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

Journal article

Patel HC, Dhillon PS, Mahfoud F, Lindsay AC, Hayward C, Ernst S, Lyon AR, Rosen SD, di Mario Cet al., 2014, The biophysics of renal sympathetic denervation using radiofrequency energy, CLINICAL RESEARCH IN CARDIOLOGY, Vol: 103, Pages: 337-344, ISSN: 1861-0684

Journal article

Keegan J, Jhooti P, Babu-Narayan SV, Drivas P, Ernst S, Firmin DNet 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

Journal article

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,&nbsp;...

Book chapter

Bonello B, Kempny A, Uebing A, Li W, Kilner PJ, Diller G-P, Pennell DJ, Shore DF, Ernst S, Gatzoulis MA, Babu-Narayan SVet 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

Journal article

Ernst S, Castellano I, 2013, Radiation Exposure and Safety for the Electrophysiologist, Current Cardiology Reports, Vol: 15, ISSN: 1523-3782

Journal article

Ernst S, Pedersen M, Uebing A, Suman-Horduna I, Mantziari L, Li W, Babu-Narayan SVet 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

Journal article

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.).

Book chapter

Ueda A, Horduna I, Rubens M, Ernst Set 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

Journal article

Mantziari L, Suman-Horduna I, Babu-Narayan SV, Ernst Set 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.

Journal article

Mantziari L, Babu-Narayan SV, Suman-Horduna I, Rigby ML, Ernst Set 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

Journal article

Mantziari L, Suman-Horduna I, Gujic M, Jones DG, Wong T, Markides V, Foran JP, Ernst Set 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

Journal article

Suman-Horduna I, Babu-Narayan SV, Ueda A, Mantziari L, Gujic M, Marchese P, Dimopoulos K, Gatzoulis MA, Rigby ML, Ho SY, Ernst Set al., 2013, Magnetic navigation in adults with atrial isomerism (heterotaxy syndrome) and supraventricular arrhythmias, EUROPACE, Vol: 15, Pages: 877-885, ISSN: 1099-5129

Journal article

Roudijk RW, Gujic M, Suman-Horduna I, Marchese P, Ernst Set 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

Journal article

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.

Journal article

Suman-Horduna I, Ueda A, Mantziari L, Babu-Narayan SV, Dimopoulos K, Gatzoulis MA, Rigby ML, Ho SY, Ernst Set 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

Journal article

Ueda A, Horduna I, Mantziari L, Marchese P, Gujic M, Bonello B, Babu-Narayan SV, Ho SY, Ernst Set al., 2012, Contribution of Remote Magnetic Navigation to Supraventricular Tachycardia Ablation in Complex Congenital Heart Diseases, CIRCULATION, Vol: 126, ISSN: 0009-7322

Journal article

Camm AJ, Lip GYH, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P, ESC Committee for Practice Guidelines CPGet 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

Journal article

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&nbsp;...

Book chapter

Verma A, Sanders P, Macle L, Deisenhofer I, Morillo CA, Chen J, Jiang C-Y, Ernst S, Mantovan Ret 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

Journal article

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