Sabine Ernst

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Jippe Balt

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Leipzig University (Universität Leipzig)

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Papers by Sabine Ernst

Multielectrode Pulmonary Vein Isolation Versus Single Tip Wide Area Catheter Ablation-Paroxysmal Atrial Fibrillation: Is There Any Mystery in Pulmonary Vein Isolation?

Circulation. Arrhythmia and electrophysiology, 2016

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Initial Experience Using the Radiofrequency Needle Visualization on the Electroanatomical Mapping System for Transseptal Puncture

Cardiology Research and Practice

Introduction. Transseptal puncture (TSP) is a routine access route in patients with left-sided ab... more Introduction. Transseptal puncture (TSP) is a routine access route in patients with left-sided ablation substrates and is performed safely on fluoroscopy (+/− echocardiographic guidance). We report on our experience using a radiofrequency (RF) needle in an unselected group of patients to demonstrate safety and usefulness of direct tip visualization on the 3D electroanatomical mapping (EAM) system with specific emphasis on total radiation exposure. Methods and Results. We retrospectively reviewed 42 consecutive left-sided ablation procedures with TSP performed using an RF needle guided by fluoroscopy and/or EAM visualization by a single operator. The procedures included atrial fibrillation (n = 33), atrial tachycardia (n = 8), and ventricular tachycardia (n = 1) ablations. Fourteen of 41 patients had congenital heart disease, including 9 patients with previous septal closure. Twenty-two patients had at least one previous TSP. All TSPs were performed successfully and without complicat...

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Arrhythmias in congenital heart disease: a position paper of the European Heart Rhythm Association (EHRA), Association for European Paediatric and Congenital Cardiology (AEPC), and the European Society of Cardiology (ESC) Working Group on Grown-up Congenital heart disease, endorsed by HRS, PACES,...

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, Jan 20, 2018

The population of patients with congenital heart disease (CHD) is continuously increasing with mo... more The population of patients with congenital heart disease (CHD) is continuously increasing with more and more patients reaching adulthood. A significant portion of these young adults will suffer from arrhythmias due to the underlying congenital heart defect itself or as a sequela of interventional or surgical treatment. The medical community will encounter an increasing challenge as even most of the individuals with complex congenital heart defects nowadays become young adults. Within the past 20 years, management of patients with arrhythmias has gained remarkable progress including pharmacological treatment, catheter ablation, and device therapy. Catheter ablation in patients with CHD has paralleled the advances of this technology in pediatric and adult patients with structurally normal hearts. Growing experience and introduction of new techniques like the 3D mapping systems into clinical practice have been particularly beneficial for this growing population of patients with abnorma...

Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study

Lancet (London, England), Jan 5, 2017

Long-term exposure to pollution can lead to an increase in the rate of decline of lung function, ... more Long-term exposure to pollution can lead to an increase in the rate of decline of lung function, especially in older individuals and in those with chronic obstructive pulmonary disease (COPD), whereas shorter-term exposure at higher pollution levels has been implicated in causing excess deaths from ischaemic heart disease and exacerbations of COPD. We aimed to assess the effects on respiratory and cardiovascular responses of walking down a busy street with high levels of pollution compared with walking in a traffic-free area with lower pollution levels in older adults. In this randomised, crossover study, we recruited men and women aged 60 years and older with angiographically proven stable ischaemic heart disease or stage 2 Global initiative for Obstructive Lung Disease (GOLD) COPD who had been clinically stable for 6 months, and age-matched healthy volunteers. Individuals with ischaemic heart disease or COPD were recruited from existing databases or outpatient respiratory and card...

Epicardial ablation of ventricular tachycardia in a patient with arrhythmogenic right ventricular dysplasia after failed conventional endocardial ablation: A case for remote navigation with functional image integration

Global Cardiology Science and Practice

Arrhythmogenic right ventricular dysplasia (ARVD) is an inheritable heart muscle disease that pre... more Arrhythmogenic right ventricular dysplasia (ARVD) is an inheritable heart muscle disease that predominantly affects the right ventricle (RV) and predisposes to ventricular arrhythmias and sudden cardiac death (SCD)1. The natural history is predominantly related to ventricular electric instability which may lead to arrhythmic SCD, mostly in young people and athletes2,3, but may progress with significant RV muscle disease and left-ventricular (LV) involvement and can result in right or biventricular heart failure4. We report on a 54-year-old male with ARVD who underwent an epicardial ventricular tachycardia (VT) ablation using remote magnetic navigation (RMN) after functional imaging from a nuclear perfusion study was fused with a 3D segmentation from computed tomography (CT) imaging.

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Major adverse events and atrial tachycardia in Ebstein's anomaly predicted by cardiovascular magnetic resonance

Heart (British Cardiac Society), Jan 6, 2017

Patients with Ebstein's anomaly of the tricuspid valve (EA) are at risk of tachyarrhythmia, c... more Patients with Ebstein's anomaly of the tricuspid valve (EA) are at risk of tachyarrhythmia, congestive heart failure and sudden cardiac death. We sought to determine the value of cardiovascular magnetic resonance (CMR) for predicting these outcomes. Seventy-nine consecutive adult patients (aged 37±15 years) with unrepaired EA underwent CMR and were followed prospectively for a median 3.4 (range 0.4-10.9) years for clinical outcomes, namely major adverse cardiovascular events (MACEs: sustained ventricular tachycardia/heart failure hospital admission/cardiac transplantation/death) and first-onset atrial tachyarrhythmia (AT). CMR-derived variables associated with MACE (n=6) were right ventricular (RV) or left ventricular (LV) ejection fraction (EF) (HR 2.06,95% CI 1.168 to 3.623, p=0.012 and HR 2.35,95% CI 1.348 to 4.082, p=0.003, respectively), LV stroke volume index (HR 2.82,95% CI 1.212 to 7.092, p=0.028) and cardiac index (HR 1.71,95% CI 1.002 to 1.366, p=0.037); all remained s...

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Erratum to: An efficient cardiac mapping strategy for radiofrequency catheter ablation with active learning

International journal of computer assisted radiology and surgery, 2017

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2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation

Heart rhythm, Oct 9, 2017

The publisher regrets that this article has been temporarily removed. A replacement will appear a... more

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Multicentre evaluation of non-invasive biatrial mapping for persistent atrial fibrillation ablation: the AFACART study

EP Europace, 2017

Non-invasive electrocardiogram (ECG) mapping allows the activation of the entire atrial epicardiu... more Non-invasive electrocardiogram (ECG) mapping allows the activation of the entire atrial epicardium to be recorded simultaneously, potentially identifying mechanisms critical for atrial fibrillation (AF) persistence. We sought to evaluate the utility of ECG mapping as a practical tool prior to ablation of persistent AF (PsAF) in centres with no practical experience of the system. A total of 118 patients with continuous AF duration &amp;amp;amp;amp;lt;1 year were prospectively studied at 8 European centres. Patients were on a median of 1 antiarrhythmic drug (AAD) that had failed to restore sinus rhythm. Electrocardiogram mapping (ECVUE™, CardioInsight, USA) was performed prior to ablation to map AF drivers (local re-entrant circuits or focal breakthroughs). Ablation targeted drivers depicted by the system, followed by pulmonary vein (PV) isolation, and finally left atrial linear ablation if AF persisted. The primary endpoint was AF termination. Totally, 4.9 ± 1.0 driver sites were mapped per patient with a cumulative mapping time of 16 ± 2 s. Of these, 53% of drivers were located in the left atrium, 27% in the right atrium, and 20% in the anterior interatrial groove. Driver-only ablation resulted in AF termination in 75 of the 118 patients (64%) with a mean radiofrequency (RF) duration of 46 ± 28 min. Acute termination rates were not significantly different amongst all 8 centres (P = 0.672). Ten additional patients terminated with PV isolation and lines resulting in a total AF termination rate of 72%. Total RF duration was 75 ± 27 min. At 1-year follow-up, 78% of the patients were off AADs and 77% of the patients were free from AF recurrence. Of the patients with no AF recurrence, 49% experienced at least one episode of atrial tachycardia (AT) which required either continued AAD therapy, cardioversion, or repeat ablation. Non-invasive mapping identifies biatrial drivers that are critical in PsAF. This is validated by successful AF termination in the majority of patients treated in centres with no experience of the system. Ablation targeting these drivers results in favourable AF-free survival at 1 year, albeit with a significant rate of AT recurrence requiring further management.

Juxtaposition of the atrial appendages: A nidus for thrombus in atriopulmonary Fontan?

Global Cardiology Science and Practice, 2016

Juxtaposition of atrial appendages is a rare cardiac congenital anomaly, usually associated with ... more Juxtaposition of atrial appendages is a rare cardiac congenital anomaly, usually associated with other cardiac malformations. Until now, it has not been linked to any significant clinical implications. We report cardiovascular magnetic resonance (CMR) findings of two adult patients who underwent atriopulmonary Fontan operation in the setting of left juxtaposition of the atrial appendages. The patients were in sinus rhythm at the time of the CMR study. Both patients had episodes of sustained atrial tachyarrhythmia requiring electrical cardioversion and were anticoagulated with warfarin with target INR 2-3. CMR images showed a thrombus located in the enlarged and juxtaposed right appendage in both patients. Blood flow frequently appears slow or sluggish in the dilated right atrium following atriopulmonary Fontan surgery. In addition, cine CMR suggested that blood flow reaches very low velocities in the massively dilated juxtaposed right atrial appendage cul-de-sac, thus potentially cr...

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Aktueller Stand der prim�ren Katheterablation von Vorhofflimmern*

Herz, 2006

Prim�re Katheterablation von Vorhofflimmern

Herz, 2002

Sekund�re Katheterablation von Vorhofflimmern

Herz, 2002

7.3 Helminthen-Infektionen

Innere Medizin, 2013

6.2 Aspergillose

Innere Medizin, 2013

4.13 Gonorrhö