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Ensite array

Hung-Yu Chang, Li-Wei Lo, Yu-Hui Chou, Wei-Lun Lin, Yenn-Jiang Lin, Shinya Yamada, Shih-Ann Chen
BACKGROUND: Both extrinsic and intrinsic cardiac autonomic nervous systems are important for initiation and maintenance of atrial fibrillation (AF). We aimed to evaluate the effect of vagotomy on the activity of cardiac autonomic ganglionated plexi (GP) and the change of dominant frequency (DF) distribution in the left atrium (LA) during AF. METHODS: A mid-sternal thoracotomy was performed in 6 dogs. High frequency stimulation was applied to locate the GPs. There were four major LA GPs, which were located near the pulmonary vein ostia, and a superior vena cava-aorta (SVC-Ao) GP that was located near the superior vena cava-right atrial junction...
October 1, 2016: International Journal of Cardiology
N Dastagir, G S Chu, F J Vanheusden, J L Salinet, T P Almeida, X Li, P J Stafford, A J Sandilands, F S Schlindwein, G A Ng
INTRODUCTION: The dominant frequency (DF) of atrial electrograms (EGMs) is believed to reflect atrial substrate with periodic activation responsible for the maintenance of persistent atrial fibrillation (persAF). This study assessed whether ablation for persAF affected DF spatio-temporal behaviour using global simultaneous non-contact mapping. METHODS: Five patients with symptomatic longstanding persAF (duration of 34±25 months) undergoing first time ablation were recruited...
October 2014: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Hung-Yu Chang, Li-Wei Lo, Yenn-Jiang Lin, Shih-Huang Lee, Chuen-Wang Chiou, Shih-Ann Chen
BACKGROUND:  Spectral analysis of the left atrium can identify high dominant frequency (DF) sites, which might play a role in the perpetuation of atrial fibrillation (AF). Furthermore, the role of the cardiac autonomic nervous system (CANS) in the genesis of AF has been demonstrated. The relationship between CANS and the high-DF sites (AF nest) was the aim of the investigation. METHODS AND RESULTS:  In 12 dogs, high frequency stimulation was applied to locate 4 major left atrial (LA) ganglionated plexi (GPs)...
2014: Circulation Journal: Official Journal of the Japanese Circulation Society
Philipp Halbfass, Oliver Turschner, Christian Mahnkopf, Johannes Brachmann
Three-dimensional (3-D) mapping systems are of great value for the diagnosis and ablation of cardiac arrhythmias. If applied appropriately, 3-D mapping systems (3DM) can reduce fluoroscopy and procedural time. In general, two advanced mapping systems are currently in use: the Carto™ system (Biosense Webster) uses ultralow-intensity magnetic fields to locate specially designed catheters in the heart chamber. Both, the activation sequence (activation map) and the local potential amplitude (voltage map) can be displayed...
December 2012: Herzschrittmachertherapie & Elektrophysiologie
Yasutsugu Nagamoto, Takeshi Tsuchiya, Koji Miyamoto, Takanori Yamaguchi, Naohiko Takahashi
BACKGROUND: Atrial tachycardia (AT) occurring during atrial fibrillation (AF) ablation is sometimes difficult to identify and eliminate. EnSite Array (EA) visualizes beat-to-beat virtual activation of AT. The aim of the present study was to characterize AT occurring during AF ablation during ongoing AF, using EA. METHODS AND RESULTS: Among 90 patients with AF (paroxysmal, n=67; persistent, n=23) who underwent radiofrequency catheter ablation during ongoing AF, 33 (37%) had 46 ATs that developed during ablation, and 9 (10%) of these patients had 9 ATs that developed before ablation...
2011: Circulation Journal: Official Journal of the Japanese Circulation Society
Mohan Nair, Amitabh Yaduvanshi, Vikas Kataria, Manoj Kumar
OBJECTIVE OF STUDY: To evaluate the efficacy of radiofrequency ablation (RFA) of ventricular tachycardia (VT) using non-contact electro-anatomic mapping in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). METHODS: Fifteen consecutive patients (44 ± 15 years) with ARVD/C and symptomatic VTs were studied. Eight patients had syncopal VTs. Two patients had recurrent VT while on AICD; in three patients, RFA was done prior to AICD implantation, and ten patients refused AICD...
August 2011: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Li-Wei Lo, Chuen-Wang Chiou, Yenn-Jiang Lin, Shih-Huang Lee, Shih-Ann Chen
BACKGROUND: It has been demonstrated that intrinsic cardiac autonomic activation of ganglionated plexi (GPs) exhibits a frequency gradient from the center to the periphery with limited mapping. OBJECTIVE: We aimed to use a global mapping tool (Ensite Array) to identify the frequency distribution and clarify the interaction between the extrinsic/intrinsic autonomic systems. METHODS: A mid sternal thoractomy was performed in anesthetized dogs...
September 2011: Journal of Cardiovascular Electrophysiology
Takanori Yamaguchi, Takeshi Tsuchiya, Koji Miyamoto, Yasutsugu Nagamoto, Naohiko Takahashi
AIMS: Non-pulmonary vein (PV) foci are sometimes difficult to identify and eliminate. The EnSite array (EA) reveals the detailed beat-to-beat virtual activation. This study aimed to characterize non-PV foci using the EA. METHODS AND RESULTS: Sixty-five patients with paroxysmal atrial fibrillation (AF) were included. All had ectopy initiating AF and/or focal atrial tachycardia analysed using the EA. All patients underwent PV isolation (PVI) and additional ablation of non-PV foci if present...
December 2010: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Marek Jastrzebski, Bogumiła Bacior, Agnieszka Olszanecka, Kalina-Kawecka Jaszcz
Two cases of inappropriate sinus tachycardia refractory to combined pharmacotherapy (beta-blocker, ivabradine) are described. Both were female patients (28 and 45 years-old) and underwent sinus node modification/ablation using non-contact mapping (EnSite Array). Since ablation had to be performed in both cases very close to the phrenic nerve (captured during 10V pacing at ablation spots) its function was monitored during ablation with constant phrenic nerve pacing from the superior vena cava. One case was successful after single and straightforward ablation session, the other case despite several attempts and initially good result had recurrences; first recurrence two days after cryoablation, and second three weeks after radiofrequency ablation with irrigated tip catheter...
September 2010: Kardiologia Polska
Koji Miyamoto, Takeshi Tsuchiya, Sumito Narita, Yasutsugu Nagamoto, Takanori Yamaguchi, Shin-ichi Ando, Kiyoshi Hayashida, Yoshito Tanioka, Naohiko Takahashi
BACKGROUND: EnSite array (EA) provides virtual activation of ventricular tachycardia (VT) and premature ventricular contraction (PVC) on a beat-to-beat basis. METHODS AND RESULTS: Fifty-five consecutive patients (age 52+/-16 years) with 79 VTs/PVCs undergoing EA-guided radiofrequency catheter ablation (RFA) were studied, of whom 7 patients had organic heart diseases. A virtual activation map showed that 66 VTs/PVCs originated from the right ventricle (RV), including the RV outflow tract in 57, lateral wall of RV in 4, His bundle region in 3 and tricuspid annulus in 2...
July 2010: Circulation Journal: Official Journal of the Japanese Circulation Society
Heike E Schneider, Thomas Kriebel, Klaus Jung, Verena D Gravenhorst, Thomas Paul
BACKGROUND: Idiopathic ventricular tachycardia (VT) in children with a structurally normal heart can cause significant morbidity, and although rare, mortality. Conventional activation and pace mapping may be limited by nonsustained tachycardia or unstable hemodynamics. OBJECTIVE: The aim of this study was to assess feasibility of catheter ablation of idiopathic VT in the pediatric population guided by noncontact mapping. METHODS: Twenty consecutive pediatric patients with idiopathic VT underwent electrophysiologic study with the intention to use the noncontact mapping system EnSite 3000 (EnSite Array, St...
June 2010: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Koji Miyamoto, Takeshi Tsuchiya, Yasutsugu Nagamoto, Takanori Yamaguchi, Sumito Narita, Shin-Ichi Ando, Kiyoshi Hayashida, Yoshito Tanioka, Naohiko Takahashi
AIMS: Complex fractionated atrial electrogram (CFAE) has been reported to relate to maintain atrial fibrillation (AF). The aims of this study were to investigate the relationship between CFAE and background conditions during sinus rhythm (SR). METHODS AND RESULTS: Electroanatomical mapping using an EnSite Array was performed in 20 patients (paroxysmal AF:persistent AF = 16:4) who underwent pulmonary vein antrum isolation (PVAI). Contact bipolar electrograms were recorded before PVAI, during SR, and subsequently during induced AF...
April 2010: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Shao-ying Zeng, Ji-jun Shi, Ju-heng Ye, Zhi-wei Zhang, Yu-fen Li
OBJECTIVE: To explore safety, indications and advantages of mapping and ablation of arrhythmia in children guided by Carto and Ensite system. METHODS: Guided by Carto system, radiofrequency catheter ablation (RFCA) was performed on 8 pediatric patients with tachycardia whose mean age was (6.2 + or - 1.7) years, mean weight was (18.0 + or - 2.0) kg. Guided by Ensite system, RFCA was performed on 10 pediatric patients with arrhythmia, 8 of them were ablated guided by Ensite Array system: 6 cases with premature ventricular contractions (PVCs), 2 cases with right atrial tachycardia, their mean age was (11...
September 2009: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Sumito Narita, Koji Miyamoto, Takeshi Tsuchiya, Yasutsugu Nagamoto, Takanori Yamaguchi
BACKGROUND: Atrial tachycardia (AT) is sometimes difficult to eliminate by radiofrequency ablation (RFA), but the EnSite array (EA) visualizes the beat-to-beat virtual activation of any tachycardia. METHODS AND RESULTS: The 51 patients with 74 ATs (mean age 57+/-18 years, 28 males) undergoing EA-guided RFA were included; 14 patients had had previous open heart surgery and 5 had organic heart disease. RFA was performed at the AT focus for focal AT (n=48) with an endpoint of AT termination and subsequent non-inducibility...
January 2010: Circulation Journal: Official Journal of the Japanese Circulation Society
Chien-Jung Chang, Yenn-Jiang Lin, Satoshi Higa, Shih-Lin Chang, Li-Wei Lo, Ta-Chuan Tuan, Yu-Feng Hu, Ameya R Udyavar, Wei-Hua Tang, Wen-Chin Tsai, Shin-Yu Huang, Nguyen-Huu Tung, Kazuyoshi Suenari, Hsuan-Ming Tsao, Shih-Ann Chen
INTRODUCTION: The peak electrogram voltage is a typical metric applied at each site for voltage mapping. However, the peak amplitude depends on the direction and complexity of the wavefront propagation. The root-mean-square (RMS) measure of the amplitude is a temporal integral that represents the steady-state value. The objective of this study was to investigate the disparities between the electrogram voltage during SR and AF by using 2 recording modalities: the conventional peak voltage and an RMS measurement...
April 2010: Journal of Cardiovascular Electrophysiology
Gopal Sivagangabalan, Jim Pouliopoulos, Kaimin Huang, Michael A Barry, Juntang Lu, Stuart P Thomas, David L Ross, Aravinda Thiagalingam, Pramesh Kovoor
BACKGROUND: We assessed a novel simultaneous biventricular mapping and ablation approach for septal ventricular tachycardia (VT) in a chronic ovine infarct model. METHODS AND RESULTS: In 8 sheep with inducible VT, mapping and ablation were performed 9+/-3 months after percutaneously induced myocardial infarction, with left ventricular ejection fraction 23+/-8%. Scar was identified by EnSite Dynamic Substrate Mapping plus CARTO voltage mapping. Thirty VT episodes (cycle length, 235+/-42 ms) were mapped with simultaneous analyses using EnSite arrays deployed in both the left ventricle and the right ventricle...
August 2009: Circulation. Arrhythmia and Electrophysiology
Gopal Sivagangabalan, Jim Pouliopoulos, Kaimin Huang, Juntang Lu, Michael A Barry, Aravinda Thiagalingam, David L Ross, Stuart P Thomas, Pramesh Kovoor
BACKGROUND: Substrate-based ablation is useful for nonhemodynamically tolerated postinfarct ventricular tachycardia. We assessed the accuracy of the CARTO contact and EnSite noncontact systems at identifying scar in a chronic ovine model with intramural plunge needle electrode recording and histological validation. METHODS AND RESULTS: Scar mapping was performed on 8 male sheep with previous percutaneous-induced myocardial infarction. Up to 20 plunge needles were inserted into the left ventricle of each animal in areas of dense scar, scar border, and normal myocardium...
December 2008: Circulation. Arrhythmia and Electrophysiology
Anshul M Patel, Andre d'Avila, Petr Neuzil, Steven J Kim, Theofanie Mela, Jagmeet P Singh, Jeremy N Ruskin, Vivek Y Reddy
BACKGROUND: Atrial tachycardia (AT) that develops after ablation of atrial fibrillation often poses a more difficult clinical situation than the index arrhythmia. This study details the use of an impedance-based electroanatomic mapping system (Ensite NavX) in concert with a specialized multielectrode mapping catheter for rapid, high-density atrial mapping. In this study, this activation mapping was combined with entrainment mapping to eliminate ATs developing late after atrial fibrillation ablation...
April 2008: Circulation. Arrhythmia and Electrophysiology
Attila Mihálcz, Tamás Tahin, Tamás Szili-Török
Due to the recent technical development of the past years, most cardiac electrophysiological laboratories are equipped with computer-based electroanatomical mapping systems that precisely describe both the temporal and spatial characteristics of cardiac activation. This development has also been driven by the need for increased accuracy in arrhythmia localization as required for catheter ablation. Computer-based electroanatomical mapping systems are able to reconstruct cardiac anatomy and provide a straightforward representation of chamber activation...
June 22, 2008: Orvosi Hetilap
Claudio Pratola, Elisa Baldo, Pasquale Notarstefano, Toselli Tiziano, Roberto Ferrari
BACKGROUND: Radiofrequency ablation of fast and unstable left ventricular tachycardia (VT) usually requires non-contact mapping. The procedure is usually performed by a retrograde-transaortic route, requiring a double femoral artery puncture, for the 9F multielectrode catheter and the 7F ablation catheter which are advanced through the aorta and aortic valve into the left ventricle (LV). Reported limitations of the procedure are due to the stiffness of the balloon catheter, particularly in patients with tortuous peripheral arteries, atherosclerotic aorta, or with aortic stenosis...
August 2006: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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