Catheter-based electrical interventions to study, diagnose and treat arrhythmias in horses: From refractory period to electro-anatomical mapping

Loon, Gunther van; Steenkiste, Glenn Van; Vera, Lisse; Decloedt, Annelies

doi:10.1016/j.tvjl.2020.105519

Cited by 16 publications

(12 citation statements)

References 27 publications

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“…A large surface area coil reduces electrical resistance and consequently minimalizes focal peak current, allowing efficient shock delivery without damaging the cardiac tissue. [38][39][40] In our study, catheter Type B was significantly negatively correlated with cumulative energy levels during TVEC. To distinguish the influence of catheter type from gain of experience through time, specific analysis was performed on the data of the period around the change of catheters, and this proved indeed an increased cumulative amount of energy administered during TVEC when using the Type A catheters vs the Type B catheters.…”

Section: Discussionmentioning

confidence: 76%

“…Moreover, the impedance was significantly higher when Type A catheters were used, suggesting an inherent difference in catheter properties between the 2 types. The Type A catheters are characterized by a shorter coil 14 and therefore a smaller surface area compared to the Type B catheters, 38 which might result in a higher resistance and therefore higher impedance at shock delivery while including less atrial tissue in the current flow.…”

Section: Discussionmentioning

confidence: 99%

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Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence

Vernemmen

Steenkiste

Dufourni

et al. 2022

Veterinary Internal Medicne

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Background Transvenous electrical cardioversion (TVEC) is 1 of the main treatment options for atrial fibrillation (AF) in horses. Large‐scale studies on factors affecting success and prognosis have primarily been performed in Standardbred populations. Hypothesis/Objectives To determine factors affecting cardioversion success, cardioversion difficulty and recurrence in a predominant Warmblood study sample. Animals TVEC records of 199 horses. Methods Retrospective study of TVEC procedures of horses admitted for AF without severe echocardiographic abnormalities. Horse and procedural factors for success and cumulative amount of energy (≤ 600 J vs > 600 J) were determined using multivariable logistic regression. A survival analysis was performed to determine risk factors for recurrence. Results Two hundred and thirty‐one TVEC procedures were included, with a 94.4% success rate and 31.9% recurrence rate (51/160). Mitral regurgitation (OR 0.151, 95% CI 0.032‐0.715, P = .02) and AF cycle length (OR 1.05, 95% CI 1.01‐1.09, P = .02) were independent determinants for success. Catheter type (OR 0.154, 95% CI 0.074‐0.322, P < .001), previous AF episode (OR 3.10, 95% CI 1.20‐8.01, P = .02), tricuspid regurgitation (OR 2.54, 95% CI 1.25‐5.13, P = .01), and body weight (OR 1.009, 95% CI 1.003‐1.015, P = .004) were significantly correlated with cumulative amount of energy delivered. Significant risk factors for recurrence after a first AF episode were sex (stallion; HR 3.05, 95% CI 1.34‐6.95, P = .008), mitral regurgitation (HR 1.91, 95% CI 1.08‐3.38, P = .03), and AF duration (HR 1.001, 95% CI 1.0001‐1.0026, P = .04). Conclusions and Clinical Importance Both horse and procedural factors should be considered when assessing treatment options and prognosis in horses with AF.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence

Vernemmen

Steenkiste

Dufourni

et al. 2022

Veterinary Internal Medicne

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“…Before RCA, atrial mapping is used to localize the area of electrical activity of the re-entry waves. These methods have been described in horses [113][114][115] but more experience in mapping and RCA is needed before the techniques can be routinely used in equine patients. Clinical trials have concluded that human patients with pAF have a lower risk of recurrence when undergoing RCA compared to anti-arrhythmic therapy [116].…”

Section: Treatment 71 Human Treatment Strategiesmentioning

confidence: 99%

Paroxysmal Atrial Fibrillation in Horses: Pathophysiology, Diagnostics and Clinical Aspects

Kjeldsen

Nissen

Buhl

et al. 2022

Animals

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Atrial fibrillation (AF) is the most common arrhythmia in horses causing poor performance. As in humans, the condition can be intermittent in nature, known as paroxysmal atrial fibrillation (pAF). This review covers the literature relating to pAF in horses and includes references to the human literature to compare pathophysiology, clinical presentation, diagnostic tools and treatment. The arrhythmia is diagnosed by auscultation and electrocardiography (ECG), and clinical signs can vary from sudden loss of racing performance to reduced fitness or no signs at all. If left untreated, pAF may promote electrical, functional and structural remodeling of the myocardium, thus creating a substrate that is able to maintain the arrhythmia, which over time may progress into permanent AF. Long-term ECG monitoring is essential for diagnosing the condition and fully understanding the duration and frequency of pAF episodes. The potential to adapt human cardiac monitoring systems and computational ECG analysis is therefore of interest and may benefit future diagnostic tools in equine medicine.

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“…No complications were observed except slight SC swelling for the first few days. Pacemaker characteristics, such as pulse amplitude and duration to reach pacing threshold, sensing amplitude, and lead impedance, 3 , 14 , 15 were checked repeatedly over the next 2 to 3 weeks and adjusted by transcutaneous programming to ensure good capture. Echocardiography was performed to confirm stable lead position.…”

Section: Case Historymentioning

confidence: 99%

Successful application of closed loop stimulation pacemakers with remote monitoring in 3 miniature donkeys with syncope

Lange

Steenkiste

Vernemmen

et al. 2021

Veterinary Internal Medicne

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Rate‐adaptive single chamber pacemakers with accelerometer, closed loop stimulation (CLS), and remote monitoring functionality (Eluna 8 SR‐T, Biotronik, SE & Co, Germany) were implanted in 3 miniature donkeys with third‐degree atrioventricular block and syncope. After recovery, different pacemaker programming modes were tested at rest, during stress without physical exercise and during physical exercise. Pacing rates were compared to actual atrial rates and showed that CLS functionality allowed physiological heart rate adaptation. A transmitter installed in the stable provided wireless connection of the pacemaker to the internet. Home monitoring was activated which performed daily wireless transmission of pacemaker functional measurements to an online server allowing diagnosis of pathological arrhythmias and pacemaker malfunction from a distance. Closed loop stimulation and remote monitoring functionality resulted in nearly physiological rate adaptation and allowed remote “from‐the‐stable” patient follow‐up.

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Catheter-based electrical interventions to study, diagnose and treat arrhythmias in horses: From refractory period to electro-anatomical mapping

Cited by 16 publications

References 27 publications

Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence

Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence

Paroxysmal Atrial Fibrillation in Horses: Pathophysiology, Diagnostics and Clinical Aspects

Successful application of closed loop stimulation pacemakers with remote monitoring in 3 miniature donkeys with syncope

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