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Equine veterinary journal2019; 52(3); 374-378; doi: 10.1111/evj.13186

Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses.

Abstract: The number of atrial premature depolarisations (APDs) is a known risk factor for atrial fibrillation (AF) recurrence in humans. Objective: To evaluate if the number of APDs over a 24-h period 5 days post cardioversion predicts AF recurrence within 1 year in horses, taking the multifactorial nature of AF into account. Methods: Retrospective case series. Methods: Eighty horses met these inclusion criteria: first AF episode, no AF recurrence within 5 days post cardioversion, cardioversion by transvenous electrical cardioversion (TVEC), 24-h ECG recording and echocardiographic examination 5 days post cardioversion, no antiarrhythmic treatment during the ECG recording and follow-up of minimum 1 year. To compare the APD burden between the recurrence and non-recurrence group a Mann-Whitney U test was used. A multivariable survival model was built to identify additional risk factors for AF recurrence. Results: The patient population mainly consisted of Warmbloods (93%). Twenty-six horses (33%) experienced AF recurrence within 1 year. The number of APDs (median [range]) was significantly higher (P = 0.01) in the recurrence group (15 [1-152]) compared with the non-recurrence group (7 [0-304]). In the multivariable survival model, APDs ≥25/24 h (hazard ratio [HR] 2.9, 95% confidence interval [CI] 1.2-6.8, P = 0.02), mitral regurgitation (HR 8.6, 95% CI 2.6-28.9, P<0.001), left atrial active fractional area change ≤9.6% (HR 2.6, 95% CI 1.0-6.5, P = 0.04) and lower body weight (HR 0.99, 95% CI 0.98-0.99, P = 0.001) were significantly associated with AF recurrence. Conclusions: This study did not evaluate early AF recurrence within 5 days. The results cannot necessarily be extrapolated to other treatment methods, as only horses converted by TVEC were included. Conclusions: The APD burden 5 days post cardioversion could be a useful predictive value for AF recurrence within 1 year in horses. However, other factors such as mitral regurgitation and atrial contractile function must also be taken into account.
© 2019 EVJ Ltd.
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Publication Date: 2019-10-24 PubMed ID: 31583742DOI: 10.1111/evj.13186Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article investigates if the number of atrial premature depolarisations (APDs) in horses, recorded five days after cardioversion, can predict the recurrence of atrial fibrillation (AF) within one year.

Objective and Methodology of the Research

  • The primary aim of this study was to explore if the count of APDs over a 24-hour period, five days post cardioversion, can forecast AF recurrence within 12 months in horses. The investigation involves accounting for the multifaceted nature of AF.
  • The researchers used the ‘retrospective case series’ method for the study. The sample included 80 horses that met the following criteria:
    • They had faced their first AF episode.
    • The horses did not show AF recurrence within five days after cardioversion.
    • The horses were treated with transvenous electrical cardioversion (TVEC).
    • 24-hour ECG recording and echocardiographic examination were performed five days post cardioversion.
    • The horses did not receive any antiarrhythmic treatment during the ECG recording.
    • The horses were monitored for at least one year.
  • The researchers used the Mann-Whitney U test to compare the APD burden between the recurrence and non-recurrence groups. Adding to this, a multivariable survival model was built to identify additional risk factors for AF recurrence.

Results of the Research

  • The majority of the patient population were Warmbloods (93%).
  • AF recurrence was observed in 26 horses (33%) within 1 year. The number of APDs was significantly higher in the recurrence group compared with the non-recurrence group.
  • In the multivariable survival model, APDs ≥25/24 h, mitral regurgitation, left atrial active fractional area change ≤9.6%, and lower body weight were significantly associated with AF recurrence.

Conclusions Derived from the Research

  • The study does not evaluate the incidence of early AF recurrence within five days.
  • The results may not necessarily be extrapolated to other treatment methods because only horses converted by TVEC were included in this research.
  • The APD burden five days post cardioversion could be a valuable predictive factor for AF recurrence within a year in horses. However, other factors like mitral regurgitation and atrial contractile function must also be considered.

Cite This Article

APA
Vernemmen I, De Clercq D, Decloedt A, Vera L, Van Steenkiste G, van Loon G. (2019). Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses. Equine Vet J, 52(3), 374-378. https://doi.org/10.1111/evj.13186

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 52
Issue: 3
Pages: 374-378

Researcher Affiliations

Vernemmen, I
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
De Clercq, D
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Decloedt, A
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Vera, L
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Van Steenkiste, G
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
van Loon, G
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

MeSH Terms

  • Animals
  • Anti-Arrhythmia Agents
  • Atrial Fibrillation / veterinary
  • Electric Countershock / veterinary
  • Heart Atria
  • Horse Diseases
  • Horses
  • Humans
  • Retrospective Studies

Grant Funding

  • 1S56217N / Fonds Wetenschappelijk Onderzoek
  • 1134917N / Fonds Wetenschappelijk Onderzoek
  • Research Foundation Flanders (FWO-Vlaanderen)

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Citations

This article has been cited 7 times.
  1. Schneider MJ, Piotrowski IL, Junge HK, van Steenkiste G, Vernemmen I, van Loon G, Schwarzwald CC. Application of Acoustic Cardiography in Assessment of Cardiac Function in Horses with Atrial Fibrillation Before and After Cardioversion. Animals (Basel) 2025 Jul 7;15(13).
    doi: 10.3390/ani15131993pubmed: 40646892google scholar: lookup
  2. Nath LC, Elliott A, La Gerche A, Weir J, Forbes G, Thomas G, Franklin S. Associations between postrace atrial fibrillation and measures of performance, racing history and airway disease in horses. J Vet Intern Med 2023 Nov-Dec;37(6):2573-2583.
    doi: 10.1111/jvim.16878pubmed: 37740606google scholar: lookup
  3. Vernemmen I, Van Steenkiste G, Dufourni A, Decloedt A, van Loon G. Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence. J Vet Intern Med 2022 Mar;36(2):758-769.
    doi: 10.1111/jvim.16395pubmed: 35246994google scholar: lookup
  4. Buhl R, Hesselkilde EM, Carstensen H, Hopster-Iversen C, van Loon G, Decloedt A, Van Steenkiste G, Marr CM, Reef VB, Schwarzwald CC, Mitchell KJ, Nostell K, Nogradi N, Nielsen SS, Carlson J, Platonov PG. Atrial fibrillatory rate as predictor of recurrence of atrial fibrillation in horses treated medically or with electrical cardioversion. Equine Vet J 2022 Nov;54(6):1013-1022.
    doi: 10.1111/evj.13551pubmed: 34957586google scholar: lookup
  5. Saljic A, Friederike Fenner M, Winters J, Flethøj M, Eggert Eggertsen C, Carstensen H, Dalgas Nissen S, Melis Hesselkilde E, van Hunnik A, Schotten U, Sørensen U, Jespersen T, Verheule S, Buhl R. Increased fibroblast accumulation in the equine heart following persistent atrial fibrillation. Int J Cardiol Heart Vasc 2021 Aug;35:100842.
    doi: 10.1016/j.ijcha.2021.100842pubmed: 34355058google scholar: lookup
  6. Nath LC, Elliott AD, Weir J, Curl P, Rosanowski SM, Franklin S. Incidence, recurrence, and outcome of postrace atrial fibrillation in Thoroughbred horses. J Vet Intern Med 2021 Mar;35(2):1111-1120.
    doi: 10.1111/jvim.16063pubmed: 33604980google scholar: lookup
  7. Buhl R, Nissen SD, Winther MLK, Poulsen SK, Hopster-Iversen C, Jespersen T, Sanders P, Carstensen H, Hesselkilde EM. Implantable loop recorders can detect paroxysmal atrial fibrillation in Standardbred racehorses with intermittent poor performance. Equine Vet J 2021 Sep;53(5):955-963.
    doi: 10.1111/evj.13372pubmed: 33113157google scholar: lookup
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