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Home / Equine Research Bank / J Vet Intern Med / Caudal vena cava isolation using ablation index-guided radio...
Journal of veterinary internal medicine2024; doi: 10.1111/jvim.17251

Caudal vena cava isolation using ablation index-guided radiofrequency catheter ablation (CARTO™ 3) to treat sustained atrial tachycardia in horses.

Abstract: Myocardial sleeves of the caudal vena cava are the predilection site for atrial tachycardia (AT) in horses. Caudal vena cava isolation guided by the ablation index, a lesion quality marker incorporating power, duration and contact force, might improve outcome. Objective: Describe the feasibility and outcome of caudal vena cava isolation using ablation index-guided radiofrequency catheter ablation (RFCA) to treat AT in horses. Methods: Ten horses with sustained AT. Methods: Records from 10 horses with sustained AT treated by three-dimensional electro-anatomical mapping and ablation index-guided RFCA (CARTO™ 3) were reviewed. Results: Three-dimensional electro-anatomical mapping of the right atrium identified a macro-reentry circuit in the caudomedial right atrium (n = 10). Point-by-point RFCA was performed to isolate the myocardial sleeves of the caudal vena cava in power-controlled mode with a mean of 17 ± 7 applications. The ablation index target was 400-450. A median ablation index of 436 (range, 311-763) was reached using a median maximum power of 35 (range, 24-45) W for a median duration of 20 (range, 8-45) seconds, with a median contact force of 10 (range, 3-48) g. Sinus rhythm was restored in all 10 horses. To date, 9-37 months post-ablation, none of the horses have had recurrence. Conclusions: Caudal vena cava isolation using ablation index-guided RFCA was feasible and effective to permanently treat sustained AT in horses. Ablation index guidance ensured efficient lesion creation, and isolation of the caudal vena cava eliminated the arrhythmogenic substrate, thereby minimizing the risk of recurrence.
© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2024-11-30 PubMed ID: 39614765DOI: 10.1111/jvim.17251Google Scholar: Lookup
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Summary

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This study explores the viability and outcome of using ablation index-guided radiofrequency catheter ablation to treat prolonged atrial tachycardia in horses by isolating the caudal vena cava, a common site for the condition.

Research Objective

  • The study primarily intends to investigate the effectiveness of caudal vena cava isolation using ablation index-guided radiofrequency catheter ablation to treat Atrial Tachycardia (AT), a heart condition in horses. Myocardial sleeves of the caudal vena cava are recognized as attribute locations for AT in horses and isolating them using ablation index, a parameter that indicates lesion quality and includes factors like power, duration, and contact force, could improve the treatment outcome.

Methods

  • The researchers used the records of ten horses with sustained AT that were treated with a process that involved mapping the heart’s three-dimensional electro-anatomical structure and performing ablation index-guided radiofrequency catheter ablation (RFCA) using the CARTO™ 3 system.
  • The point-by-point method of RFCA was applied to isolate the myocardial sleeves in the caudal vena cava (using a controlled power mode). On average, 17 applications were required per horse.
  • The target for the ablation index was set between 400 and 450.

Results

  • The three-dimensional electro-anatomical mapping of the horses’ right atrium showed a macro-reentry circuit in the caudomedial right atrium.
  • The median ablation index achieved was 436, which was attained using a median maximum power of 35W for a median duration of 20 seconds, with a median contact force of 10g.
  • The procedure successfully restored sinus rhythm (regular heart function) in all the tested horses.
  • In the follow-up period (9-37 months after treatment), none of the treated horses experienced a recurrence of AT.

Conclusion

  • This investigation concluded that using ablation index-guided RFCA to isolate the caudal vena cava is a viable and efficient method for treating sustained AT in horses.
  • The guidance provided by the ablation index ensures effective lesion creation, and the isolation of the caudal vena cava eliminates the arrhythmogenic substrate, therefore reducing the risk of recurrence.

Cite This Article

APA
Buschmann E, Van Steenkiste G, Vernemmen I, Demeyere M, Schauvliege S, Decloedt A, van Loon G. (2024). Caudal vena cava isolation using ablation index-guided radiofrequency catheter ablation (CARTO™ 3) to treat sustained atrial tachycardia in horses. J Vet Intern Med. https://doi.org/10.1111/jvim.17251

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English

Researcher Affiliations

Buschmann, Eva
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Van Steenkiste, Glenn
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Vernemmen, Ingrid
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Demeyere, Marie
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Schauvliege, Stijn
  • Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Ghent University, Merelbeke, Belgium.
Decloedt, Annelies
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
van Loon, Gunther
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Grant Funding

  • 1S71521N / Fonds Wetenschappelijk Onderzoek
  • 1SE9122N / Fonds Wetenschappelijk Onderzoek
  • 01B05818 / Bijzonder Onderzoeksfonds UGent

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