Feasibility of transthoracic echocardiographic guidance for multicatheter electrophysiological mapping studies in horses.
Abstract: Improved characterization of arrhythmias is based on minimally invasive catheterizations. However, these catheterizations have been poorly explored in horses because apart from 3-dimensional (3D) mapping systems, continuous guidance of the catheter's position with adequate detail is difficult using current imaging modalities. Objective: Position multiple electrophysiology catheters simultaneously at predetermined strategical positions in the heart using transthoracic echocardiographic guidance. Methods: Eight adult healthy horses. Methods: Observational study. Two electrophysiological studies were performed: 1 procedure with catheters positioned in the right heart in the standing sedated horse and 1 procedure under general anesthesia with catheters positioned in the left heart. Except for the coronary sinus catheter, each catheter positioning was simultaneously guided by right-parasternal transthoracic echocardiography and 3D electro-anatomical mapping. Results: For each catheter position, a central imaging plane was taken as the starting point, after which the imaging probe was shifted, rotated, and angulated to visualize the catheter over its entire length, including its distal electrode. Catheter positionings in the right heart and left ventricle were successfully guided in the majority of the horses whereas catheter positionings in the left atrium, and especially the pulmonary veins, were challenging to guide echocardiographically. Conclusions: Ultrasound guidance of catheters to specific positions useful for electrophysiological mapping was feasible in the right heart and left ventricle but challenging for the left atrium. This approach creates a perspective for minimally invasive arrhythmia diagnosis without the need for a 3D mapping system. Left parasternal views and intracardiac echocardiography might provide better guidance for left atrial positions.
© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Publication Date: 2024-08-03 PubMed ID: 39096119PubMed Central: PMC11423469DOI: 10.1111/jvim.17156Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
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 discussed an experimental method in equine cardiology where multiple electrophysiology catheters were placed at strategic heart locations using transthoracic echocardiographic guidance. The researchers aim was to provide a less invasive means for diagnosing heart arrhythmias in horses without the need for 3D mapping systems.
Objective and Methodology
- The research aimed to examine the feasibility of positioning multiple electrophysiology catheters in the heart of horses through the guidance of transthoracic echocardiography, a non-invasive ultrasound technique that visualizes the heart.
- The study involved eight healthy adult horses, on which two electrophysiological studies were performed. One operation involved placing catheters in the right heart while the horse is sedated, and the other under general anesthesia with catheters positioned in the left heart.
- Every catheter placement, except for the one in the coronary sinus, had its positioning guided by right-parasternal transthoracic echocardiography combined with 3D electro-anatomical mapping.
Results
- For every catheter positioning, a fundamental imaging plane was first established. After this, the imaging probe was adjusted to visualize the complete length of the catheter and its distal electrode.
- The researchers found catheter positioning in the right heart and left ventricle to be successfully guided in most horses. However, positioning in the left atrium and, especially, the pulmonary veins was challenging to guide using echocardiography.
- The study suggests that ultrasound-guided catheter positioning for electrophysiological mapping is feasible in the right heart and left ventricle but is difficult for the left atrium.
Conclusion
- The research concludes that the study’s approach provides a perspective for minimally invasive arrhythmia diagnosis in horses without the need for 3D mapping systems. However, this technique presents challenges in precise catheter placements, especially in the left atrium.
- As a potential solution to this issue, the researchers suggest left parasternal views and intracardiac echocardiography to provide better guidance for positions in the left atrium.
Cite This Article
APA
Vernemmen I, Buschmann E, Demeyere M, Verhaeghe LM, Van Steenkiste G, Decloedt A, van Loon G.
(2024).
Feasibility of transthoracic echocardiographic guidance for multicatheter electrophysiological mapping studies in horses.
J Vet Intern Med, 38(5), 2686-2697.
https://doi.org/10.1111/jvim.17156 Publication
Researcher Affiliations
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
MeSH Terms
- Animals
- Horses
- Echocardiography / veterinary
- Echocardiography / methods
- Female
- Male
- Cardiac Catheterization / veterinary
- Cardiac Catheterization / methods
- Electrophysiologic Techniques, Cardiac / veterinary
- Electrophysiologic Techniques, Cardiac / instrumentation
- Electrophysiologic Techniques, Cardiac / methods
- Feasibility Studies
- Arrhythmias, Cardiac / veterinary
- Arrhythmias, Cardiac / diagnostic imaging
- Arrhythmias, Cardiac / physiopathology
Grant Funding
- 1S71521N / Fonds Wetenschappelijk Onderzoek
- 1SA2223N / Fonds Wetenschappelijk Onderzoek
- 1SE9122N / Fonds Wetenschappelijk Onderzoek
- 01B05818 / Bijzonder Onderzoeksfonds UGent
Conflict of Interest Statement
Authors declare no conflict of interest.
References
This article includes 30 references
- Van Steenkiste G, Delhaas T, Hermans B. An exploratory study on vectorcardiographic identification of the site of origin of focally induced premature depolarizations in horses, part I: the atria.. Animals (Basel) 2022;12:549.
- Van Steenkiste G, Delhaas T, Hermans B. An exploratory study on vectorcardiographic identification of the site of origin of focally induced premature depolarizations in horses, part II: the ventricles.. Animals (Basel) 2022;12:550.
- Buschmann E, Van Steenkiste G, Boussy T. Three‐dimensional electro‐anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: a case report.. J Vet Intern Med 2023;37:728‐734.
- Van Steenkiste G, Boussy T, Duytschaever M. Detection of the origin of atrial tachycardia by 3D electro‐anatomical mapping and treatment by radiofrequency catheter ablation in horses.. J Vet Intern Med 2022;36:1481‐1490.
- Balter S, Hopewell JW, Miller DL, Wagner LK, Zelefsky MJ. Fluoroscopy guided interventional procedures: a review of radiation effects on patients' skin and hair.. Radiology 2010;254:326‐341.
- Chida K. What are useful methods to reduce occupational radiation exposure among radiological medical workers, especially for interventional radiology personnel?. Radiol Phys Technol 2022;15:101‐115.
- Chida K, Kato M, Kagaya Y. Radiation dose and radiation protection for patients and physicians during interventional procedure.. J Radiat Res (Tokyo) 2010;51:97‐105.
- van Loon G, Van Steenkiste G, Vera L. Catheter‐based electrical interventions to study, diagnose and treat arrhythmias in horses: from refractory period to electro‐anatomical mapping.. Vet J 2020;263:105519.
- Lang RM, Badano LP, Tsang W. EAE/ASE recommendations for image acquisition and display using three‐dimensional echocardiography.. Eur Heart J Cardiovasc Imaging 2012;13:1‐46.
- Issa ZF, Miller JM, Zipes DP. Electrophysiological testing: tools and techniques.. In: Issa ZF, Miller JM, Zipes DP, eds. Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald's Heart Disease. Elsevier; 2019:81‐124.
- Ibrahim L, Buschmann E, van Loon G, Cornillie P. Morphological evidence of a potential arrhythmogenic substrate in the caudal right atrium of horses.. Equine Vet J 2024.
- Vernemmen I, Van Steenkiste G, Buschmann E. Development of an atrial transseptal puncture procedure in horses to access the left heart: an ultrasound‐guided jugular vein and transhepatic approach.. Equine Vet J 2024.
- Vandecasteele T, Cornillie P, van Steenkiste G. Echocardiographic identification of atrial‐related structures and vessels in horses validated by computed tomography of casted hearts.. Equine Vet J 2019;51:90‐96.
- Vernemmen I, Vera L, Van Steenkiste G. Right atrial‐related structures in horses of interest during electrophysiological studies.. Equine Vet J 2021;53:1210‐1217.
- Silvestry FE, Kerber RE, Brook MM. Echocardiography‐guided interventions.. J Am Soc Echocardiogr 2009;22:213‐231.
- Luani B, Zrenner B, Basho M. Zero‐fluoroscopy cryothermal ablation of atrioventricular nodal re‐entry tachycardia guided by endovascular and endocardial catheter visualization using intracardiac echocardiography (Ice&ICE Trial).. J Cardiovasc Electrophysiol 2018;29:160‐166.
- Luani B, Rauwolf T, Genz C, Schmeißer A, Wiemer M, Braun‐Dullaeus RC. Intracardiac echocardiography versus fluoroscopy for endovascular and endocardial catheter navigation during cryo‐ablation of the slow pathway in AVNRT patients.. Cardiovasc Ultrasound 2019;17:12.
- Haïssaguerre M, Jaïs P, Shah DC. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.. N Engl J Med 1998;339:659‐666.
- Vandecasteele T, Van Den Broeck W, Tay H. 3D reconstruction of the porcine and equine pulmonary veins, supplemented with the identification of telocytes in the horse.. Anat Histol Embryol 2018;47:145‐152.
- Linz D, Hesselkilde E, Kutieleh R, Jespersen T, Buhl R, Sanders P. Pulmonary vein firing initiating atrial fibrillation in the horse: oversized dimensions but similar mechanisms.. J Cardiovasc Electrophysiol 2020;31:1211‐1212.
- Kjeldsen ST, Nissen SD, Saljic A. Structural and electro‐anatomical characterization of the equine pulmonary veins: implications for atrial fibrillation.. J Vet Cardiol 2024;52:1‐13.
- Vandecasteele T, van Loon G, Vandevelde K, De Pauw B, Simoens P, Cornillie P. Topography and ultrasonographic identification of the equine pulmonary vein draining pattern.. Vet J 2016;210:17‐23.
- Boutet BG, Gordon SG, De Solis CN. Feasibility and clinical utility of transvenous intracardiac echocardiography in conscious, sedated horses.. J Vet Cardiol 2022;42:15‐22.
- Banchs JE, Patel P, Naccarelli GV, Gonzalez MD. Intracardiac echocardiography in complex cardiac catheter ablation procedures.. J Interv Card Electrophysiol 2010;28:167‐184.
- Bishop SP, Cole CR. Morphology of the specialized conducting tissue in the atria of the equine heart.. Anat Rec 1967;158:401‐416.
- Priori SG, Blomstrom‐Lundqvist C, Mazzanti A. 2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC).. Eur Heart J 2015;36:2793‐2867.
- Vernemmen I, Van Steenkiste G, Hauspie S. Development of a three‐dimensional computer model of the equine heart using a polyurethane casting technique and in vivo contrast‐enhanced computed tomography.. J Vet Cardiol 2024;51:72‐85.
- Worsman FCF, Miller ZJ, Shaw DJ, Blissitt KJ, Keen JA. Real‐time three‐dimensional echocardiography for left atrial volume assessment in Thoroughbred racehorses: observer variability and comparison with two‐dimensional echocardiography.. Equine Vet J 2022;54:176‐190.
- Lang RM, Badano LP, Mor‐Avi V. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.. J Am Soc Echocardiogr 2015;28:1‐39.
- Baad M, Lu ZF, Reiser I, Paushter D. Clinical significance of US artifacts.. Radiographics 2017;37:1408‐1423.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
