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Equine veterinary journal2024; doi: 10.1111/evj.14424

Lesion size index-guided radiofrequency catheter ablation using an impedance-based three-dimensional mapping system to treat sustained atrial tachycardia in a horse.

Abstract: Sustained atrial tachycardia at an atrial rate of 191/min on the surface ECG was detected in a 6-year-old Warmblood mare. The vectorcardiogram obtained from a 12-lead ECG suggested a caudo-dorsal right atrial origin of the arrhythmia. Impedance-based three-dimensional electro-anatomical mapping, using the EnSite™ Precision Cardiac Mapping System revealed a clockwise macro-reentry around a line of conduction block in the caudomedial right atrium. Ten radiofrequency applications were applied to isolate the caudal vena cava myocardial sleeves at a power of 35 W and mean contact force of 14 ± 3 g until a lesion size index of 6 was reached. Sinus rhythm was restored at the first energy application. Successful isolation was confirmed by demonstrating entrance and exit block. Holter monitoring 5 days post-ablation revealed no abnormalities. To date, 9 months after treatment, no recurrence has been observed. The use of lesion size index-guided ablation and isolation of the arrhythmogenic substrate in the caudal vena cava may minimise the risk of recurrence.
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Publication Date: 2024-10-21 PubMed ID: 39434506DOI: 10.1111/evj.14424Google 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 focuses on the effective treatment of sustained atrial tachycardia in a horse using lesion size index-guided radiofrequency catheter ablation with an impedance-based three-dimensional mapping system.

Background

  • Sustained atrial tachycardia, a heart problem noted for irregularly and abnormally fast heart rhythm, was diagnosed in a 6-year-old horse. This was detected on the surface Electrocardiogram (ECG) with an atrial rate of 191 per minute.
  • The vectorcardiogram obtained from a 12-lead ECG suggested that the arrhythmia’s source was the caudo-dorsal right atrium, a specific part of the heart.

Methodology

  • An impedance-based three-dimensional electro-anatomical mapping system, specifically the EnSite™ Precision Cardiac Mapping System, was used. This revealed that there was a clockwise macro-reentry around a line of conduction block in the caudomedial right atrium of the horse’s heart.
  • The treatment involved radiofrequency applications to isolate the caudal vena cava myocardial sleeves at a power of 35 W and mean contact force of 14 ± 3 g until a lesion size index of 6 was reached.
    • The caudal vena cava is a large vein that carries deoxygenated blood from the lower half of the body back to the right atrium of the heart. Radiofrequency application served to isolate the arrhythmogenic site to correct the heart’s rhythm by ablation or scar formation.
    • The index size of a lesion helped the researchers in determining the effectiveness and duration of the application.

Results

  • After the radiofrequency applications, the horse’s heart rhythm returned to normal sinus rhythm at the first energy application.
  • The success of the isolation was demonstrated by confirming both entrance and exit blocks, indicators of correctly performed isolation.
  • Five days after treatment with a Holter monitoring device, no abnormalities were observed in the horse’s heart rhythm.
  • Nine months after treatment, no recurrence of the atrial tachycardia was noted in the horse.

Conclusion

  • The study revealed that using lesion size index-guided ablation to treat sustained atrial tachycardia in horses can be successful.
  • The technique of isolation for the arrhythmogenic site in the caudal vena cava also reduces the potential risk of recurrence of the condition.

Cite This Article

APA
Buschmann E, Van Steenkiste G, Vernemmen I, Demeyere M, Schauvliege S, Decloedt A, van Loon G. (2024). Lesion size index-guided radiofrequency catheter ablation using an impedance-based three-dimensional mapping system to treat sustained atrial tachycardia in a horse. Equine Vet J. https://doi.org/10.1111/evj.14424

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
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, Anesthesia and Orthopedics, 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

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

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Citations

This article has been cited 3 times.
  1. Buschmann E, Van Steenkiste G, Vernemmen I, Demeyere M, Schauvliege S, Decloedt A, van Loon G. Multiple Catheter Recording in Horses to Investigate Atrial Depolarization Pattern During Sinus Rhythm and Induced Premature Atrial Complexes. J Vet Intern Med 2025 Sep-Oct;39(5):e70218.
    doi: 10.1111/jvim.70218pubmed: 40966305google scholar: lookup
  2. Buschmann E, Easton-Jones C, Van Steenkiste G, De Wilde H, Roberts V, Durando M, Decloedt A, Marr C, van Loon G. Orthodromic Atrioventricular Reentry Bradycardia and Tachycardia Caused by an Accessory Pathway in Horses. J Vet Intern Med 2025 Jul-Aug;39(4):e70175.
    doi: 10.1111/jvim.70175pubmed: 40671630google scholar: lookup
  3. Ibrahim L, Vernemmen I, Buschmann E, van Loon G, Cornillie P. Morphological variations of the interatrial septum and potential implications in equine cardiology. Sci Rep 2025 May 12;15(1):16500.
    doi: 10.1038/s41598-025-01387-3pubmed: 40355652google scholar: lookup
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