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Equine veterinary journal2023; 56(5); 1068-1076; doi: 10.1111/evj.14037

Successful caudal vena cava and pulmonary vein isolation in healthy horses using 3D electro-anatomical mapping and a contact force-guided ablation system.

Abstract: Recently, treatment of equine atrial tachycardia by three-dimensional electro-anatomical mapping (3D EAM) and radiofrequency catheter ablation (RFCA) has been described. Myocardial sleeves in the caudal vena cava and pulmonary veins are a potential trigger for initiation and perpetuation of atrial tachycardia and atrial fibrillation in the horse. Isolation of these myocardial sleeves by RFCA may be an effective treatment for these arrhythmias. Objective: To describe the feasibility of 3D EAM and RFCA to isolate caudal vena cava and pulmonary veins in adult horses using 3D mapping and a contact force (CF)-guided ablation system. Methods: In vivo experiments. Methods: 3D EAM and RFCA was performed in five horses without cardiovascular disease under general anaesthesia, using the CF-guided system CARTO®3. Point-by-point RFCA aimed for isolation of caudal vena cava and pulmonary veins. Radiofrequency energy was delivered in power-controlled mode with a target power of 45 W, CF between 10 and 15 g and 30 mL/min irrigation rate, until an ablation-index of 450-500 was reached. Results: In the right atrium, myocardial sleeves of the caudal vena cava were isolated (n = 5). In the left atrium, isolation of ostium II (n = 3), ostium III (n = 1) and ostium I, II and III en bloc (n = 1) was performed. Successful isolation was confirmed by entrance and exit block. Conclusions: Horses were euthanised at the end of the procedure, so long term effects such as potential reconnection of isolated veins could not be studied. Conclusions: This is the first description of 3D EAM and RFCA with CARTO®3 in horses, thereby showing the technical feasibility and successful caudal vena cava and pulmonary vein isolation. CF measurement allowed monitoring of catheter-tissue contact, resulting in efficient acute lesion creation as confirmed by entrance and exit block. This is a promising treatment for cardiac arrhythmias in horses.
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Publication Date: 2023-12-27 PubMed ID: 38151793DOI: 10.1111/evj.14037Google 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 describes a successful trial of a method called 3D electro-anatomical mapping and radiofrequency catheter ablation (RFCA) using a contact force-guided system to isolate certain sections of the hearts in adult horses. The purpose of these isolations is to treat a specific heart condition, atrial tachycardia, by isolating the sections that potentially trigger it. The trial was only run in the short term, however, future studies would be necessary to determine long-term outcomes.

Research Objective

  • Examining if it’s feasible to use a 3D electro-anatomical mapping (3D EAM) and radiofrequency catheter ablation (RFCA) to isolate particular parts of a horse’s heart. These structures include the caudal vena cava and pulmonary veins, suspected of causing types of arrhythmias (abnormal heartbeats) such as atrial tachycardia and atrial fibrillation.

Methodology

  • The researchers conducted experimental trials on five adult horses that did not report any cardiovascular disease.
  • The horses underwent general anesthesia, and the researchers used a device called CARTO®3 to guide the process.
  • The researchers delivered radiofrequency energy in a power-controlled method with a target power of 45W and irrigation rate of 30ml/min, intending to achieve an ablation-index of 450-500.
  • A point-by-point RFCA approach was employed to isolate the caudal vena cava and the pulmonary veins.

Results

  • The results confirmed successful isolation of the required areas, particularly the myocardial sleeves in the right atrium of the horse’s heart.
  • In the left atrium, the researchers were able to isolate specific parts as well, such as ostium II and ostium III en bloc.
  • The successful isolation was confirmed through what is known as entrance and exit block – information about electrical activity that shows the treated area is correctly isolated.

Conclusions

  • The horses were euthanized after the procedure, meaning the research was unable to monitor for potential reconnection of the isolated veins or determine long-term effects.
  • This study was the first to describe using 3D EAM and RFCA with CARTO®3 in horses, showing its technical feasibility and potential ability to improve treatment for cardiac arrhythmias in horses.
  • Consequently, the experiments successfully demonstrated that using a CF measurement allowed proper monitoring of catheter-tissue contact, culminating in efficient lesion creations (indicative of successful isolation).

Cite This Article

APA
Buschmann E, Van Steenkiste G, Duytschaever M, Boussy T, Vernemmen I, Ibrahim L, Schauvliege S, Decloedt A, van Loon G. (2023). Successful caudal vena cava and pulmonary vein isolation in healthy horses using 3D electro-anatomical mapping and a contact force-guided ablation system. Equine Vet J, 56(5), 1068-1076. https://doi.org/10.1111/evj.14037

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 56
Issue: 5
Pages: 1068-1076

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.
Duytschaever, Mattias
  • Department of Cardiology, AZ Sint-Jan, Brugge, Belgium.
Boussy, Tim
  • Department of Cardiology, AZ Groeninge, Kortrijk, Belgium.
Vernemmen, Ingrid
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Ibrahim, Lara
  • Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, 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.

MeSH Terms

  • Animals
  • Horses
  • Pulmonary Veins / surgery
  • Catheter Ablation / veterinary
  • Catheter Ablation / methods
  • Catheter Ablation / instrumentation
  • Venae Cavae / surgery
  • Vena Cava, Inferior / surgery
  • Male
  • Female

Grant Funding

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

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Citations

This article has been cited 7 times.
  1. Natterson-Horowitz B, Wright K, Van Steenkiste G, Decloedt A, Gagnon AL, Cai X, Mazmanian A. Arrhythmias across the tree of life: comparative insights for human electrophysiology. Front Cardiovasc Med 2025;12:1652591.
    doi: 10.3389/fcvm.2025.1652591pubmed: 41567384google scholar: lookup
  2. 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
  3. 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
  4. 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
  5. Buschmann E, Van Steenkiste G, Vernemmen I, Demeyere M, Schauvliege S, Decloedt A, van Loon G. Caudal vena cava isolation using ablation index-guided radiofrequency catheter ablation (CARTO™ 3) to treat sustained atrial tachycardia in horses. J Vet Intern Med 2025 Jan-Feb;39(1):e17251.
    doi: 10.1111/jvim.17251pubmed: 39614765google scholar: lookup
  6. Buschmann E, Van Steenkiste G, Duytschaever M, Segers P, Ibrahim L, van Loon G, Decloedt A. In vitro characterization of radiofrequency ablation lesions in equine and swine myocardial tissue. Sci Rep 2024 Oct 2;14(1):22877.
    doi: 10.1038/s41598-024-74486-2pubmed: 39358479google scholar: lookup
  7. Vernemmen I, Buschmann E, Van Steenkiste G, Demeyere M, Verhaeghe LM, De Somer F, Devreese KMJ, Schauvliege S, Decloedt A, van Loon G. Intracardiac ultrasound-guided transseptal puncture in horses: Outcome, follow-up, and perioperative anticoagulant treatment. J Vet Intern Med 2024 Sep-Oct;38(5):2707-2717.
    doi: 10.1111/jvim.17158pubmed: 39086137google scholar: lookup
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