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Home / Equine Research Bank / Equine Vet J / Three-dimensional electro-anatomical mapping of premature at...
Equine veterinary journal2025; doi: 10.1111/evj.70095

Three-dimensional electro-anatomical mapping of premature atrial complexes originating from the right atrial free wall and treatment by radiofrequency ablation in three horses.

Abstract: Frequent premature atrial complexes (PACs) can increase the risk of atrial fibrillation or atrial tachycardia, and pharmacological therapy can be challenging. Objective: To report the use of three-dimensional electro-anatomical mapping of PAC originating from the right atrial free wall and treatment by radiofrequency ablation in three horses. Methods: Retrospective case report. Methods: Frequent premature atrial complexes (PACs) were diagnosed in three horses. Twelve-lead ECG and vectorcardiography suggested an origin in the right lateral free wall in two horses and the caudal right atrium in one horse. Three-dimensional electro-anatomical mapping (3D EAM) and radiofrequency ablation using the CARTO™ 3 system were performed. Isoprenaline or dobutamine administration allowed activating the focus of PACs during general anaesthesia. Activation mapping using Pattern Matching Filtering identified the origin of PACs at the mid portion of the right atrial free wall in all horses. In the first horse, ablation was not performed due to pacing-induced phrenic nerve stimulation at the site of earliest activation. In the second horse, PACs disappeared after the 18th energy application and were no longer inducible by dobutamine. In the last horse, ablation was not successful in eliminating PACs. Conclusions: Small number of cases. Conclusions: The 3D EAM identified the focus of PACs at the right atrial free wall in three horses, revealing it as a possible arrhythmogenic area. Although still challenging, radiofrequency ablation has promise as a treatment to provide a permanent solution for frequent PACs.
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Publication Date: 2025-09-09 PubMed ID: 40922641DOI: 10.1111/evj.70095Google Scholar: Lookup
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Summary

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Overview

  • This study reports on the use of three-dimensional electro-anatomical mapping (3D EAM) and radiofrequency ablation to locate and treat premature atrial complexes (PACs) originating from the right atrial free wall in three horses.
  • It evaluates the potential of 3D EAM as a diagnostic tool and radiofrequency ablation as a therapeutic approach for arrhythmias in equine patients.

Background

  • Premature atrial complexes (PACs) are early heartbeats originating in the atria, which can increase the risk of more serious arrhythmias such as atrial fibrillation or atrial tachycardia.
  • Pharmacological (drug) therapy for PACs in horses is often challenging and may not always be effective.
  • Three-dimensional electro-anatomical mapping (3D EAM) is an advanced technique commonly used in human cardiology to map electrical activity and identify arrhythmia foci.
  • The study aims to explore the applicability of 3D EAM and radiofrequency ablation—a technique that uses heat generated by radio waves to destroy problematic cardiac tissue—in horses with frequent PACs.

Methods

  • Three horses diagnosed with frequent PACs were studied retrospectively.
  • Diagnostic tools used included:
    • Twelve-lead electrocardiography (ECG) to assess heart rhythm.
    • Vectorcardiography, which helps determine the spatial origin of electrical activity, suggesting the right lateral free wall or caudal right atrium as the PAC source.
  • 3D EAM was performed using the CARTO™ 3 system to build a detailed electrical map of the right atrium.
  • To provoke PACs during general anesthesia, medications such as isoprenaline or dobutamine were administered to activate the arrhythmia focus.
  • Activation mapping with Pattern Matching Filtering was used to precisely localize PAC origins to the mid-portion of the right atrial free wall in all horses.
  • Radiofrequency ablation was attempted to eliminate the PACs by applying targeted energy to the identified arrhythmogenic area.

Results

  • Horse 1:
    • Ablation was not performed because pacing at the target site caused phrenic nerve stimulation, posing a safety risk.
  • Horse 2:
    • Successful elimination of PACs was achieved after the 18th application of radiofrequency energy.
    • PACs could no longer be induced by dobutamine after ablation, indicating treatment effectiveness.
  • Horse 3:
    • Ablation was unsuccessful in eliminating the PACs.
    • Reasons for failure were not specified but could relate to anatomical complexity or inability to completely target the arrhythmia focus.

Conclusions

  • The study demonstrates that the right atrial free wall can be an arrhythmogenic site responsible for PACs in horses.
  • 3D electro-anatomical mapping reliably identified the focus of PACs, indicating it is a valuable diagnostic tool in equine cardiology.
  • Radiofrequency ablation showed promise as a treatment for frequent PACs, with one horse achieving successful elimination of arrhythmia.
  • However, procedural challenges remain, such as avoidance of phrenic nerve stimulation and incomplete ablation success, underscoring the need for further research and refinement.
  • The small case number limits generalization but provides important preliminary evidence supporting the use of advanced mapping and ablation techniques in horses with arrhythmias.

Cite This Article

APA
Buschmann E, Van Steenkiste G, Bulckens H, Schauvliege S, Decloedt A, van Loon G. (2025). Three-dimensional electro-anatomical mapping of premature atrial complexes originating from the right atrial free wall and treatment by radiofrequency ablation in three horses. Equine Vet J. https://doi.org/10.1111/evj.70095

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.
Bulckens, Hannes
  • Biosense Webster - Electrophysiology, Johnson & Johnson, J&J Medtech, Diegem, 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

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

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