Transvenous electrical cardioversion of atrial fibrillation in six horses using custom made cardioversion catheters.
Abstract: Pharmacological conversion of atrial fibrillation (AF) to sinus rhythm in horses can be difficult. The objective of this study was to investigate the feasibility of transvenous electrical cardioversion with custom made catheters in eight horses, of which three had failed cardioversion using quinidine sulfate. Two cardioversion catheters and one pacing/sensing electrode were inserted via the right jugular vein and placed using ultrasound guidance into the left pulmonary artery, the right atrium and the right ventricle, respectively. Because immediate recurrence of AF was encountered in the second horse treated, pre-treatment with amiodarone was given to each of the remaining six horses. Induction of general anaesthesia was associated with dislocation of the cardioversion catheter in three horses, requiring a second catheterisation procedure. During general anaesthesia, biphasic R wave synchronised shocks of up to 360 J were delivered between both cardioversion electrodes. In six horses (75%), including two which had failed quinidine sulfate treatment, sinus rhythm was restored with a mean energy level of 295+/-62 J. No side effects were observed. Blood analysis 3 h after cardioversion revealed normal parameters, including cardiac troponin I values. Transvenous electrical cardioversion of atrial fibrillation with custom made cardioversion catheters can be considered as a treatment option for atrial fibrillation in horses, especially when conventional drugs fail.
Publication Date: 2007-10-24 PubMed ID: 17920965DOI: 10.1016/j.tvjl.2007.08.019Google Scholar: Lookup
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- Clinical Trial
- Journal Article
Summary
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This study explores the feasibility of using transvenous electrical cardioversion by custom-made catheters to treat atrial fibrillation (a heart condition that causes irregular heart rhythms) in horses. The technique was successful in 75% of horses, including two that had not responded to conventional medication.
Study Objective and Methodology
The main goal of the study was to examine the potential of transvenous electrical cardioversion for treating atrial fibrillation in horses. This was done using custom-made cardioversion catheters. The study involved eight horses, three of whom had failed to respond to conventional treatment using quinidine sulfate.
- Researchers inserted two cardioversion catheters and a pacing/sensing electrode via the right jugular vein into the left pulmonary artery, the right atrium, and the right ventricle respectively. Ultrasound guidance was used for this process.
- After the second horse treated experienced an immediate recurrence of atrial fibrillation, the remaining six horses were pre-treated with amiodarone, a medication used to restore normal heart rhythm.
Issues Encountered
The insertion of the cardioversion catheter was a complex process and faced certain issues, mainly with the onset of general anaesthesia.
- During the induction of general anaesthesia, there was a displacement of the cardioversion catheter in three horses. This required a second catheterization procedure.
- Once under general anaesthesia, biphasic R wave synchronized shocks of up to 360 J were delivered between both cardioversion electrodes.
Results of the Study
The results of the study demonstrated a promising success rate, with transvenous electrical cardioversion effectively restoring normal sinus rhythm in six of the eight horses (75%). This included two horses for which conventional treatment with quinidine sulfate was unsuccessful.
- The average energy level used to achieve successful cardioversion was around 295 +/- 62 J, with no observed side effects.
- Post-cardioversion blood analysis was done 3 hours after the procedure and showed normal parameters, including cardiac troponin I values. Cardiac troponin I is a protein that is released into the bloodstream when there is damage to the heart, and therefore normal levels indicate no damage or adverse effects from the cardioversion.
Conclusions
Based on the results, transvenous electrical cardioversion using custom-made cardioversion catheters could be a viable treatment option for atrial fibrillation in horses, especially in cases where conventional drug treatments prove ineffective.
Cite This Article
APA
De Clercq D, van Loon G, Schauvliege S, Tavernier R, Baert K, Croubels S, De Backer P, Deprez P.
(2007).
Transvenous electrical cardioversion of atrial fibrillation in six horses using custom made cardioversion catheters.
Vet J, 177(2), 198-204.
https://doi.org/10.1016/j.tvjl.2007.08.019 Publication
Researcher Affiliations
- Department of Large Animal Internal Medicine, Ghent University, Merelbeke, Belgium. Dominique.DeClercq@UGent.be
MeSH Terms
- Animals
- Atrial Fibrillation / therapy
- Atrial Fibrillation / veterinary
- Catheter Ablation / veterinary
- Catheterization / instrumentation
- Catheterization / veterinary
- Electric Countershock / instrumentation
- Electric Countershock / veterinary
- Female
- Horse Diseases / therapy
- Horses
- Male
Citations
This article has been cited 9 times.- Foreman JH, Tennent-Brown BS, Oyama MA, Sisson DD. Plasma Cardiac Troponin-I Concentration in Normal Horses and in Horses with Cardiac Abnormalities. Animals (Basel) 2025 Jan 3;15(1).
- Van Steenkiste G, Boussy T, Duytschaever M, Vernemmen I, Schauvlieghe S, Decloedt A, van Loon G. 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 Jul;36(4):1481-1490.
- Vernemmen I, Van Steenkiste G, Dufourni A, Decloedt A, van Loon G. Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence. J Vet Intern Med 2022 Mar;36(2):758-769.
- Gozalo-Marcilla M, Ringer SK. Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021 Jun 14;11(6).
- McGurrin MKJ. The diagnosis and management of atrial fibrillation in the horse. Vet Med (Auckl) 2015;6:83-90.
- Decloedt A, Broux B, De Clercq D, Deprez P, Van Steenkiste G, Vera L, Ven S, van Loon G. Effect of sotalol on heart rate, QT interval, and atrial fibrillation cycle length in horses with atrial fibrillation. J Vet Intern Med 2018 Mar;32(2):815-821.
- Decloedt A, Schwarzwald CC, De Clercq D, Van Der Vekens N, Pardon B, Reef VB, van Loon G. Risk factors for recurrence of atrial fibrillation in horses after cardioversion to sinus rhythm. J Vet Intern Med 2015 May-Jun;29(3):946-53.
- Reef VB, Bonagura J, Buhl R, McGurrin MK, Schwarzwald CC, van Loon G, Young LE. Recommendations for management of equine athletes with cardiovascular abnormalities. J Vet Intern Med 2014 May-Jun;28(3):749-61.
- De Clercq D, Decloedt A, Sys SU, Verheyen T, Van Der Vekens N, van Loon G. Atrial fibrillation cycle length and atrial size in horses with and without recurrence of atrial fibrillation after electrical cardioversion. J Vet Intern Med 2014 Mar-Apr;28(2):624-9.
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