Transvenous electrical cardioversion of equine atrial fibrillation: patient factors and clinical results in 72 treatment episodes.
Abstract: Transvenous electrical cardioversion (TVEC) has been developed for treatment of atrial fibrillation (AF) in horses. The relationship among patient variables, treatment response, and outcome in a typical referral population has not been evaluated. Objective: Patient variables such as age, sex, weight, and duration of arrhythmia affect prognosis for response to treatment and the energy level at which cardioversion occurs. Methods: TVEC was applied to 72 episodes of lone AF in 63 client-owned performance horses, with the majority (54) being Standardbred racehorses. Methods: Catheterization of the right atrium (RA) and pulmonary artery (PA) through the jugular vein was used for electrode placement before horses were placed under general anesthesia. Biphasic, truncated exponential shock waves were delivered at incremental energy levels until cardioversion was achieved or a maximum single-energy level of 300 J was reached (cumulative energy 50-1,960 J). A multivariate model was constructed to evaluate influence of patient factors on cardioversion energy. Results: Cardioversion was achieved in 71 of 72 episodes (62 of 63 horses) at a mean energy of 165.43 +/- 8.75 J. Cardioversion energy was higher for females than for males, and for interaction terms, weight was negatively related to energy in females and positively related in males. Age was positively related to cardioversion energy in females. No relationship was identified between duration of arrhythmia before treatment and prognosis for response or cardioversion energy. Conclusions: TVEC is highly effective in the treatment of lone AF in horses. Although age and sex influence cardioversion energy level, duration of arrhythmia does not.
Publication Date: 2008-05-02 PubMed ID: 18466256DOI: 10.1111/j.1939-1676.2008.0081.xGoogle Scholar: Lookup
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- Clinical Trial
- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research investigates how transvenous electrical cardioversion (TVEC), a treatment for atrial fibrillation (AF) in horses, is affected by certain patient variables such as age, sex, weight, and duration of arrhythmia. The study finds the treatment highly effective, though age and sex impact the energy level required for cardioversion.
Methodology
- The study was conducted on 63 client-owned performance horses that had registered 72 episodes of lone AF, with 54 of these horses being Standardbred racehorses.
- The treatment process involved catheterization of the right atrium (RA) and pulmonary artery (PA) through the jugular vein for electrode placement before the horses were placed under general anesthesia.
- Biphasic, truncated exponential shock waves were then delivered at increasing energy levels until cardioversion, or restoration of regular heart rhythm, was achieved or a maximum level of 300 J was hit. The cumulative energy applied ranged from 50 to 1,960 J.
- To understand the influence of patient factors like age, sex, weight, and duration of arrhythmia on the necessary cardioversion energy, a multivariate model was set up.
Results
- The treatment was successful in 71 of the 72 episodes, effectively treating 62 of the 63 horses. The mean cardioversion energy used was approximately 165.43 +/- 8.75 J.
- It was observed that the necessary cardioversion energy was higher for female horses as compared to males.
- Interestingly, weight influenced cardioversion energy differently in males and females. While heavier female horses required less energy for cardioversion, male horses showed the opposite pattern where greater weight was related to needing more energy.
- Age was found to increase the necessary cardioversion energy in female horses.
- Despite initial assumptions, the researchers found no identifiable correlation between the duration of arrhythmia before treatment and the outcome of the treatment or the necessary cardioversion energy.
Conclusion
- The study concluded that TVEC is a highly effective method for treating lone AF in horses. However, age and sex play a role in determining the amount of energy necessary for successful cardioversion.
- The duration of arrhythmia before seeking treatment shows no significance in influencing the treatment’s outcome or the required cardioversion energy, a finding which contradicts earlier expectations.
Cite This Article
APA
McGurrin MK, Physick-Sheard PW, Kenney DG.
(2008).
Transvenous electrical cardioversion of equine atrial fibrillation: patient factors and clinical results in 72 treatment episodes.
J Vet Intern Med, 22(3), 609-615.
https://doi.org/10.1111/j.1939-1676.2008.0081.x Publication
Researcher Affiliations
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada. mcgurrin@uoguelph.ca
MeSH Terms
- Animals
- Atrial Fibrillation / therapy
- Cardiac Catheterization / veterinary
- Catheterization, Swan-Ganz / veterinary
- Electric Countershock / methods
- Electric Countershock / veterinary
- Female
- Horse Diseases / therapy
- Horses
- Male
- Sex Factors
Citations
This article has been cited 16 times.- Schneider MJ, Piotrowski IL, Junge HK, van Steenkiste G, Vernemmen I, van Loon G, Schwarzwald CC. Application of Acoustic Cardiography in Assessment of Cardiac Function in Horses with Atrial Fibrillation Before and After Cardioversion. Animals (Basel) 2025 Jul 7;15(13).
- Kuroda T, Minamijima Y, Kinman CK, Takahashi Y, Ebisuda Y, Inoue K, Ishikawa H, Mita H, Tamura N, Nukada T, Toutain PL, Ohta M. Rational quinidine dosage regimen for atrial fibrillation in Thoroughbred racehorses based on population pharmacokinetics. Front Vet Sci 2024;11:1454342.
- Burns JJ, MacMillan KM, John EE. Retrospective review of atrial fibrillation in Standardbred racehorses at a tertiary care facility in Atlantic Canada. Can Vet J 2022 Oct;63(10):1051-1056.
- 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.
- Buhl R, Hesselkilde EM, Carstensen H, Hopster-Iversen C, van Loon G, Decloedt A, Van Steenkiste G, Marr CM, Reef VB, Schwarzwald CC, Mitchell KJ, Nostell K, Nogradi N, Nielsen SS, Carlson J, Platonov PG. Atrial fibrillatory rate as predictor of recurrence of atrial fibrillation in horses treated medically or with electrical cardioversion. Equine Vet J 2022 Nov;54(6):1013-1022.
- Nath LC, Elliott AD, Weir J, Curl P, Rosanowski SM, Franklin S. Incidence, recurrence, and outcome of postrace atrial fibrillation in Thoroughbred horses. J Vet Intern Med 2021 Mar;35(2):1111-1120.
- Hesselkilde E, Linz D, Saljic A, Carstensen H, Kutieleh R, Jespersen T, Sanders P, Buhl R. First catheter-based high-density endocardial 3D electroanatomical mapping of the right atrium in standing horses. Equine Vet J 2021 Jan;53(1):186-193.
- Broux B, De Clercq D, Vera L, Ven S, Deprez P, Decloedt A, van Loon G. Can heart rate variability parameters derived by a heart rate monitor differentiate between atrial fibrillation and sinus rhythm?. BMC Vet Res 2018 Oct 25;14(1):320.
- Kraus M, Physick-Sheard P, Brito LF, Sargolzaei M, Schenkel FS. Marginal ancestral contributions to atrial fibrillation in the Standardbred racehorse: Comparison of cases and controls. PLoS One 2018;13(5):e0197137.
- 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.
- Marly-Voquer C, Schwarzwald CC, Bettschart-Wolfensberger R. The use of dexmedetomidine continuous rate infusion for horses undergoing transvenous electrical cardioversion--A case series. Can Vet J 2016 Jan;57(1):70-5.
- 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.
- Van Der Vekens N, Decloedt A, Ven S, De Clercq D, van Loon G. Cardiac troponin I as compared to troponin T for the detection of myocardial damage in horses. J Vet Intern Med 2015 Jan;29(1):348-54.
- Haugaard MM, Pehrson S, Carstensen H, Flethøj M, Hesselkilde EZ, Praestegaard KF, Diness JG, Grunnet M, Jespersen T, Buhl R. Antiarrhythmic and electrophysiologic effects of flecainide on acutely induced atrial fibrillation in healthy horses. J Vet Intern Med 2015 Jan;29(1):339-47.
- 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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