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Home / Equine Research Bank / J Vet Intern Med / Twenty-four hour continuous transvenous temporary right vent...
Journal of veterinary internal medicine2024; doi: 10.1111/jvim.17027

Twenty-four hour continuous transvenous temporary right ventricular pacing in healthy horses.

Abstract: The ability to perform transvenous temporary cardiac pacing (TV-TP) is critical to stabilize horses with symptomatic bradyarrhythmias. Reports of successful TV-TP in horses are limited, and only briefly describe short-term pacing. Objective: To describe temporary, medium-term (24 h) transvenous right ventricular pacing in awake horses using a bipolar torque-directed pacing catheter. Methods: Six healthy adult institutional teaching horses. Methods: Prospective experimental study with 2 immediately successive TV-TP lead placements in each horse with a target location of the RV apex. One placement was performed primarily with echocardiographic guidance and 1 primarily with fluoroscopic guidance. In all placements, corresponding images were obtained with both imaging modalities. Horses were then paced for 24 h, unrestricted in a stall with continuous telemetric ECG monitoring. Echocardiographically determined lead position, episodes of pacing failure in the preceding 6 h, and pacing thresholds were recorded every 6 h. Pacing failure was defined as a period of loss of capture longer than 20 s. Results: Pacing leads were placed with both guidance methods and maintained for 24 h with no complications. Two horses with leads angled caudally in the right ventricular apex had no pacing failure, the remaining 4 horses had varying degrees of loss of capture. Leads located in the right ventricular apex had longer time to pacing failure and lower capture thresholds P < 0.05. Conclusions: Medium-term TV-TP is feasible and has potential for stabilization of horses with symptomatic bradyarrhythmias. Lead position in the right ventricular apex appears optimal. Continuous ECG monitoring is recommended to detect pacing failure.
© 2024 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2024-03-21 PubMed ID: 38514200DOI: 10.1111/jvim.17027Google 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 paper details an experimental study on the feasibility of medium-term (24-hour) temporary transvenous right ventricular cardiac pacing (TV-TP) in healthy adult horses. The study employed echocardiographic and fluoroscopic guidance for lead placements, and observations were gathered over a 24-hour pacing period with continuous ECG monitoring.

Study Objective and Methodology

  • The purpose of this study was to provide a comprehensive understanding of the temporary, medium-term (24-hour) transvenous right ventricular pacing in awake, healthy horses using a bipolar torque-directed pacing catheter.
  • The study was carried out on six healthy adult institutional teaching horses in a prospective experimental setting.
  • Two immediate successive TV-TP lead placements were conducted per horse, with one placement executed primarily under echocardiographic guidance and another under fluoroscopic guidance. Images were acquired using both the imaging techniques irrespective of the primary guidance method.
  • The horses were allowed to live unrestricted in a stall while being paced for 24 hours with continuous telemetric ECG monitoring.
  • Every 6 hours, the pacing thresholds, episodes of pacing failure in the proceeding 6 hours, and the echocardiographically determined lead position were recorded.
  • Pacing failure was defined as a lack of capture for a period exceeding 20 seconds.

Study Findings and Conclusion

  • Pacing leads were successfully placed using both guidance methods and were maintained for 24 hours with no complications reported.
  • Two horses with leads angled downwards in the right ventricular apex had no pacing failure, while the remaining four horses experienced varying degrees of loss of capture.
  • The leads located in the right ventricular apex had a longer time to pacing failure and lower capture thresholds, thereby suggesting the optimal position for the leads.
  • Based on the findings, the study concluded that medium-term TV-TP was indeed feasible and could potentially stabilize horses with symptomatic bradyarrhythmias.
  • It was recommended that continuous ECG monitoring be implemented to promptly detect any pacing failure.

Cite This Article

APA
Avison A, Gelzer AR, Reef VB, Wulster Bills KB, de Solis CN, Kraus MS, Slack J, Stefanovski D, Deacon LJ, Underwood C. (2024). Twenty-four hour continuous transvenous temporary right ventricular pacing in healthy horses. J Vet Intern Med. https://doi.org/10.1111/jvim.17027

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English

Researcher Affiliations

Avison, Amanda
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Gelzer, Anna R
  • Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Reef, Virginia B
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Wulster Bills, Kathryn B
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
de Solis, Cris Navas
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Kraus, Marc S
  • Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Slack, JoAnn
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Stefanovski, Darko
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Deacon, Lindsay J
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Underwood, Claire
  • Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.

Grant Funding

  • Raker-Tulleners grant

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