Catheter-based electrical interventions to study, diagnose and treat arrhythmias in horses: From refractory period to electro-anatomical mapping. (September 2020)

• Record Type: Journal Article
• Authors: van Loon, Gunther; Van Steenkiste, Glenn; Vera, Lisse; Decloedt, Annelies
• Is Part Of: Veterinary journal. Volume 263(2020)
• Publication Date: 2020-09
• Subjects: Ablation -- Arrhythmia -- Electrophysiological study -- Interventional cardiology -- Pacing; Veterinary medicine -- Periodicals; 636
• DOI: 10.1016/j.tvjl.2020.105519
• Languages: English
• ISSNs: 1090-0233

Abstract

Highlights: Temporary or permanent (pacemaker) pacing can be used in horses. Cardiac pacing and sensing are the cornerstones of electrophysiological studies. Three-dimensional electro-anatomical mapping can identify the precise mechanism of arrhythmia. Radiofrequency ablation of arrhythmias can be performed in adult horses. Transvenous electrical shock is an effective treatment for equine atrial fibrillation. Abstract: Minimally-invasive catheter-based interventional cardiology is a mainstay for the diagnosis and treatment of arrhythmias in human medicine. Very accurate imaging using fluoroscopy, CT and MRI is essential during interventional cardiology procedures. Because these imaging techniques are either not possible or provide too little anatomical detail in horses, echocardiography is currently the best technique to visualize catheters in horses. Over the past decades, catheter-based techniques have been applied to induce arrhythmias using pacing and to perform arrhythmia research using electrophysiological studies. In bradycardic animals with clinical signs, permanent pacing can be achieved by pacemaker implantation via the cephalic vein. Transvenous electrical cardioversion, based on one cardioversion catheter in the pulmonary artery and one in the right atrium, has become the treatment of choice for atrial fibrillation in horses, even for longstanding or drug-resistant atrial fibrillation. Recently, the highly advanced technique of three dimensional electroanatomical mapping has been described in horses. This technique has not only revealed essential electrophysiological data in horses, but has also facilitated the successful ablation of atrial tachycardia in horses.