Sustained atrial tachycardia in horses and treatment by transvenous electrical cardioversion.
arrhythmia
atrial flutter
electrophysiology
focal atrial tachycardia
horse
macroreentrant atrial tachycardia
supraventricular tachyarrhythmia
Journal
Equine veterinary journal
ISSN: 2042-3306
Titre abrégé: Equine Vet J
Pays: United States
ID NLM: 0173320
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
03
08
2018
accepted:
06
01
2019
pubmed:
17
1
2019
medline:
7
1
2020
entrez:
17
1
2019
Statut:
ppublish
Résumé
Atrial tachycardia including focal atrial tachycardia and macroreentrant atrial tachycardia (atrial flutter), are occasionally found in horses. Diagnosis, treatment and follow-up of these arrhythmias has been inadequately described. To describe the findings on surface electrocardiography (ECG), intra-atrial electrogram recording and tissue Doppler imaging (TDI), the response to treatment by transvenous electrical cardioversion (TVEC), and TDI follow-up, of sustained atrial tachycardia in horses. Case series. Records from horses with sustained atrial tachycardia treated by biphasic TVEC at Ghent University were reviewed. Horses with atrial fibrillation were not included. Seven horses with sustained atrial tachycardia were treated with TVEC. In six cases an exercise ECG was available and in 4 a 12-lead ECG had been recorded. The mean bias between atrial cycle length measured from a right atrial intra-atrial electrogram and from TDI ranged between -2 and 3 ms depending on the sampled region. All seven cases converted to sinus rhythm during the first TVEC procedure. TDI showed atrial contractile function recovery similar to cases that were treated for atrial fibrillation. One case developed atrial fibrillation 1 day after TVEC treatment, another case showed recurrence 8 years post conversion. The other five cases were still in sinus rhythm at 9 months - 5 years after TVEC. Due to the small number of patients, data on recurrence and follow-up of atrial recovery should be interpreted with caution. Since no invasive electrophysiology studies were performed, differentiation between focal atrial tachycardia and atrial flutter remains speculative. Treatment of focal atrial tachycardia or atrial flutter by TVEC has a very high success rate. Tissue Doppler imaging allows noninvasive measurement of atrial cycle length and suggests reduced atrial function after cardioversion. Long-term prognosis after cardioversion seemed similar compared to horses with atrial fibrillation, although early recurrence (<24 h) occurred in one horse.
Sections du résumé
BACKGROUND
BACKGROUND
Atrial tachycardia including focal atrial tachycardia and macroreentrant atrial tachycardia (atrial flutter), are occasionally found in horses. Diagnosis, treatment and follow-up of these arrhythmias has been inadequately described.
OBJECTIVES
OBJECTIVE
To describe the findings on surface electrocardiography (ECG), intra-atrial electrogram recording and tissue Doppler imaging (TDI), the response to treatment by transvenous electrical cardioversion (TVEC), and TDI follow-up, of sustained atrial tachycardia in horses.
STUDY DESIGN
METHODS
Case series.
METHODS
METHODS
Records from horses with sustained atrial tachycardia treated by biphasic TVEC at Ghent University were reviewed. Horses with atrial fibrillation were not included.
RESULTS
RESULTS
Seven horses with sustained atrial tachycardia were treated with TVEC. In six cases an exercise ECG was available and in 4 a 12-lead ECG had been recorded. The mean bias between atrial cycle length measured from a right atrial intra-atrial electrogram and from TDI ranged between -2 and 3 ms depending on the sampled region. All seven cases converted to sinus rhythm during the first TVEC procedure. TDI showed atrial contractile function recovery similar to cases that were treated for atrial fibrillation. One case developed atrial fibrillation 1 day after TVEC treatment, another case showed recurrence 8 years post conversion. The other five cases were still in sinus rhythm at 9 months - 5 years after TVEC.
MAIN LIMITATIONS
CONCLUSIONS
Due to the small number of patients, data on recurrence and follow-up of atrial recovery should be interpreted with caution. Since no invasive electrophysiology studies were performed, differentiation between focal atrial tachycardia and atrial flutter remains speculative.
CONCLUSIONS
CONCLUSIONS
Treatment of focal atrial tachycardia or atrial flutter by TVEC has a very high success rate. Tissue Doppler imaging allows noninvasive measurement of atrial cycle length and suggests reduced atrial function after cardioversion. Long-term prognosis after cardioversion seemed similar compared to horses with atrial fibrillation, although early recurrence (<24 h) occurred in one horse.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
634-640Subventions
Organisme : Research Foundation Flanders
ID : 1134917N
Organisme : Research Foundation Flanders
ID : 1S56217N
Informations de copyright
© 2019 EVJ Ltd.