Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence
Abstract Background Transvenous electrical cardioversion (TVEC) is 1 of the main treatment options for atrial fibrillation (AF) in horses. Large‐scale studies on factors affecting success and prognosis have primarily been performed in Standardbred populations. Hypothesis/Objectives To determine fact...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-03-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16395 |
| _version_ | 1818759133978951680 |
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| author | Ingrid Vernemmen Glenn Van Steenkiste Alexander Dufourni Annelies Decloedt Gunther vanLoon |
| author_facet | Ingrid Vernemmen Glenn Van Steenkiste Alexander Dufourni Annelies Decloedt Gunther vanLoon |
| author_sort | Ingrid Vernemmen |
| collection | DOAJ |
| description | Abstract Background Transvenous electrical cardioversion (TVEC) is 1 of the main treatment options for atrial fibrillation (AF) in horses. Large‐scale studies on factors affecting success and prognosis have primarily been performed in Standardbred populations. Hypothesis/Objectives To determine factors affecting cardioversion success, cardioversion difficulty and recurrence in a predominant Warmblood study sample. Animals TVEC records of 199 horses. Methods Retrospective study of TVEC procedures of horses admitted for AF without severe echocardiographic abnormalities. Horse and procedural factors for success and cumulative amount of energy (≤ 600 J vs > 600 J) were determined using multivariable logistic regression. A survival analysis was performed to determine risk factors for recurrence. Results Two hundred and thirty‐one TVEC procedures were included, with a 94.4% success rate and 31.9% recurrence rate (51/160). Mitral regurgitation (OR 0.151, 95% CI 0.032‐0.715, P = .02) and AF cycle length (OR 1.05, 95% CI 1.01‐1.09, P = .02) were independent determinants for success. Catheter type (OR 0.154, 95% CI 0.074‐0.322, P < .001), previous AF episode (OR 3.10, 95% CI 1.20‐8.01, P = .02), tricuspid regurgitation (OR 2.54, 95% CI 1.25‐5.13, P = .01), and body weight (OR 1.009, 95% CI 1.003‐1.015, P = .004) were significantly correlated with cumulative amount of energy delivered. Significant risk factors for recurrence after a first AF episode were sex (stallion; HR 3.05, 95% CI 1.34‐6.95, P = .008), mitral regurgitation (HR 1.91, 95% CI 1.08‐3.38, P = .03), and AF duration (HR 1.001, 95% CI 1.0001‐1.0026, P = .04). Conclusions and Clinical Importance Both horse and procedural factors should be considered when assessing treatment options and prognosis in horses with AF. |
| first_indexed | 2024-12-18T06:37:53Z |
| format | Article |
| id | doaj.art-800312e018184050aa167b34407c66cd |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-12-18T06:37:53Z |
| publishDate | 2022-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-800312e018184050aa167b34407c66cd2022-12-21T21:17:43ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762022-03-0136275876910.1111/jvim.16395Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrenceIngrid Vernemmen0Glenn Van Steenkiste1Alexander Dufourni2Annelies Decloedt3Gunther vanLoon4Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Merelbeke BelgiumEquine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Merelbeke BelgiumEquine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Merelbeke BelgiumEquine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Merelbeke BelgiumEquine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Merelbeke BelgiumAbstract Background Transvenous electrical cardioversion (TVEC) is 1 of the main treatment options for atrial fibrillation (AF) in horses. Large‐scale studies on factors affecting success and prognosis have primarily been performed in Standardbred populations. Hypothesis/Objectives To determine factors affecting cardioversion success, cardioversion difficulty and recurrence in a predominant Warmblood study sample. Animals TVEC records of 199 horses. Methods Retrospective study of TVEC procedures of horses admitted for AF without severe echocardiographic abnormalities. Horse and procedural factors for success and cumulative amount of energy (≤ 600 J vs > 600 J) were determined using multivariable logistic regression. A survival analysis was performed to determine risk factors for recurrence. Results Two hundred and thirty‐one TVEC procedures were included, with a 94.4% success rate and 31.9% recurrence rate (51/160). Mitral regurgitation (OR 0.151, 95% CI 0.032‐0.715, P = .02) and AF cycle length (OR 1.05, 95% CI 1.01‐1.09, P = .02) were independent determinants for success. Catheter type (OR 0.154, 95% CI 0.074‐0.322, P < .001), previous AF episode (OR 3.10, 95% CI 1.20‐8.01, P = .02), tricuspid regurgitation (OR 2.54, 95% CI 1.25‐5.13, P = .01), and body weight (OR 1.009, 95% CI 1.003‐1.015, P = .004) were significantly correlated with cumulative amount of energy delivered. Significant risk factors for recurrence after a first AF episode were sex (stallion; HR 3.05, 95% CI 1.34‐6.95, P = .008), mitral regurgitation (HR 1.91, 95% CI 1.08‐3.38, P = .03), and AF duration (HR 1.001, 95% CI 1.0001‐1.0026, P = .04). Conclusions and Clinical Importance Both horse and procedural factors should be considered when assessing treatment options and prognosis in horses with AF.https://doi.org/10.1111/jvim.16395amiodaronearrhythmiacardiologyequinesotalol |
| spellingShingle | Ingrid Vernemmen Glenn Van Steenkiste Alexander Dufourni Annelies Decloedt Gunther vanLoon Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence Journal of Veterinary Internal Medicine amiodarone arrhythmia cardiology equine sotalol |
| title | Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence |
| title_full | Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence |
| title_fullStr | Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence |
| title_full_unstemmed | Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence |
| title_short | Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence |
| title_sort | transvenous electrical cardioversion of atrial fibrillation in horses horse and procedural factors correlated with success and recurrence |
| topic | amiodarone arrhythmia cardiology equine sotalol |
| url | https://doi.org/10.1111/jvim.16395 |
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