Effect of transvenous electrical cardioversion on plasma cardiac troponin I concentrations in horses with atrial fibrillation.
Authors: Jesty S A, Kraus M S, Gelzer A R, Rishniw M, Moise N S
Journal: Journal of veterinary internal medicine
Summary
# Effect of Transvenous Electrical Cardioversion on Cardiac Troponin I in Equine Atrial Fibrillation Transvenous electrical cardioversion (TVEC) is an established treatment for atrial fibrillation in horses, but whether the electrical current causes direct myocardial injury has remained unclear. This prospective observational study measured plasma cardiac troponin I (cTnI)—a sensitive marker of cardiomyocyte damage—before and after TVEC in 14 horses undergoing 16 procedures at a university referral centre between 2006 and 2008. Median cTnI concentrations rose significantly from 0.045 ng/mL at baseline to 0.11 ng/mL post-procedure (P = 0.036), with maximum values reaching 3.73 ng/mL in some cases; however, this elevation was independent of shock number, energy delivered, or arrhythmia duration. Whilst the troponin elevation indicates some degree of myocardial perturbation following TVEC, the authors suggest these changes are unlikely to be clinically consequential, though the potential correlation with persistent atrial dysfunction raises the possibility that extended convalescence post-cardioversion may be warranted. These findings provide reassurance regarding TVEC safety in equine practice whilst highlighting the need for careful post-procedure monitoring and recovery management.
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Practical Takeaways
- •Transvenous electrical cardioversion for atrial fibrillation in horses causes a measurable but clinically insignificant rise in cardiac troponin I
- •The procedure does not appear to cause substantial cardiomyocyte damage regardless of shock parameters used
- •Longer convalescent periods may be warranted post-cardioversion due to potential persistent atrial dysfunction despite troponin elevation
Key Findings
- •Median plasma cardiac troponin I (cTnI) concentration increased from 0.045 ng/mL at baseline to 0.11 ng/mL after transvenous electrical cardioversion (P=0.036)
- •The increase in cTnI was not associated with number of shocks, maximal energy, cumulative energy, chronicity of atrial fibrillation, or catheter positioning
- •The cTnI elevation is unlikely to be clinically important but may correlate with persistent atrial dysfunction post-procedure