Catheter-based electrical interventions to study, diagnose and treat arrhythmias in horses: From refractory period to electro-anatomical mapping.
Authors: van Loon Gunther, Van Steenkiste Glenn, Vera Lisse, Decloedt Annelies
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Catheter-based electrical interventions are becoming increasingly valuable in equine cardiology, offering diagnostic and therapeutic options previously unavailable in veterinary practice. Belgian researchers reviewed the evolution of minimally-invasive catheter techniques in horses, from basic electrophysiological studies and arrhythmia induction through to advanced three-dimensional electroanatomical mapping, highlighting how echocardiographic guidance has overcome the imaging limitations that would otherwise constrain such procedures in equine patients. Key developments include permanent pacemaker implantation via the cephalic vein for symptomatic bradycardic horses, transvenous electrical cardioversion as the gold-standard treatment for atrial fibrillation (including longstanding and drug-resistant cases), and most recently, electroanatomical mapping-guided ablation for atrial tachycardia. These techniques have not only expanded the therapeutic toolkit available to equine cardiologists but have also generated novel electrophysiological data that deepens our understanding of equine cardiac function. For practitioners managing horses with refractory arrhythmias, referral to centres equipped with these capabilities may now offer definitive treatment options where conventional medical management or external cardioversion has failed.
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Practical Takeaways
- •Refer horses with refractory atrial fibrillation to specialists equipped for transvenous electrical cardioversion, as this catheter-based approach offers superior outcomes compared to medical management alone
- •Echocardiography-guided catheter procedures are feasible in equine practice and represent the most practical imaging solution for interventional cardiology in horses
- •Advanced electrophysiological mapping and ablation techniques are now available for equine arrhythmias and should be considered for animals with atrial tachycardia or other complex arrhythmias
Key Findings
- •Echocardiography is the most practical imaging technique for visualizing catheters during interventional cardiology procedures in horses due to limitations of fluoroscopy, CT, and MRI in equine practice
- •Transvenous electrical cardioversion using catheters in the pulmonary artery and right atrium is the treatment of choice for atrial fibrillation in horses, including longstanding and drug-resistant cases
- •Three-dimensional electroanatomical mapping has been successfully applied in horses for arrhythmia diagnosis and has facilitated successful ablation of atrial tachycardia
- •Permanent pacemaker implantation via the cephalic vein is achievable in bradycardic horses with clinical signs