Atrial fibrillatory rate as predictor of recurrence of atrial fibrillation in horses treated medically or with electrical cardioversion.

Authors: Buhl Rikke, Hesselkilde Eva M, Carstensen Helena, Hopster-Iversen Charlotte, van Loon Gunther, Decloedt Annelies, Van Steenkiste Glenn, Marr Celia M, Reef Virginia B, Schwarzwald Colin C, Mitchell Katharyn J, Nostell Katarina, Nogradi Nora, Nielsen Søren S, Carlson Jonas, Platonov Pyotr G

Journal: Equine veterinary journal

DOI: 10.1111/evj.13551 PubMed: 34957586Log in to save

Summary

# Editorial Summary Atrial fibrillation recurrence remains a significant clinical challenge in equine practice, with many horses reverting to arrhythmia following successful cardioversion. This multicentre European study investigated whether atrial fibrillatory rate (AFR)—the frequency of fibrillatory waves visible on surface electrocardiography—could serve as a predictive marker for AF recurrence in 98 horses treated either medically or with electrical cardioversion. Higher AFR values (reflecting greater electrical remodelling of atrial tissue) were associated with increased recurrence risk, suggesting AFR derived from a standard ECG could help clinicians identify which horses are more likely to relapse post-treatment. The findings have practical value: measuring AFR before cardioversion might allow practitioners to counsel owners more accurately about prognosis, guide selection between medical and electrical therapy, or inform decisions about adjunctive anti-arrhythmic protocols to reduce recurrence rates. Given the non-invasive nature of ECG analysis and its ready availability in equine practice, incorporating AFR assessment into pre-cardioversion diagnostic protocols warrants consideration.

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Practical Takeaways

•Surface ECG measurement of atrial fibrillatory rate may help predict which horses with AF are likely to recur after cardioversion, allowing better treatment planning
•AFR could be used as a non-invasive screening tool to identify horses with electrical remodelling before attempting cardioversion
•Knowing AFR status may help practitioners counsel owners on prognosis and likelihood of successful long-term conversion to normal sinus rhythm

Key Findings

•Atrial fibrillatory rate (AFR) derived from surface ECG is a biomarker for electrical remodelling in equine AF
•AFR has potential utility for predicting successful cardioversion and AF recurrence in horses
•AFR may help identify horses at higher risk of AF recurrence after treatment with medical therapy or electrical cardioversion

Conditions Studied

atrial fibrillationcardiac arrhythmiarecurrence after cardioversion

Related References

Atrial fibrillation in horses Part 2: Diagnosis, treatment and prognosis.

Decloedt Annelies, Van Steenkiste Glenn, Vera Lisse, Buhl Rikke, van Loon Gunther(2021)Veterinary journal (London, England : 1997)

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