First catheter-based high-density endocardial 3D electroanatomical mapping of the right atrium in standing horses.
Authors: Hesselkilde Eva, Linz Dominik, Saljic Arnela, Carstensen Helena, Kutieleh Rayed, Jespersen Thomas, Sanders Prashanthan, Buhl Rikke
Journal: Equine veterinary journal
Summary
# Editorial Summary Three-dimensional electroanatomical mapping represents a significant advancement for equine cardiac diagnostics, offering the potential to identify arrhythmia mechanisms and guide targeted ablation therapy—techniques well established in human and small animal cardiology but previously undemonstrated in horses. Hesselkilde and colleagues successfully performed high-density endocardial mapping of the right atrium in four standing Standardbreds using a multipolar grid catheter introduced via the jugular vein, collecting a median of 32,719 activation and voltage mapping points across the entire atrial chamber whilst horses remained sedated in stocks. The procedure yielded detailed electroanatomical information about critical structures including the sinoatrial node, intervenous tubercle and cavotricuspid isthmus, with the mapping system also permitting real-time guidance of transvenous biopsy collection. For practitioners managing horses with complex or refractory arrhythmias, this capability could substantially improve diagnostic precision and potentially enable catheter-based interventions currently unavailable in equine practice. Future work must establish whether the technique translates to left atrial mapping and larger breeds before widespread clinical application becomes realistic.
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Practical Takeaways
- •Catheter-based electroanatomical mapping is now feasible in standing horses, offering a diagnostic tool to identify arrhythmia mechanisms without general anesthesia
- •This technique could guide ablation strategies and characterize electrical substrates in horses with cardiac arrhythmias, potentially improving treatment outcomes
- •Further development is needed for left atrial mapping and application in larger horse breeds before widespread clinical adoption
Key Findings
- •High-density 3D electroanatomical mapping of the right atrium was successfully performed in all 4 standing horses using a catheter-based approach via jugular vein
- •A median of 32,719 mapping points were collected, covering the entire right atrium with detailed activation patterns
- •The technique provided detailed electrogram characteristics of the sinoatrial node, intervenous tubercle, and cavotricuspid isthmus
- •Transvenous biopsy forceps could be visualized and guided using the mapping system for tissue collection