Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence

• Published in: Journal of veterinary internal medicine 2022-03, Vol.36 (2), p.758-769
• Main Authors: Vernemmen, Ingrid, Van Steenkiste, Glenn, Dufourni, Alexander, Decloedt, Annelies, Loon, Gunther
• Format: Article
• Language: English
• Subjects: amiodarone; Anesthesia; Animals; arrhythmia; Atrial Fibrillation - therapy; Atrial Fibrillation - veterinary; Cardiac arrhythmia; cardiology; Cardioversion; Catheters; Echocardiography - veterinary; Electric Countershock - veterinary; Energy; EQUINE; Horse Diseases - etiology; Horse Diseases - therapy; Horses; Hypotheses; Male; Pulmonary arteries; Recurrence; Retrospective Studies; sotalol; Success; Survival analysis; Variables
• ISSN: 0891-6640; 1939-1676
• DOI: 10.1111/jvim.16395

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