An article titled, "Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses" was published in BEVA's Equine Veterinary Journal. The authors were Vernemmen, I.; De Clercq, D.; Decloedt, A.; Vera, L.; Van Steenkiste, G.; and van Loon, G.
This retrospective case series investigated whether a high atrial premature depolarization (APD) burden after cardioversion is associated with recurrence of atrial fibrillation (AF). (Editor's note: Cardioversion is a medical procedure that restores a normal heart rhythm when there are certain types of abnormal heartbeats or arrhythmias.)
Medical records were searched for horses that successfully underwent transvenous electrical cardioversion (TVEC) for atrial fibrillation between 2008 and 2017. Horses were included in the study if they met the following inclusion criteria:
- it was their first episode of AF
- there was no AF recurrence in the first five days post-cardioversion
- 24‐hour ECG recording and echocardiographic examination five days post-cardioversion were available
- no antiarrhythmic treatment was administered during the 24‐hour ECG recording, and
- follow‐up information was available for at least one year.
- An APD was defined as a premature P-wave, occurring at least 8% earlier, with a normal or abnormal morphology and, if conducted to the ventricles, followed by a QRS‐complex with a normal morphology.
A total of 80 horses met the inclusion criteria, 33% of which (n = 26) experienced atrial fibrillation recurrence within one year, with a median time to recurrence of 125 days.
Horses experiencing recurrence within one year showed a significantly higher number (median [range]) of APDs (15 [1–152]) compared with the non‐recurrence group (7 [0–304]). In the multivariable model, ≥25 APDs/24 hours, mitral regurgitation, left atrial active fractional area change and lower body weight were significantly associated with AF recurrence.
Bottom line: The APD burden five days post cardioversion could be a useful predictive value for atrial fibrillation recurrence within one year in horses.
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