Atrial fibrillatory rate as predictor of recurrence of atrial fibrillation in horses treated medically or with electrical cardioversion
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Atrial fibrillatory rate as predictor of recurrence of atrial fibrillation in horses treated medically or with electrical cardioversion. / 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, Soren S.; Carlson, Jonas; Platonov, Pyotr G.
I: Equine Veterinary Journal, Bind 54, Nr. 6, 2022, s. 1013-1022.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Atrial fibrillatory rate as predictor of recurrence of atrial fibrillation in horses treated medically or with electrical cardioversion
AU - Buhl, Rikke
AU - Hesselkilde, Eva M.
AU - Carstensen, Helena
AU - Hopster-Iversen, Charlotte
AU - van Loon, Gunther
AU - Decloedt, Annelies
AU - van Steenkiste, Glenn
AU - Marr, Celia M.
AU - Reef, Virginia B.
AU - Schwarzwald, Colin C.
AU - Mitchell, Katharyn J.
AU - Nostell, Katarina
AU - Nogradi, Nora
AU - Nielsen, Soren S.
AU - Carlson, Jonas
AU - Platonov, Pyotr G.
PY - 2022
Y1 - 2022
N2 - BackgroundThe recurrence rate of atrial fibrillation (AF) in horses after cardioversion to sinus rhythm (SR) is relatively high. Atrial fibrillatory rate (AFR) derived from surface ECG is considered a biomarker for electrical remodelling and could potentially be used for the prediction of successful AF cardioversion and AF recurrence.ObjectivesEvaluate if AFR was associated with successful treatment and could predict AF recurrence in horses.Study designRetrospective multicentre study.MethodsElectrocardiograms (ECG) from horses with persistent AF admitted for cardioversion with either medical treatment (quinidine) or transvenous electrical cardioversion (TVEC) were included. Bipolar surface ECG recordings were analysed by spatiotemporal cancellation of QRST complexes and calculation of AFR from the remaining atrial signal. Kaplan-Meier survival curve and Cox regression analyses were performed to assess the relationship between AFR and the risk of AF recurrence.ResultsOf the 195 horses included, 74 received quinidine treatment and 121 were treated with TVEC. Ten horses did not cardiovert to SR after quinidine treatment and AFR was higher in these, compared with the horses that successfully cardioverted to SR (median [interquartile range]), (383 [367-422] vs 351 [332-389] fibrillations per minute (fpm), P < .01). Within the first 180 days following AF cardioversion, 12% of the quinidine and 34% of TVEC horses had AF recurrence. For the horses successfully cardioverted with TVEC, AFR above 380 fpm was significantly associated with AF recurrence (hazard ratio = 2.4, 95% confidence interval 1.2-4.8, P = .01).Main limitationsThe treatment groups were different and not randomly allocated, therefore the two treatments cannot be compared. Medical records and the follow-up strategy varied between the centres.ConclusionsHigh AFR is associated with failure of quinidine cardioversion and AF recurrence after successful TVEC. As a noninvasive marker that can be retrieved from surface ECG, AFR can be clinically useful in predicting the probability of responding to quinidine treatment as well as maintaining SR after electrical cardioversion.
AB - BackgroundThe recurrence rate of atrial fibrillation (AF) in horses after cardioversion to sinus rhythm (SR) is relatively high. Atrial fibrillatory rate (AFR) derived from surface ECG is considered a biomarker for electrical remodelling and could potentially be used for the prediction of successful AF cardioversion and AF recurrence.ObjectivesEvaluate if AFR was associated with successful treatment and could predict AF recurrence in horses.Study designRetrospective multicentre study.MethodsElectrocardiograms (ECG) from horses with persistent AF admitted for cardioversion with either medical treatment (quinidine) or transvenous electrical cardioversion (TVEC) were included. Bipolar surface ECG recordings were analysed by spatiotemporal cancellation of QRST complexes and calculation of AFR from the remaining atrial signal. Kaplan-Meier survival curve and Cox regression analyses were performed to assess the relationship between AFR and the risk of AF recurrence.ResultsOf the 195 horses included, 74 received quinidine treatment and 121 were treated with TVEC. Ten horses did not cardiovert to SR after quinidine treatment and AFR was higher in these, compared with the horses that successfully cardioverted to SR (median [interquartile range]), (383 [367-422] vs 351 [332-389] fibrillations per minute (fpm), P < .01). Within the first 180 days following AF cardioversion, 12% of the quinidine and 34% of TVEC horses had AF recurrence. For the horses successfully cardioverted with TVEC, AFR above 380 fpm was significantly associated with AF recurrence (hazard ratio = 2.4, 95% confidence interval 1.2-4.8, P = .01).Main limitationsThe treatment groups were different and not randomly allocated, therefore the two treatments cannot be compared. Medical records and the follow-up strategy varied between the centres.ConclusionsHigh AFR is associated with failure of quinidine cardioversion and AF recurrence after successful TVEC. As a noninvasive marker that can be retrieved from surface ECG, AFR can be clinically useful in predicting the probability of responding to quinidine treatment as well as maintaining SR after electrical cardioversion.
KW - AFR
KW - arrhythmia
KW - cardiology
KW - ECG
KW - electrophysiology
KW - horse
KW - surface electrocardiogram
U2 - 10.1111/evj.13551
DO - 10.1111/evj.13551
M3 - Journal article
C2 - 34957586
VL - 54
SP - 1013
EP - 1022
JO - Equine Veterinary Journal
JF - Equine Veterinary Journal
SN - 0425-1644
IS - 6
ER -
ID: 290526547