TY - JOUR

T1 - Long-term monitoring with an implantable loop recorder detects multiple episodes of paroxysmal atrial fibrillation after electrical cardioversion in a Warmblood horse

AU - Kjeldsen, Sofie Troest

AU - Jensen, Maria

AU - Sørensen, Carina Thermann

AU - Hopster-Iversen, Charlotte

AU - Nissen, Sarah Dalgas

N1 - Publisher Copyright: © 2022 The Authors. Equine Veterinary Education published by John Wiley & Sons Ltd on behalf of EVJ Ltd.

PY - 2023

Y1 - 2023

N2 - Atrial fibrillation (AF) is a pathological arrhythmia affecting performance horses and is termed paroxysmal (pAF) when self-terminating to sinus rhythm. Little is known about pAF as its sporadic nature makes it difficult to diagnose. Therefore, continuous electrocardiographic monitoring devices, such as implantable loop recorders (ILR), are necessary to detect the time of onset and episode duration. This case report presents the detection of pAF in a 9-year-old Warmblood horse after successful transvenous electrical cardioversion (TVEC). An ILR continuously monitored the heart rhythm over 28 months and detected 12 episodes of pAF of which two episodes were associated with reduced performance, while others occurred asymptomatically at rest. The estimated episode duration ranged from 6 min to 46.5 h. The antiarrhythmic drug sotalol (2 mg/kg bwt BID PO) was given prior to TVEC and then for 4 weeks. As episodes continued to occur, sotalol was prescribed for another 4 weeks, 6 months after TVEC. Continuous monitoring after TVEC allows for detection of AF recurrence and identification of AF burden, approximate time of onset and possible identification of trigger events. Early diagnosis and antiarrhythmic treatment may prevent a progression to persistent AF.

AB - Atrial fibrillation (AF) is a pathological arrhythmia affecting performance horses and is termed paroxysmal (pAF) when self-terminating to sinus rhythm. Little is known about pAF as its sporadic nature makes it difficult to diagnose. Therefore, continuous electrocardiographic monitoring devices, such as implantable loop recorders (ILR), are necessary to detect the time of onset and episode duration. This case report presents the detection of pAF in a 9-year-old Warmblood horse after successful transvenous electrical cardioversion (TVEC). An ILR continuously monitored the heart rhythm over 28 months and detected 12 episodes of pAF of which two episodes were associated with reduced performance, while others occurred asymptomatically at rest. The estimated episode duration ranged from 6 min to 46.5 h. The antiarrhythmic drug sotalol (2 mg/kg bwt BID PO) was given prior to TVEC and then for 4 weeks. As episodes continued to occur, sotalol was prescribed for another 4 weeks, 6 months after TVEC. Continuous monitoring after TVEC allows for detection of AF recurrence and identification of AF burden, approximate time of onset and possible identification of trigger events. Early diagnosis and antiarrhythmic treatment may prevent a progression to persistent AF.

KW - AF recurrence

KW - atrial arrhythmia

KW - heart rhythm monitoring

KW - horse

KW - insertable cardiac monitor

KW - sotalol

U2 - 10.1111/eve.13745

DO - 10.1111/eve.13745

M3 - Journal article

AN - SCOPUS:85142871777

VL - 35

SP - 340

EP - 346

JO - Equine Veterinary Education

JF - Equine Veterinary Education

SN - 0957-7734

IS - 7

ER -