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First successful radiofrequency ablation of focal atrial tachycardia in a horse guided by a high density 3D electro-anatomical mapping system (Rhythmia®)

Boekbijdrage - Boekabstract Conferentiebijdrage

Transvenous electrical cardioversion (TVEC) has a 95% success rate for cardioversion of atrial tachyarrhythmia but recurrence rate is about 35%. A 5-year-old showjumper stallion with regular atrial tachyarrhythmia was treated successfully with TVEC twice but showed early recurrence each time. An electrophysiological study suggested a right sided atrial tachycardia and the option for ablation was taken. In the standing horse, a decapolar catheter and two TVEC catheters, in case atrial fibrillation would occur during the procedure, were inserted in the left jugular vein and placed in the coronary sinus, right atrium and left pulmonary artery, respectively. Subsequently, under general anesthesia, an electro-anatomical mapping catheter (Intellamap Orion, Boston Scientific) was inserted into the right jugular vein and used to create a 3D electro-anatomical map (Rhythmia, Boston Scientific) of right atrium and venae cavae. Activation mapping, whereby the coronary sinus signal served as time reference, revealed a focal atrial tachycardia with a cycle length of 400ms with earliest activity at the caudodorsal interatrial wall. An ablation catheter (Intellanav OI, Boston Scientific) was guided towards the site of earliest activation using the Rhythmia mapping system and targeted for ablation. During the 5th application (temperature-controlled 60W, maximal temperature 60°C), the atrial tachycardia terminated and became non-inducible. Total ablation time was 366 seconds. Recovery was uneventful. This is the first time that the exact origin of an atrial arrhythmia is identified by 3D electro-anatomical mapping and is successfully treated by radiofrequency ablation. This study proves that both techniques are technically feasible in adult horses.
Boek: Proceedings of the 11th European College of Equine Internal Medicine congress
Pagina's: 97 - 97
Jaar van publicatie:2018