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Influence of detomidine on atrial fibrillation cycle length measured by intracardiac electrogram recording and by colour tissue Doppler imaging in horses

Annelies Decloedt (UGent) , Dominique De Clercq (UGent) , Nicky Van Der Vekens (UGent) , Tinne Verheyen (UGent) , Sofie Ven (UGent) and Gunther van Loon (UGent)
(2016) EQUINE VETERINARY JOURNAL. 48(1). p.21-26
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Abstract
Reasons for performing study: Shortening of atrial fibrillation cycle length (AFCL) is a marker of atrial electrical remodeling due to atrial fibrillation (AF). Objectives: To investigate the effect of detomidine administration on AFCL measured invasively from an intra-atrial electrogram (AFCLEGM) and non-invasively by tissue Doppler imaging (AFCLTDI). We hypothesized that detomidine would have no effect on AFCL but would improve the ease of TDI measurements and facilitate non-invasive AFCL determination. Study design: Prospective study. Methods: Measurements were performed before and after intravenous administration of 7.5 µg/kg detomidine in 33 episodes of AF in 32 horses (582±64 kg, 10±3 years) referred for electrical cardioversion. AFCLEGM was measured from a right atrial intra-cardiac electrogram. AFCLTDI was measured from atrial color tissue velocity curves in five atrial wall regions. Mean AFCLEGM and AFCLTDI without and with sedation were compared using a repeated measures linear mixed model with Bonferroni correction for multiple comparisons and calculation of the Bland-Altman mean bias and limits of agreement between AFCLEGM and AFCLTDI. Results: The mean AFCL was significantly increased after sedation, however, this increase was very small (mean difference +4 ms). For AFCLTDI measurements, sedation significantly improved the quality of the atrial myocardial velocity curves and the number of AF cycles that could be measured per cardiac cycle. The Bland-Altman bias between AFCLEGM without sedation and AFCLTDI with sedation ranged from –18 ms to +15 ms depending on wall region. Bland-Altman limits of agreement were similar between AFCLEGM without sedation and AFCLTDI without and with sedation. Therefore, non-invasive AFCLTDI measurements with sedation can be used to estimate the atrial fibrillatory rate. Conclusions: Sedation facilitates non-invasive AFCL measurements but causes a slight increase in AFCL. Non-invasive AFCL measurements can be used as an indicator of atrial electrical remodeling, to study AF pathophysiology and to investigate the effect of anti-arrhythmic drugs.
Keywords
sedation, electrocardiography, echocardiography, electrophysiology, atrial remodeling, horse, TRANSVENOUS ELECTRICAL CARDIOVERSION, CONTRACTILE, ANESTHESIA

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Chicago
Decloedt, Annelies, Dominique De Clercq, Nicky Van Der Vekens, Tinne Verheyen, Sofie Ven, and Gunther van Loon. 2016. “Influence of Detomidine on Atrial Fibrillation Cycle Length Measured by Intracardiac Electrogram Recording and by Colour Tissue Doppler Imaging in Horses.” Equine Veterinary Journal 48 (1): 21–26.
APA
Decloedt, Annelies, De Clercq, D., Van Der Vekens, N., Verheyen, T., Ven, S., & van Loon, G. (2016). Influence of detomidine on atrial fibrillation cycle length measured by intracardiac electrogram recording and by colour tissue Doppler imaging in horses. EQUINE VETERINARY JOURNAL, 48(1), 21–26.
Vancouver
1.
Decloedt A, De Clercq D, Van Der Vekens N, Verheyen T, Ven S, van Loon G. Influence of detomidine on atrial fibrillation cycle length measured by intracardiac electrogram recording and by colour tissue Doppler imaging in horses. EQUINE VETERINARY JOURNAL. 2016;48(1):21–6.
MLA
Decloedt, Annelies, Dominique De Clercq, Nicky Van Der Vekens, et al. “Influence of Detomidine on Atrial Fibrillation Cycle Length Measured by Intracardiac Electrogram Recording and by Colour Tissue Doppler Imaging in Horses.” EQUINE VETERINARY JOURNAL 48.1 (2016): 21–26. Print.
@article{5753148,
  abstract     = {Reasons for performing study: Shortening of atrial fibrillation cycle length (AFCL) is a marker of atrial electrical remodeling due to atrial fibrillation (AF).
Objectives: To investigate the effect of detomidine administration on AFCL measured invasively from an intra-atrial electrogram (AFCLEGM) and non-invasively by tissue Doppler imaging (AFCLTDI). We hypothesized that detomidine would have no effect on AFCL but would improve the ease of TDI measurements and facilitate non-invasive AFCL determination. 
Study design: Prospective study.
Methods: Measurements were performed before and after intravenous administration of 7.5 {\textmu}g/kg detomidine in 33 episodes of AF in 32 horses (582{\textpm}64 kg, 10{\textpm}3 years) referred for electrical cardioversion. AFCLEGM was measured from a right atrial intra-cardiac electrogram. AFCLTDI was measured from atrial color tissue velocity curves in five atrial wall regions. Mean AFCLEGM and AFCLTDI without and with sedation were compared using a repeated measures linear mixed model with Bonferroni correction for multiple comparisons and calculation of the Bland-Altman mean bias and limits of agreement between AFCLEGM and AFCLTDI. 
Results: The mean AFCL was significantly increased after sedation, however, this increase was very small (mean difference +4 ms). For AFCLTDI measurements, sedation significantly improved the quality of the atrial myocardial velocity curves and the number of AF cycles that could be measured per cardiac cycle. The Bland-Altman bias between AFCLEGM without sedation and AFCLTDI with sedation ranged from --18 ms to +15 ms depending on wall region. Bland-Altman limits of agreement were similar between AFCLEGM without sedation and AFCLTDI without and with sedation. Therefore, non-invasive AFCLTDI  measurements with sedation can be used to estimate the atrial fibrillatory rate.
Conclusions: Sedation facilitates non-invasive AFCL measurements but causes a slight increase in AFCL. Non-invasive AFCL measurements can be used as an indicator of atrial electrical remodeling, to study AF pathophysiology and to investigate the effect of anti-arrhythmic drugs.},
  author       = {Decloedt, Annelies and De Clercq, Dominique and Van Der Vekens, Nicky and Verheyen, Tinne and Ven, Sofie and van Loon, Gunther},
  issn         = {0425-1644},
  journal      = {EQUINE VETERINARY JOURNAL},
  keyword      = {sedation,electrocardiography,echocardiography,electrophysiology,atrial remodeling,horse,TRANSVENOUS ELECTRICAL CARDIOVERSION,CONTRACTILE,ANESTHESIA},
  language     = {eng},
  number       = {1},
  pages        = {21--26},
  title        = {Influence of detomidine on atrial fibrillation cycle length measured by intracardiac electrogram recording and by colour tissue Doppler imaging in horses},
  url          = {http://dx.doi.org/10.1111/evj.12366},
  volume       = {48},
  year         = {2016},
}

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