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Cardiovascular responses to transvenous electrical cardioversion of atrial fibrillation in anaesthetized horses

Stijn Schauvliege UGent, Gunther van Loon UGent, Dominique De Clercq UGent, Lindsey Devisscher, Piet Deprez UGent and Frank Gasthuys UGent (2009) VETERINARY ANAESTHESIA AND ANALGESIA. 36(4). p.341-351
abstract
To examine the influence of direct current shock application in anaesthetized horses with atrial fibrillation (AF) and to study the effects of cardioversion to sinus rhythm (SR). Prospective clinical study. Eight horses successfully treated for AF (transvenous electrical cardioversion after amiodarone pre-treatment). Cardioversion catheters and a pacing catheter were placed under sedation [detomidine 10 mu g kg(-1) intravenously (IV)]. After additional sedation (5-10 mu g kg(-1) detomidine, 0.1 mg kg(-1) methadone IV), anaesthesia was induced with ketamine, 2.2 mg kg(-1) and midazolam, 0.06 mg kg(-1) (IV) in a sling and maintained with isoflurane in oxygen. Flunixin meglumine, 1.1 mg kg(-1), was administered IV. Shocks were delivered as biphasic truncated exponential waves, synchronized with the R-wave of the electrocardiogram. Monitoring included pulse oximetry, electrocardiography, capnography, inhalational anaesthetic agent concentration, arterial blood pressure, LiDCO and PulseCO cardiac index (CI) and arterial blood gases. Values before and after the first unsuccessful shock and before and after cardioversion to SR were compared. Values before the first shock were comparable to reported values in healthy, isoflurane anaesthetized horses. Reliable CI measurements could not be obtained using the PulseCO technique. Intermittent positive pressure ventilation was required in most horses (bradypnea and/or PaCO2 > 8 kPa, 60 mmHg), while dobutamine was administered in two horses (0.3-0.5 mu g kg(-1) minute(-1)). After the 1st unsuccessful shock application, systolic arterial pressure (SAP) was decreased (p = 0.025), other recorded values were not influenced (CI measurements not available for this analysis). SR was associated with increases in CI (p = 0.039) and stroke index (p = 0.002) and a decrease in SAP (p = 0.030). Despite the presence of AF, cardiovascular function was well maintained during anaesthesia and was not affected by shock application. Cardiac index and stroke index increased and SAP decreased after cardioversion.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
cardiovascular function, atrial fibrillation, horses, transvenous electrical cardioversion, GUINEA-PIG HEART, SINUS RHYTHM, ATRIOVENTRICULAR-CONDUCTION, MYOCARDIAL-CELLS, ANESTHESIA, CONVERSION, LIDOCAINE, SHOCK, HEMODYNAMICS, AMIODARONE
journal title
VETERINARY ANAESTHESIA AND ANALGESIA
Vet. Anaesth. Analg.
volume
36
issue
4
pages
341 - 351
Web of Science type
Article
Web of Science id
000266677700007
JCR category
VETERINARY SCIENCES
JCR impact factor
1.426 (2009)
JCR rank
35/141 (2009)
JCR quartile
1 (2009)
ISSN
1467-2987
DOI
10.1111/j.1467-2995.2009.00470.x
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
705953
handle
http://hdl.handle.net/1854/LU-705953
date created
2009-06-22 11:04:03
date last changed
2009-10-01 10:33:33
@article{705953,
  abstract     = {To examine the influence of direct current shock application in anaesthetized horses with atrial fibrillation (AF) and to study the effects of cardioversion to sinus rhythm (SR).
Prospective clinical study.
Eight horses successfully treated for AF (transvenous electrical cardioversion after amiodarone pre-treatment).
Cardioversion catheters and a pacing catheter were placed under sedation [detomidine 10 mu g kg(-1) intravenously (IV)]. After additional sedation (5-10 mu g kg(-1) detomidine, 0.1 mg kg(-1) methadone IV), anaesthesia was induced with ketamine, 2.2 mg kg(-1) and midazolam, 0.06 mg kg(-1) (IV) in a sling and maintained with isoflurane in oxygen. Flunixin meglumine, 1.1 mg kg(-1), was administered IV. Shocks were delivered as biphasic truncated exponential waves, synchronized with the R-wave of the electrocardiogram. Monitoring included pulse oximetry, electrocardiography, capnography, inhalational anaesthetic agent concentration, arterial blood pressure, LiDCO and PulseCO cardiac index (CI) and arterial blood gases. Values before and after the first unsuccessful shock and before and after cardioversion to SR were compared.
Values before the first shock were comparable to reported values in healthy, isoflurane anaesthetized horses. Reliable CI measurements could not be obtained using the PulseCO technique. Intermittent positive pressure ventilation was required in most horses (bradypnea and/or PaCO2 {\textrangle} 8 kPa, 60 mmHg), while dobutamine was administered in two horses (0.3-0.5 mu g kg(-1) minute(-1)). After the 1st unsuccessful shock application, systolic arterial pressure (SAP) was decreased (p = 0.025), other recorded values were not influenced (CI measurements not available for this analysis). SR was associated with increases in CI (p = 0.039) and stroke index (p = 0.002) and a decrease in SAP (p = 0.030).
Despite the presence of AF, cardiovascular function was well maintained during anaesthesia and was not affected by shock application. Cardiac index and stroke index increased and SAP decreased after cardioversion.},
  author       = {Schauvliege, Stijn and van Loon, Gunther and De Clercq, Dominique and Devisscher, Lindsey and Deprez, Piet and Gasthuys, Frank},
  issn         = {1467-2987},
  journal      = {VETERINARY ANAESTHESIA AND ANALGESIA},
  keyword      = {cardiovascular function,atrial fibrillation,horses,transvenous electrical cardioversion,GUINEA-PIG HEART,SINUS RHYTHM,ATRIOVENTRICULAR-CONDUCTION,MYOCARDIAL-CELLS,ANESTHESIA,CONVERSION,LIDOCAINE,SHOCK,HEMODYNAMICS,AMIODARONE},
  language     = {eng},
  number       = {4},
  pages        = {341--351},
  title        = {Cardiovascular responses to transvenous electrical cardioversion of atrial fibrillation in anaesthetized horses},
  url          = {http://dx.doi.org/10.1111/j.1467-2995.2009.00470.x},
  volume       = {36},
  year         = {2009},
}

Chicago
Schauvliege, Stijn, Gunther van Loon, Dominique De Clercq, Lindsey Devisscher, Piet Deprez, and Frank Gasthuys. 2009. “Cardiovascular Responses to Transvenous Electrical Cardioversion of Atrial Fibrillation in Anaesthetized Horses.” Veterinary Anaesthesia and Analgesia 36 (4): 341–351.
APA
Schauvliege, S., van Loon, G., De Clercq, D., Devisscher, L., Deprez, P., & Gasthuys, F. (2009). Cardiovascular responses to transvenous electrical cardioversion of atrial fibrillation in anaesthetized horses. VETERINARY ANAESTHESIA AND ANALGESIA, 36(4), 341–351.
Vancouver
1.
Schauvliege S, van Loon G, De Clercq D, Devisscher L, Deprez P, Gasthuys F. Cardiovascular responses to transvenous electrical cardioversion of atrial fibrillation in anaesthetized horses. VETERINARY ANAESTHESIA AND ANALGESIA. 2009;36(4):341–51.
MLA
Schauvliege, Stijn, Gunther van Loon, Dominique De Clercq, et al. “Cardiovascular Responses to Transvenous Electrical Cardioversion of Atrial Fibrillation in Anaesthetized Horses.” VETERINARY ANAESTHESIA AND ANALGESIA 36.4 (2009): 341–351. Print.