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

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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.
Keywords
cardiovascular function, atrial fibrillation, horses, transvenous electrical cardioversion, GUINEA-PIG HEART, SINUS RHYTHM, ATRIOVENTRICULAR-CONDUCTION, MYOCARDIAL-CELLS, ANESTHESIA, CONVERSION, LIDOCAINE, SHOCK, HEMODYNAMICS, AMIODARONE

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MLA
Schauvliege, Stijn et al. “Cardiovascular Responses to Transvenous Electrical Cardioversion of Atrial Fibrillation in Anaesthetized Horses.” VETERINARY ANAESTHESIA AND ANALGESIA 36.4 (2009): 341–351. Print.
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.
Chicago author-date
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.
Chicago author-date (all authors)
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.
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.
IEEE
[1]
S. Schauvliege, G. van Loon, D. De Clercq, L. Devisscher, P. Deprez, and F. Gasthuys, “Cardiovascular responses to transvenous electrical cardioversion of atrial fibrillation in anaesthetized horses,” VETERINARY ANAESTHESIA AND ANALGESIA, vol. 36, no. 4, pp. 341–351, 2009.
@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 > 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},
  keywords     = {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},
}

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