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Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses

Ingrid Vernemmen (UGent) , Dominique De Clercq (UGent) , Annelies Decloedt (UGent) , Lisse Vera (UGent) , Glenn Van Steenkiste (UGent) and Gunther van Loon (UGent)
(2020) EQUINE VETERINARY JOURNAL. 52(3). p.374-378
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Abstract
Background: The number of atrial premature depolarisations (APDs) is a known risk factor for atrial fibrillation (AF) recurrence in humans. Objectives: To evaluate if the number of APDs over a 24-h period 5 days post cardioversion predicts AF recurrence within 1 year in horses, taking the multifactorial nature of AF into account. Study design: Retrospective case series. Methods Eighty horses met these inclusion criteria: first AF episode, no AF recurrence within 5 days post cardioversion, cardioversion by transvenous electrical cardioversion (TVEC), 24-h ECG recording and echocardiographic examination 5 days post cardioversion, no antiarrhythmic treatment during the ECG recording and follow-up of minimum 1 year. To compare the APD burden between the recurrence and non-recurrence group a Mann-Whitney U test was used. A multivariable survival model was built to identify additional risk factors for AF recurrence. Results: The patient population mainly consisted of Warmbloods (93%). Twenty-six horses (33%) experienced AF recurrence within 1 year. The number of APDs (median [range]) was significantly higher (P = 0.01) in the recurrence group (15 [1-152]) compared with the non-recurrence group (7 [0-304]). In the multivariable survival model, APDs >= 25/24 h (hazard ratio [HR] 2.9, 95% confidence interval [CI] 1.2-6.8, P = 0.02), mitral regurgitation (HR 8.6, 95% CI 2.6-28.9, P<0.001), left atrial active fractional area change <= 9.6% (HR 2.6, 95% CI 1.0-6.5, P = 0.04) and lower body weight (HR 0.99, 95% CI 0.98-0.99, P = 0.001) were significantly associated with AF recurrence. Main limitations: This study did not evaluate early AF recurrence within 5 days. The results cannot necessarily be extrapolated to other treatment methods, as only horses converted by TVEC were included. Conclusions: The APD burden 5 days post cardioversion could be a useful predictive value for AF recurrence within 1 year in horses. However, other factors such as mitral regurgitation and atrial contractile function must also be taken into account.
Keywords
horse, transvenous electrical cardioversion, atrial ectopy, arrhythmias, electrocardiogram, PROGNOSTIC-SIGNIFICANCE, MECHANISMS, TACHYCARDIA, ECTOPY

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MLA
Vernemmen, Ingrid, et al. “Atrial Premature Depolarisations Five Days Post Electrical Cardioversion Are Related to Atrial Fibrillation Recurrence Risk in Horses.” EQUINE VETERINARY JOURNAL, vol. 52, no. 3, 2020, pp. 374–78, doi:10.1111/evj.13186.
APA
Vernemmen, I., De Clercq, D., Decloedt, A., Vera, L., Van Steenkiste, G., & van Loon, G. (2020). Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses. EQUINE VETERINARY JOURNAL, 52(3), 374–378. https://doi.org/10.1111/evj.13186
Chicago author-date
Vernemmen, Ingrid, Dominique De Clercq, Annelies Decloedt, Lisse Vera, Glenn Van Steenkiste, and Gunther van Loon. 2020. “Atrial Premature Depolarisations Five Days Post Electrical Cardioversion Are Related to Atrial Fibrillation Recurrence Risk in Horses.” EQUINE VETERINARY JOURNAL 52 (3): 374–78. https://doi.org/10.1111/evj.13186.
Chicago author-date (all authors)
Vernemmen, Ingrid, Dominique De Clercq, Annelies Decloedt, Lisse Vera, Glenn Van Steenkiste, and Gunther van Loon. 2020. “Atrial Premature Depolarisations Five Days Post Electrical Cardioversion Are Related to Atrial Fibrillation Recurrence Risk in Horses.” EQUINE VETERINARY JOURNAL 52 (3): 374–378. doi:10.1111/evj.13186.
Vancouver
1.
Vernemmen I, De Clercq D, Decloedt A, Vera L, Van Steenkiste G, van Loon G. Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses. EQUINE VETERINARY JOURNAL. 2020;52(3):374–8.
IEEE
[1]
I. Vernemmen, D. De Clercq, A. Decloedt, L. Vera, G. Van Steenkiste, and G. van Loon, “Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses,” EQUINE VETERINARY JOURNAL, vol. 52, no. 3, pp. 374–378, 2020.
@article{8644364,
  abstract     = {Background: The number of atrial premature depolarisations (APDs) is a known risk factor for atrial fibrillation (AF) recurrence in humans.
Objectives: To evaluate if the number of APDs over a 24-h period 5 days post cardioversion predicts AF recurrence within 1 year in horses, taking the multifactorial nature of AF into account.
Study design: Retrospective case series. Methods Eighty horses met these inclusion criteria: first AF episode, no AF recurrence within 5 days post cardioversion, cardioversion by transvenous electrical cardioversion (TVEC), 24-h ECG recording and echocardiographic examination 5 days post cardioversion, no antiarrhythmic treatment during the ECG recording and follow-up of minimum 1 year. To compare the APD burden between the recurrence and non-recurrence group a Mann-Whitney U test was used. A multivariable survival model was built to identify additional risk factors for AF recurrence.
Results: The patient population mainly consisted of Warmbloods (93%). Twenty-six horses (33%) experienced AF recurrence within 1 year. The number of APDs (median [range]) was significantly higher (P = 0.01) in the recurrence group (15 [1-152]) compared with the non-recurrence group (7 [0-304]). In the multivariable survival model, APDs >= 25/24 h (hazard ratio [HR] 2.9, 95% confidence interval [CI] 1.2-6.8, P = 0.02), mitral regurgitation (HR 8.6, 95% CI 2.6-28.9, P<0.001), left atrial active fractional area change <= 9.6% (HR 2.6, 95% CI 1.0-6.5, P = 0.04) and lower body weight (HR 0.99, 95% CI 0.98-0.99, P = 0.001) were significantly associated with AF recurrence.
Main limitations: This study did not evaluate early AF recurrence within 5 days. The results cannot necessarily be extrapolated to other treatment methods, as only horses converted by TVEC were included.
Conclusions: The APD burden 5 days post cardioversion could be a useful predictive value for AF recurrence within 1 year in horses. However, other factors such as mitral regurgitation and atrial contractile function must also be taken into account.},
  author       = {Vernemmen, Ingrid and De Clercq, Dominique and Decloedt, Annelies and Vera, Lisse and Van Steenkiste, Glenn and van Loon, Gunther},
  issn         = {0425-1644},
  journal      = {EQUINE VETERINARY JOURNAL},
  keywords     = {horse,transvenous electrical cardioversion,atrial ectopy,arrhythmias,electrocardiogram,PROGNOSTIC-SIGNIFICANCE,MECHANISMS,TACHYCARDIA,ECTOPY},
  language     = {eng},
  number       = {3},
  pages        = {374--378},
  title        = {Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses},
  url          = {http://dx.doi.org/10.1111/evj.13186},
  volume       = {52},
  year         = {2020},
}

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