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Buschmann E, Van Steenkiste G, Boussy T, Vernemmen I, Schauvliege S, Decloedt A, van Loon G. Three-dimensional electro-anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: A case report. J Vet Intern Med 2023; 37:728-734. [PMID: 36866668 DOI: 10.1111/jvim.16668] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 02/07/2023] [Indexed: 03/04/2023] Open
Abstract
We describe the diagnosis and treatment of an atrioventricular accessory pathway (AP) in a horse using 3-dimensional electro-anatomical mapping (3D EAM) and radiofrequency catheter ablation (RFCA). During routine evaluation of the horse, intermittent ventricular pre-excitation was identified on the ECG, characterized by a short PQ interval and abnormal QRS morphology. A right cranial location of the AP was suspected from the 12-lead ECG and vectorcardiography. After precise localization of the AP using 3D EAM, ablation was performed and AP conduction was eliminated. Immediately after recovery from anesthesia an occasional pre-excited complex still was observed, but a 24-hour ECG and an ECG during exercise 1 and 6 weeks after the procedure showed complete disappearance of pre-excitation. This case shows the feasibility of 3D EAM and RFCA to identify and treat an AP in horses.
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Affiliation(s)
- Eva Buschmann
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Glenn Van Steenkiste
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Tim Boussy
- Department of Cardiology, AZ Groeninge, Kortrijk, Belgium
| | - Ingrid Vernemmen
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Stijn Schauvliege
- Department of Large Animal Surgery, and Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Annelies Decloedt
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Gunther van Loon
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Jastrzębski M, Kukla P, Pitak M, Rudziński A, Baranchuk A, Czarnecka D. Intermittent preexcitation indicates "a low-risk" accessory pathway: Time for a paradigm shift? Ann Noninvasive Electrocardiol 2017; 22. [PMID: 28497860 DOI: 10.1111/anec.12464] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We report three patients with intermittent loss of the preexcitation pattern in the ECG that had undergone an electrophysiological study. Despite apparently poorly conducting accessory pathway (AP), in each case a fast anterograde conduction, either during spontaneous atrial fibrillation or during incremental atrial pacing (on isoproterenol) was documented; shortest preexcited RR intervals of 200-240 ms were observed. We review the literature and conclude that intermittent preexcitation observed on resting 12-lead ECG lacks sufficient specificity for the diagnosis of an AP with long refractory period and cannot be considered a substitute for electrophysiological study in patients with this electrocardiographical phenomenon.
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Affiliation(s)
- Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Cracow, Poland
| | - Piotr Kukla
- Department of Cardiology, H. Klimontowicz Specialistic Hospital, Gorlice, Poland
| | - Maciej Pitak
- Department of Cardiology, Institute of Pediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Andrzej Rudziński
- Department of Cardiology, Institute of Pediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Adrian Baranchuk
- Division of Cardiology, Kingston General Hospital, Queen's University, Kingston, ON, Canada
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Cracow, Poland
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