Multiple Catheter Recording in Horses to Investigate Atrial Depolarization Pattern During Sinus Rhythm and Induced Premature Atrial Complexes

Abstract

Background: Detailed characterization of arrhythmias can be performed by multiple catheter mapping; but this has not yet been explored in horses. Objectives: Perform ultrasound-guided multiple catheter mapping of the right heart during sinus rhythm and right and left atrial pacing to identify activation patterns characteristic of the origin of ectopy. Obtain His signals and effective refractory periods (ERP). Animals: Eight healthy adult horses. Methods: Experimental study. Recording catheters were placed at the terminal crest, intervenous tubercle, caudal vena cava, and coronary sinus. Right atrial pacing was performed in standing, sedated horses from each catheter and from the cranial vena cava, right atrial appendage, and right atrial free wall. Left atrial pacing was performed during general anesthesia at the four pulmonary vein ostia, left atrial appendage, and interatrial septum. Atrial activation patterns were recorded from the catheters during sinus rhythm and during pacing at the different sites. During sinus rhythm, the His bundle was recorded, and ERP at different sites was determined. Results: Characteristic activation maps during sinus rhythm and pacing were identified. Late coronary sinus activation indicated ectopy originating from the right atrium or ostium III. The direction of coronary sinus electrode activation aided in differentiating left atrial ectopy locations. His signals were recorded in 5/8 horses. Atrial ERP varied between 170 and 420 ms with inter-horse and intra-horse variation. Conclusions and Clinical Importance: Performing an electrophysiological study in horses, including multiple catheter recording, was feasible. Pacing-induced ectopy resulted in characteristic activation patterns, which might aid in identifying the site of atrial ectopy.