Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses
Summary 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 mult...
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| Veröffentlicht in: | Equine veterinary journal 2020-05, Vol.52 (3), p.374-378 |
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| creator | Vernemmen, I. De Clercq, D. Decloedt, A. Vera, L. Van Steenkiste, G. van Loon, G. |
| description | Summary
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 |
| doi_str_mv | 10.1111/evj.13186 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2301430632</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2386947436</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3886-1ec81ac49bc4acaecbea2cb50d64d28d8987d2a2a55284b8dc75e237d925c53</originalsourceid><addsrcrecordid>eNp1kc1u1DAURi0EokNhwQsgS2xgkTb-SeJZVlVbiiqxKGIb3dh3hIdMHK6TQfMAvHdvm8KiUr2xZZ_v6MqfEO9VeaJ4neJ-e6KMcvULsdKl1YUxZf1SrPhYFaq29ki8yXlblsZoq1-LI6MqZxqrV-Lv2UQRejkS7mCaCWXAMfVAMcMU05DlJu75Eg5ZjilPEnv0HPGc8UAhpj1SZlACZwl7mDDIKUlYvJvYUez7Bxc_-5kIB89kzL9kHOTPRBnzW_FqA33Gd4_7sbi9vPh-_qW4-XZ1fX52U3jjXF0o9E6Bt-vOW_CAvkPQvqvKUNugXXBr1wQNGqpKO9u54JsKtWnCWle-Msfi02IdKf2eMU_tLmaPPN2Aac6tNqWy_HNGM_rxCbpNMw08G1OuXtvGmpqpzwvlKeVMuGlHijugQ6vK9r6ZlptpH5ph9sOjce52GP6T_6pg4HQB_sQeD8-b2osfXxflHVxFmxs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2386947436</pqid></control><display><type>article</type><title>Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Vernemmen, I. ; De Clercq, D. ; Decloedt, A. ; Vera, L. ; Van Steenkiste, G. ; van Loon, G.</creator><creatorcontrib>Vernemmen, I. ; De Clercq, D. ; Decloedt, A. ; Vera, L. ; Van Steenkiste, G. ; van Loon, G.</creatorcontrib><description>Summary
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.</description><identifier>ISSN: 0425-1644</identifier><identifier>EISSN: 2042-3306</identifier><identifier>DOI: 10.1111/evj.13186</identifier><identifier>PMID: 31583742</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Animals ; Anti-Arrhythmia Agents ; arrhythmias ; atrial ectopy ; Atrial Fibrillation - veterinary ; Cardiac arrhythmia ; Electric Countershock - veterinary ; electrocardiogram ; Heart Atria ; horse ; Horse Diseases ; Horses ; Humans ; Retrospective Studies ; transvenous electrical cardioversion</subject><ispartof>Equine veterinary journal, 2020-05, Vol.52 (3), p.374-378</ispartof><rights>2019 EVJ Ltd</rights><rights>2019 EVJ Ltd.</rights><rights>Copyright © 2020 EVJ Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3886-1ec81ac49bc4acaecbea2cb50d64d28d8987d2a2a55284b8dc75e237d925c53</citedby><cites>FETCH-LOGICAL-c3886-1ec81ac49bc4acaecbea2cb50d64d28d8987d2a2a55284b8dc75e237d925c53</cites><orcidid>0000-0002-8185-1450 ; 0000-0001-8129-2006 ; 0000-0002-0165-5215 ; 0000-0001-5191-5241 ; 0000-0003-4171-6315 ; 0000-0003-3416-1745</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fevj.13186$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fevj.13186$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31583742$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vernemmen, I.</creatorcontrib><creatorcontrib>De Clercq, D.</creatorcontrib><creatorcontrib>Decloedt, A.</creatorcontrib><creatorcontrib>Vera, L.</creatorcontrib><creatorcontrib>Van Steenkiste, G.</creatorcontrib><creatorcontrib>van Loon, G.</creatorcontrib><title>Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses</title><title>Equine veterinary journal</title><addtitle>Equine Vet J</addtitle><description>Summary
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.</description><subject>Animals</subject><subject>Anti-Arrhythmia Agents</subject><subject>arrhythmias</subject><subject>atrial ectopy</subject><subject>Atrial Fibrillation - veterinary</subject><subject>Cardiac arrhythmia</subject><subject>Electric Countershock - veterinary</subject><subject>electrocardiogram</subject><subject>Heart Atria</subject><subject>horse</subject><subject>Horse Diseases</subject><subject>Horses</subject><subject>Humans</subject><subject>Retrospective Studies</subject><subject>transvenous electrical cardioversion</subject><issn>0425-1644</issn><issn>2042-3306</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAURi0EokNhwQsgS2xgkTb-SeJZVlVbiiqxKGIb3dh3hIdMHK6TQfMAvHdvm8KiUr2xZZ_v6MqfEO9VeaJ4neJ-e6KMcvULsdKl1YUxZf1SrPhYFaq29ki8yXlblsZoq1-LI6MqZxqrV-Lv2UQRejkS7mCaCWXAMfVAMcMU05DlJu75Eg5ZjilPEnv0HPGc8UAhpj1SZlACZwl7mDDIKUlYvJvYUez7Bxc_-5kIB89kzL9kHOTPRBnzW_FqA33Gd4_7sbi9vPh-_qW4-XZ1fX52U3jjXF0o9E6Bt-vOW_CAvkPQvqvKUNugXXBr1wQNGqpKO9u54JsKtWnCWle-Msfi02IdKf2eMU_tLmaPPN2Aac6tNqWy_HNGM_rxCbpNMw08G1OuXtvGmpqpzwvlKeVMuGlHijugQ6vK9r6ZlptpH5ph9sOjce52GP6T_6pg4HQB_sQeD8-b2osfXxflHVxFmxs</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Vernemmen, I.</creator><creator>De Clercq, D.</creator><creator>Decloedt, A.</creator><creator>Vera, L.</creator><creator>Van Steenkiste, G.</creator><creator>van Loon, G.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8185-1450</orcidid><orcidid>https://orcid.org/0000-0001-8129-2006</orcidid><orcidid>https://orcid.org/0000-0002-0165-5215</orcidid><orcidid>https://orcid.org/0000-0001-5191-5241</orcidid><orcidid>https://orcid.org/0000-0003-4171-6315</orcidid><orcidid>https://orcid.org/0000-0003-3416-1745</orcidid></search><sort><creationdate>202005</creationdate><title>Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses</title><author>Vernemmen, I. ; De Clercq, D. ; Decloedt, A. ; Vera, L. ; Van Steenkiste, G. ; van Loon, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3886-1ec81ac49bc4acaecbea2cb50d64d28d8987d2a2a55284b8dc75e237d925c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Animals</topic><topic>Anti-Arrhythmia Agents</topic><topic>arrhythmias</topic><topic>atrial ectopy</topic><topic>Atrial Fibrillation - veterinary</topic><topic>Cardiac arrhythmia</topic><topic>Electric Countershock - veterinary</topic><topic>electrocardiogram</topic><topic>Heart Atria</topic><topic>horse</topic><topic>Horse Diseases</topic><topic>Horses</topic><topic>Humans</topic><topic>Retrospective Studies</topic><topic>transvenous electrical cardioversion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vernemmen, I.</creatorcontrib><creatorcontrib>De Clercq, D.</creatorcontrib><creatorcontrib>Decloedt, A.</creatorcontrib><creatorcontrib>Vera, L.</creatorcontrib><creatorcontrib>Van Steenkiste, G.</creatorcontrib><creatorcontrib>van Loon, G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Equine veterinary journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vernemmen, I.</au><au>De Clercq, D.</au><au>Decloedt, A.</au><au>Vera, L.</au><au>Van Steenkiste, G.</au><au>van Loon, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses</atitle><jtitle>Equine veterinary journal</jtitle><addtitle>Equine Vet J</addtitle><date>2020-05</date><risdate>2020</risdate><volume>52</volume><issue>3</issue><spage>374</spage><epage>378</epage><pages>374-378</pages><issn>0425-1644</issn><eissn>2042-3306</eissn><abstract>Summary
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.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31583742</pmid><doi>10.1111/evj.13186</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-8185-1450</orcidid><orcidid>https://orcid.org/0000-0001-8129-2006</orcidid><orcidid>https://orcid.org/0000-0002-0165-5215</orcidid><orcidid>https://orcid.org/0000-0001-5191-5241</orcidid><orcidid>https://orcid.org/0000-0003-4171-6315</orcidid><orcidid>https://orcid.org/0000-0003-3416-1745</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Equine veterinary journal, 2020-05, Vol.52 (3), p.374-378 |
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| language | eng |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Animals Anti-Arrhythmia Agents arrhythmias atrial ectopy Atrial Fibrillation - veterinary Cardiac arrhythmia Electric Countershock - veterinary electrocardiogram Heart Atria horse Horse Diseases Horses Humans Retrospective Studies transvenous electrical cardioversion |
| title | Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses |
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