equis - Articles
Transvenous cardioversion
Introduction
- Transvenous cardioversion (TVEC) is a complex procedure requiring trained personnel with a high degree of specialist knowledge.
Uses
- For the treatment of atrial fibrillation Heart: atrial fibrillation Poor performance: cardiac causes and treatment.
Advantages
- Controllable.
- Minimal morbidity.
- Efficacious.
- Predictable.
- Best for atrial fibrillation or chronic or unknown duration.
Disadvantages
- Relatively expensive.
- Involves short general anesthesia Anesthesia: general - overview.
Technical problems
- Electrode placement can be challenging, needs specialist personnel and equipment.
- Electrodes can be displaced during anesthetic induction Anesthesia: induction – overview.
Alternative techniques
- Use of oral quinidine sulfate Quinidine.
Time required
Preparation
- 40-120 min.
Procedure
- 30-40 min.
Decision taking
Criteria for choosing test
- Atrial fibrillation Heart: atrial fibrillation of unknown/chronic duration.
- Owner preference.
- Horse has previous history of gastric ulceration Stomach: gastric ulceration or recurrent colic Abdomen: pain – adult (contraindicates quinidine sulfate).
- Quinidine sulfate treatment has failed to convert atrial fibrillation.
- Recurrence of atrial fibrillation after initial successful medical cardioversion.
Risk assessment
- As for general anesthesia.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- van Loon G (2019) Cardiac arrhythmias in horses. Vet Clin North Am Equine Pract 35 (1), 85-102 PubMed.
- Vernemmem I, De Clercq D, Decloedt A et al (2019) Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses. Equine Vet J 4, PubMed.
- McGurrin M K, Physick-Sheard P W & Kenney D G (2008) Transvenous electrical cardioversion of equine atrial fibrillation: patient factors and clinical results in 72 treatment episodes. J Vet Intern Med 22 (3), 609-615 PubMed.
- McGurrin M K, Physick-Sheard P W, Kenney D G, Kerr C & Hanna W J (2005) Transvenous electrical cardioversion of equine atrial fibrillation: technical considerations. J Vet Intern Med 19 (5), 695-702 PubMed.
Organisation(s)
- University of Edinburgh. Website: www.ed.ac.uk/vet.
- Professor Lesley Young BVSc DVA DVC DipECEIM PhD MRCVS, Specialist Equine Cardiology Services, UK.