Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
J Vet Intern Med. 2024 Sep-Oct;38(5):2686-2697. doi: 10.1111/jvim.17156. Epub 2024 Aug 3.
Improved characterization of arrhythmias is based on minimally invasive catheterizations. However, these catheterizations have been poorly explored in horses because apart from 3-dimensional (3D) mapping systems, continuous guidance of the catheter's position with adequate detail is difficult using current imaging modalities.
Position multiple electrophysiology catheters simultaneously at predetermined strategical positions in the heart using transthoracic echocardiographic guidance.
Eight adult healthy horses.
Observational study. Two electrophysiological studies were performed: 1 procedure with catheters positioned in the right heart in the standing sedated horse and 1 procedure under general anesthesia with catheters positioned in the left heart. Except for the coronary sinus catheter, each catheter positioning was simultaneously guided by right-parasternal transthoracic echocardiography and 3D electro-anatomical mapping.
For each catheter position, a central imaging plane was taken as the starting point, after which the imaging probe was shifted, rotated, and angulated to visualize the catheter over its entire length, including its distal electrode. Catheter positionings in the right heart and left ventricle were successfully guided in the majority of the horses whereas catheter positionings in the left atrium, and especially the pulmonary veins, were challenging to guide echocardiographically.
Ultrasound guidance of catheters to specific positions useful for electrophysiological mapping was feasible in the right heart and left ventricle but challenging for the left atrium. This approach creates a perspective for minimally invasive arrhythmia diagnosis without the need for a 3D mapping system. Left parasternal views and intracardiac echocardiography might provide better guidance for left atrial positions.
心律失常的特征改善基于微创导管术。然而，由于除了三维（3D）映射系统之外，当前的成像方式很难用足够的细节连续指导导管的位置，因此这些导管术在马中尚未得到充分探索。
使用经胸超声心动图引导，同时将多个电生理导管定位于心脏中的预定战略位置。
8 匹成年健康马。
观察性研究。进行了 2 项电生理研究：1 项程序是在站立镇静的马的右心放置导管，1 项程序是在全身麻醉下左心放置导管。除了冠状窦导管外，每个导管定位都同时通过右胸骨旁经胸超声心动图和 3D 电解剖映射进行引导。
对于每个导管位置，取一个中央成像平面作为起点，然后移动、旋转和倾斜成像探头，以可视化整个导管的位置，包括其远端电极。在大多数马中成功地引导了右心和左心室的导管定位，而在左心房，尤其是肺静脉的导管定位，经超声心动图引导具有挑战性。
将导管引导至对电生理映射有用的特定位置的超声引导在右心和左心室是可行的，但对左心房具有挑战性。这种方法为无需 3D 映射系统的微创心律失常诊断创造了一种可能性。左胸骨旁视图和心内超声可能为左心房位置提供更好的引导。
