Buschmann Eva, Van Steenkiste Glenn, Bulckens Hannes, Schauvliege Stijn, Decloedt Annelies, van Loon Gunther
Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Biosense Webster - Electrophysiology, Johnson & Johnson, J&J Medtech, Diegem, Belgium.
Equine Vet J. 2025 Sep 9. doi: 10.1111/evj.70095.
Frequent premature atrial complexes (PACs) can increase the risk of atrial fibrillation or atrial tachycardia, and pharmacological therapy can be challenging.
To report the use of three-dimensional electro-anatomical mapping of PAC originating from the right atrial free wall and treatment by radiofrequency ablation in three horses.
Retrospective case report.
Frequent premature atrial complexes (PACs) were diagnosed in three horses. Twelve-lead ECG and vectorcardiography suggested an origin in the right lateral free wall in two horses and the caudal right atrium in one horse. Three-dimensional electro-anatomical mapping (3D EAM) and radiofrequency ablation using the CARTO™ 3 system were performed. Isoprenaline or dobutamine administration allowed activating the focus of PACs during general anaesthesia. Activation mapping using Pattern Matching Filtering identified the origin of PACs at the mid portion of the right atrial free wall in all horses. In the first horse, ablation was not performed due to pacing-induced phrenic nerve stimulation at the site of earliest activation. In the second horse, PACs disappeared after the 18th energy application and were no longer inducible by dobutamine. In the last horse, ablation was not successful in eliminating PACs.
Small number of cases.
The 3D EAM identified the focus of PACs at the right atrial free wall in three horses, revealing it as a possible arrhythmogenic area. Although still challenging, radiofrequency ablation has promise as a treatment to provide a permanent solution for frequent PACs.
频发房性早搏（PACs）会增加房颤或房性心动过速的风险，药物治疗可能具有挑战性。
报告三匹马中源自右心房游离壁的PACs的三维电解剖标测及射频消融治疗情况。
回顾性病例报告。
在三匹马中诊断出频发房性早搏（PACs）。十二导联心电图和向量心电图提示，两匹马的起源于右外侧游离壁，一匹马的起源于右心房尾部。使用CARTO™ 3系统进行了三维电解剖标测（3D EAM）和射频消融。在全身麻醉期间给予异丙肾上腺素或多巴酚丁胺可激活PACs的起源点。使用模式匹配滤波的激动标测确定所有马匹的PACs起源于右心房游离壁中部。在第一匹马中，由于在最早激动部位起搏诱发膈神经刺激，未进行消融。在第二匹马中，第18次能量施加后PACs消失，多巴酚丁胺不再能诱发。在最后一匹马中，消融未能成功消除PACs。
病例数量少。
三维电解剖标测确定了三匹马右心房游离壁的PACs起源点，表明其为一个可能的致心律失常区域。尽管仍然具有挑战性，但射频消融有望为频发PACs提供永久性治疗方案。
