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Influence of detomidine on atrial fibrillation cycle length measured by intracardiac electrogram recording and by colour tissue Doppler imaging in horses.
MedLine Citation:
PMID:  25266765     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
REASONS FOR PERFORMING STUDY: Shortening of atrial fibrillation cycle length (AFCL) is a marker of atrial electrical remodelling due to atrial fibrillation (AF).
OBJECTIVES: To investigate the effect of detomidine administration on AFCL measured invasively from an intra-atrial electrogram (AFCLEGM) and non-invasively by tissue Doppler imaging (AFCLTDI). We hypothesised that detomidine would have no effect on AFCL but would improve the ease of TDI measurements and facilitate non-invasive AFCL determination.
STUDY DESIGN: Prospective clinical study.
METHODS: Measurements were performed before and after intravenous administration of 7.5 μg/kg detomidine in 33 episodes of AF in 32 horses (582 ± 64 kg, 10 ± 3 years) referred for electrical cardioversion. AFCLEGM was measured from a right atrial intra-cardiac electrogram. AFCLTDI was measured from atrial colour tissue velocity curves in 5 atrial wall regions. Mean AFCLEGM and AFCLTDI without and with sedation were compared using a repeated measures linear mixed model with Bonferroni correction for multiple comparisons and calculation of the Bland-Altman mean bias and limits of agreement between AFCLEGM and AFCLTDI .
RESULTS: The mean AFCL was significantly increased after sedation, however, this increase was very small (mean difference +4 ms). For AFCLTDI measurements, sedation significantly improved the quality of the atrial myocardial velocity curves and the number of AF cycles that could be measured per cardiac cycle. The Bland-Altman bias between AFCLEGM without sedation and AFCLTDI with sedation ranged from -18 ms to +15 ms depending on wall region. Bland-Altman limits of agreement were similar between AFCLEGM without sedation and AFCLTDI without and with sedation. Therefore, non-invasive AFCLTDI measurements with sedation can be used to estimate the atrial fibrillatory rate.
CONCLUSIONS: Sedation facilitates non-invasive AFCL measurements but causes a slight increase in AFCL. Non-invasive AFCL measurements can be used as an indicator of atrial electrical remodelling, to study AF pathophysiology and to investigate the effect of anti-arrhythmic drugs.
Authors:
A Decloedt; D De Clercq; N Van Der Vekens; T Verheyen; S Ven; G van Loon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-30
Journal Detail:
Title:  Equine veterinary journal     Volume:  -     ISSN:  2042-3306     ISO Abbreviation:  Equine Vet. J.     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-30     Completed Date:  -     Revised Date:  2014-10-1    
Medline Journal Info:
Nlm Unique ID:  0173320     Medline TA:  Equine Vet J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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This article is protected by copyright. All rights reserved.
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