Abstract

BackgroundIn human and veterinary medicine, monophasic action potential (MAP) analysis and determination of local refractory periods by contact electrode technique gives valuable information about local cardiac electrophysiological properties. It is used to investigate dysrhythmias and the impact of drugs on the myocardium. Precise measurement of total MAP duration is difficult, therefore the MAP duration is usually determined at a repolarization level of 90% (APD90). Until now, no studies are published about the feasibility of this technique in the standing non-sedated horse. In 6 healthy Warmblood horses, on two different days, an 8F quadripolar contact catheter was passed through a jugular introducer sheath and placed under ultrasound guidance at the level of the intervenous tubercle or right atrial free wall (RA), and in the right ventricular apex (RV) to record the MAP. The MAP amplitude and APD90 were measured at a resting sinus rhythm (heart rate of 30-42 bpm) and at pacing cycle lengths (PCL) of 1000 and 600 ms. The effective refractory period (ERP) was determined at PCL of 1000 and 600 ms.ResultsThe overall mean (±SD) APD90 (rest), APD90 (1000) and APD90 (600) were 263 ± 39 ms, 262 ± 41 ms, 236 ± 47 ms for the RA and 467 ± 23 ms, 412 ± 38 ms, 322 ± 29 ms for the RV. The mean ERP1000 and ERP600 were 273 ± 24 ms and 256 ± 22 ms for the RA and 386 ± 40 ms and 293 ± 30 ms for the RV. The measurement variability for the amplitude, APD90 and ERP measurements in the RA ranged between 36 and 44, 9–22 and 7–8%, respectively. The measurement variability for the amplitude, APD90 and ERP measurements in the RV ranged between 49 and 66, 6–7 and 10–12%, respectively.ConclusionsRA and RV MAP duration and ERP can be obtained by a contact electrode in standing non-sedated horses. The measurement variability varies with catheter location.

Highlights

  • In human and veterinary medicine, monophasic action potential (MAP) analysis and determination of local refractory periods by contact electrode technique gives valuable information about local cardiac electrophysiological properties

  • Monophasic action potential (MAP) has a smaller magnitude than the intracellular action potential (IAP) but it is proven that MAP recordings can give highly accurate information about local atrial or ventricular activation time and the entire time course of myocardial repolarization [3,4,5,6,7,8,9,10,11]

  • The catheter was inserted via the introducer sheath and placed under ultrasound guidance at the level of the intervenous tubercle or at the level of the right atrial free wall (RA) and in the right ventricular apex (RV) (Fig. 2)

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Summary

Results

Right atrial (Fig. 3a) and right ventricular (Fig. 3b) MAP recordings of sufficient quality could be obtained and analysed in non-sedated standing horses. Horse movements, occasionally resulted in loss of contact requiring MAP catheter repositioning. Catheter positioning was occasionally associated with self-limiting atrial or ventricular depolarizations which terminated after slight catheter tip movements. During atrial ERP measurements, a short episodes of self-limiting episode of atrial tachycardia was occasionally found and 1 horse showed a 20-min paroxysm of atrial fibrillation. Ventricular ERP measurements were never associated with tachyarrhythmias. All the results of the two different days are shown in Table 1 and Fig. 4. In 1 horse a difference of up to 100 ms was observed during VERP1000 measurement.

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