Peer-reviewed veterinary case report
Detection of paroxysmal atrial fibrillation preceding persistent atrial fibrillation in a horse using an implantable loop recorder with remote monitoring.
- Journal:
- Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology
- Year:
- 2024
- Authors:
- Vernemmen, I et al.
- Affiliation:
- Department of Internal Medicine
- Species:
- horse
Plain-English summary
In this case, a horse with a history of irregular heartbeats called atrial fibrillation (AF) had an implantable loop recorder (ILR) placed to monitor its heart. This ILR had a special feature that allowed it to send heart recordings to a server daily, so the veterinarian could check the horse's heart health without needing special equipment. About three months after the ILR was put in, it detected a brief episode of AF, but later, it misidentified a more serious, ongoing case of AF as a different issue. Ultimately, the horse had to be retired due to the heart condition. This case highlights the usefulness of remote monitoring for heart issues in horses, but also points out that the technology still has some limitations in accurately reading heart rhythms.
Abstract
Implantable loop recorders (ILRs) are increasingly used in equine cardiology to detect arrhythmias in the context of collapse, poor performance or monitoring for recurrence of atrial fibrillation (AF). However to date, the ILR has never been reported to be used with a remote monitoring functionality in horses, therefore the arrhythmia is only discovered when a clinician interrogates the ILR using dedicated equipment, which might delay diagnosis and intervention. This case report describes the use of an ILR with remote monitoring functionality in a horse with recurrent AF. The remote monitoring consisted of a transmission device located in the stable allowing daily transmission of arrhythmia recordings and functioning messages to an online server, available for the clinician to evaluate without specialised equipment. The ILR detected an episode of paroxysmal AF approximately three months after implantation. Seven months after implantation, initiation of persistent AF was seen on an episode misclassified by the ILR as bradycardia, and the horse was retired. This report shows the feasibility and benefits of remote monitoring for ILRs in horses, but also the shortcomings of current algorithms to interpret the equine electrocardiogram.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/38402667/