Temporary transvenous atrial pacing in horses: threshold determination

The purpose of this study was to perform temporary atrial pacing and to determine the atrial strength-duration (S-D) curve which displays the minimal pulse intensity necessary to achieve atrial capture. In 7 horses, atrial pacing was applied using a temporary pacing catheter and a pacemaker as electrical pulse generator. Using the stimulus reduction method, 3 approaches for atrial threshold determination were used. With the fixed pulse width method, at several pulse widths, the corresponding minimal amplitudes to achieve capture were determined, describing an S-D curve. With the fixed amplitude method, the corresponding threshold pulse widths were determined at several fixed amplitudes. The third method proved to be the best and was a combination of both aforementioned methods to determine 2 points of the S-D curve. From these 2 points the whole S-D curve was calculated using a mathematical equation. Temporary pacing can be used to terminate atrial flutter, to induce atrial arrhythmias or to obtain more information about the electrophysiological properties of the heart, such as the atrial refractory period, atrial vulnerability and atrioventricular conduction.