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Background  Although atrial fibrillation ( AF ) can be successfully treated in horses, recurrence occurs frequently. In humans, atrial function after cardioversion can predict recurrence.    Objectives  To examine the prognostic value of atrial mechanical function at 24 hours after cardioversion and other potential predictor variables for  AF  recurrence in horses.    Animals  117 horses treated for  AF  at 4 referral centers.    Methods  Retrospective study. Inclusion criteria were successful cardioversion, echocardiography at 24 hours after cardioversion and ≥4 months follow‐up. To determine factors associated with  AF  recurrence, a multivariable survival model was built.    Results  133  AF  episodes in 117 horses were included.  AF  recurred in 36/100 horses with a first  AF  episode and in 57/133  AF  episodes overall. Factors associated with recurrence in horses with a first episode were previous unsuccessful treatment attempt (hazard ratio  HR  2.36, 95% confidence interval  CI  1.11–4.99,  P  = .025) and mild or moderate mitral regurgitation ( HR  2.70, 95%  CI  1.23–5.91,  P  = .013). When the last  AF  episode of all horses was included, previous  AF  ( HR  2.53, 1.33–4.82,  P  = .005) and active left atrial fractional area change ≤9.6% ( HR  3.43, 1.22–9.67,  P  = .020) were significant predictors.    Conclusions and Clinical Importance  The only echocardiographic variable of left atrial function with significant prognostic value for recurrence was low active left atrial fractional area change. Further research is necessary to evaluate whether echocardiography at a later timepoint could provide more prognostic information.

Risk Factors for Recurrence of Atrial Fibrillation in Horses After Cardioversion to Sinus Rhythm