Atrial fibrillation is a cardiac arrhythmia observed in horses characterized by irregular and often rapid heart rhythms. This condition arises from disorganized electrical signals in the atria, leading to ineffective atrial contractions. Atrial fibrillation can affect a horse's performance and may be detected through clinical signs such as exercise intolerance, irregular heartbeat, and sometimes respiratory distress. Diagnosis typically involves electrocardiography to identify the irregular electrical activity. Management and treatment strategies vary based on the underlying cause and the horse's intended use. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, and management of atrial fibrillation in equine patients.
Vernemmen I, Van Steenkiste G, Decloedt A, Meert H, Walser U, van Loon G.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...
Ferlini Agne G, Kapusniak AE, Wooldridge AA, Jung SW.In this case report, a high dose of torsemide (6mg/kg, every 12 hours for 3 days followed by 12mg/kg, every 12 hours for 4 days) was administered orally to a horse with congestive heart failure (CHF) and atrial fibrillation. Blood samples for measurement of plasma torsemide concentrations were obtained one hour after each drug administration. Pharmacodynamic effects of oral torsemide were evaluated by daily physical examination, electrocardiography, and serum biochemistry. The horse tolerated administration of torsemide. A decrease in ventral oedema and venous congestion was subjectively noted...
Kjeldsen ST, Nissen SD, Saljic A, Hesselkilde EM, Carstensen H, Sattler SM, Jespersen T, Linz D, Hopster-Iversen C, Kutieleh R, Sanders P, Buhl R.Spontaneous pulmonary vein (PV) activity triggers atrial fibrillation (AF) in humans. Although AF frequently occurs in horses, the origin remains unknown. This study investigated the structural and electro-anatomical properties of equine PVs to determine the potential presence of an arrhythmogenic substrate. Methods: Endocardial three-dimensional electro-anatomical mapping (EnSite Precision) using high-density (HD) catheters was performed in 13 sedated horses in sinus rhythm. Left atrium (LA) access was obtained retrogradely through the carotid artery. Post-mortem, tissue was harvested from th...
Buschmann E, Van Steenkiste G, Duytschaever M, Boussy T, Vernemmen I, Ibrahim L, Schauvliege S, Decloedt A, van Loon G.Recently, treatment of equine atrial tachycardia by three-dimensional electro-anatomical mapping (3D EAM) and radiofrequency catheter ablation (RFCA) has been described. Myocardial sleeves in the caudal vena cava and pulmonary veins are a potential trigger for initiation and perpetuation of atrial tachycardia and atrial fibrillation in the horse. Isolation of these myocardial sleeves by RFCA may be an effective treatment for these arrhythmias. Objective: To describe the feasibility of 3D EAM and RFCA to isolate caudal vena cava and pulmonary veins in adult horses using 3D mapping and a contact...
Nath LC, Elliott A, La Gerche A, Weir J, Forbes G, Thomas G, Franklin S.Atrial fibrillation (AF) is the most common performance limiting arrhythmia in racehorses. High dose exercise and airway disease promote AF in humans. Few studies have investigated epidemiological factors associated with AF in horses. Objective: Explore variables relating to performance, exercise volume and postrace endoscopic findings in horses with AF. Methods: A total of 164 horses with poor race performance and postrace AF were compared to 321 horses with poor performance without AF (PP) and 314 horses performing to expectation (TE). Methods: Horse-level and race-level variables for horses...
Decloedt A, Van Steenkiste G, Vera L, Buhl R, van Loon G.Atrial fibrillation (AF) is the most common clinically relevant arrhythmia in horses, with a reported prevalence up to 2.5%. The pathophysiology has mainly been investigated in experimental animal models and human medicine, with limited studies in horses. Atrial fibrillation results from the interplay between electrical triggers and a susceptible substrate. Triggers consist of atrial premature depolarizations due to altered automaticity or triggered activity, or local (micro)reentry. The arrhythmia is promoted by atrial myocardial ion channel alterations, Ca2+ handling alterations, structural ...
van Loon G.Arrhythmias are common in horses. Sinus arrhythmia and first- and second-degree atrioventricular block are frequently found physiologic arrhythmias, but should immediately disappear after stress or exercise. Atrial premature depolarizations are usually not associated with poor performance, but are a potential trigger for atrial fibrillation. Atrial fibrillation results in an abnormal ventricular response during exercise and poses a risk for collapse in some horses. This arrhythmia can usually be treated by quinidine sulfate or transvenous electrical cardioversion. Ventricular premature depolar...
Decloedt A, Broux B, De Clercq D, Deprez P, Van Steenkiste G, Vera L, Ven S, van Loon G.Based on its pharmacokinetic profile and electrophysiological effects in healthy horses, sotalol potentially could be used as a long-term PO antiarrhythmic drug in horses. Objective: To evaluate the effect of sotalol on heart rate (HR), QT interval, atrial fibrillatory rate, and success of cardioversion in horses with naturally occurring chronic atrial fibrillation (AF). Methods: Twenty-eight horses referred for transvenous electrical cardioversion of AF were treated with 2 mg/kg sotalol PO q12h for 3 days before cardioversion, and 13 horses underwent the same protocol without sotalol administ...
Navas de Solís C, Reef VB, Slack J, Jose-Cunilleras E.To evaluate horses with atrial fibrillation for hypercoagulability; plasma D-dimer concentrations, as a marker of a procoagulant state; and a relationship between coagulation profile results and duration of atrial fibrillation or presence of structural heart disease. Methods: Case-control study. Methods: Plasma samples from 42 horses (25 with atrial fibrillation and 17 without cardiovascular or systemic disease [control group]). Methods: Results of hematologic tests (ie, plasma fibrinogen and D-dimer concentrations, prothrombin and activated partial thromboplastin times, and antithrombin activ...
Decloedt A, Schwarzwald CC, De Clercq D, Van Der Vekens N, Pardon B, Reef VB, van Loon G.Although atrial fibrillation (AF) can be successfully treated in horses, recurrence occurs frequently. In humans, atrial function after cardioversion can predict recurrence. Objective: To examine the prognostic value of atrial mechanical function at 24 hours after cardioversion and other potential predictor variables for AF recurrence in horses. Methods: 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 A...
Hanka J, van den Hoven R, Schwarz B.Cor pulmonale is considered an uncommon complication in horses with recurrent airway obstruction (RAO). This case report describes the history, clinical and further examination findings, treatment, progression and outcome of a horse diagnosed with cor pulmonale and paroxysmal atrial fibrillation of 2 days duration due to a severe exacerbation of RAO. To our best knowledge, this is the first report of RAO induced pulmonary hypertension in a horse causing atrial fibrillation. However, even severe cardiac changes due to respiratory dysfunction seem to be largely reversible in horses.
Walders W, Gehlen H.This study evaluated a device for blood pressure measurement using high definition oscillometry (HDO) for its acceptability and practicability in the horse. Furthermore, we evaluated whether this device can determine differences in blood pressure between healthy horses and horses with heart diseases and between different measurement times. Methods: The study population consisted of 60 horses (aged 4-31 years). All horses underwent clinical examination, conventional echocardiography (including cardiac output measurement at the pulmonary artery), repeated noninvasive blood pressure measurement a...
Peters ST, Hopkins A, Stewart S, Slack J, de Solis CN.To describe the clinical findings and management of myocardial injury secondary to blunt thoracic trauma and rib fracture in an adult horse. Methods: A 6-year-old Warmblood gelding presented for treatment of blunt thoracic trauma. Sonographic examination of the thorax revealed a complete, mildly comminuted fracture of the left 5th rib with a fragment overlying the left atrium and coronary artery, hemothorax, and subjective left ventricular dyskinesis. Evidence of myocardial injury included atrial fibrillation, ventricular ectopy, and increased plasma cardiac troponin I concentration. The rib f...
Jesty SA, Kraus MS, Johnson AL, Gelzer AR, Bartol J.Accessory bypass tracts are rarely documented in horses. Here, we present a case of an accessory bypass tract which was initially masked by the presence of atrial fibrillation. Evidence of ventricular pre-excitation was recognized after cardioversion to normal sinus rhythm and the horse was diagnosed with Wolff-Parkinson-White Syndrome. In people, atrial fibrillation in the presence of an accessory bypass tract is considered dangerous due to the risk of sudden cardiac death. Although we did not consider this horse safe to ride, he continues to compete successfully and has not had recurrence of...
Gehlen H, Bubeck K, Rohn K, Stadler P.The aim of this study was to investigate the potential haemodynamic effects of valvular insufficiency and recurrent airway obstruction (RAO) in horses with atrial fibrillation (AF). Therefore in ten healthy horses (group 1) and 40 horses with AF a clinical examination, a lung examination, echocardiography and right heart catheterization for measurement of intracardic and pulmonary pressures were performed. According to the clinical findings the horses with AF were subdivided into 4 groups (group 2: AF; group 3: AF/valvular insufficiency; group 4: AF/RAO; group 5: AF/valvular insufficiency/RAO)...
Bellei MH, Kerr C, McGurrin MK, Kenney DG, Physick-Sheard P.To describe management of anesthesia for transvenous electrical cardioversion (TVEC) in horses and report perianesthetic complications. Methods: Retrospective case series. Methods: 62 horses with atrial fibrillation and without underlying cardiac disease and 60 horses without atrial fibrillation. Methods: Medical records of horses with atrial fibrillation anesthetized for TVEC were reviewed, as were records of horses without atrial fibrillation anesthetized for magnetic resonance imaging (MRI). The TVEC group horses were compared with MRI group horses for incidence of intraoperative bradycardi...
De Clercq D, van Loon G, Baert K, Tavernier R, Croubels S, De Backer P, Deprez P.Good results have been obtained with a human amiodarone (AD) i.v. protocol in horses with chronic atrial fibrillation (AF) and a pharmacokinetic study is required for a specific i.v. amiodarone treatment protocol for horses. Objective: To study the efficacy of this pharmacokinetic based i.v. AD protocol in horses with chronic AF. Methods: Six horses with chronic AF were treated with an adapted AD infusion protocol. The protocol consisted of 2 phases with a loading dose followed by a maintenance infusion. In the first phase, horses received an infusion of 6.52 mg AD/kg bwt/h for 1 h followed by...
Gehlen H, Bubeck K, Rohn K, Stadler P.The heart rate and the pulmonary artery wedge pressure (PWP) was measured in 10 healthy warmblood horses and in six warmblood horses with atrial fibrillation (AF) at rest and during standardised treadmill exercise. During treadmill exercise, the increase in heart rate was significantly higher in the horses with AF than in the healthy horses. Horses with AF showed a significantly higher increase in PWP at treadmill velocities of 5m/s and faster, than did the healthy horses. The differences in PWP between both groups increased with treadmill strain. The present study demonstrates that there is a...
Schwarzwald CC, Bonagura JD, Luis-Fuentes V.Quinidine is effective for treatment of atrial fibrillation (AF) in horses, but often accelerates ventricular response rate. Diltiazem effectively controls heart rate response to AF in other species. This investigation determined the effects of diltiazem on cardiac rate and rhythm, left ventricular (LV) function, central hemodynamics, and peripheral blood flow in normal, standing, nonsedated horses. A dose-finding study was performed. Afterward, 8 healthy horses were treated with diltiazem IV every 30 minutes to achieve cumulative dosages of 0 (saline control), 1, 1.5, and 2 mg/kg. Plasma dilt...
van Loon G, De Clercq D, Tavernier R, Amory H, Deprez P.Transvenous electrical cardioversion was attempted in a horse with drug refractory atrial fibrillation. A temporary pacing catheter and two defibrillation catheters were inserted transvenously into the right ventricular apex, the right atrium and the pulmonary artery, respectively. Under general anaesthesia 100, 200, 300 and 360 J monophasic shocks were delivered between both defibrillation catheters but sinus rhythm could not be restored. Immediately after the 200, 300 and 360 J shock, transient third-degree atrioventricular block occurred for a period of, respectively, 15, 40 and 55 s. These...
De Clercq D, van Loon G, Baert K, Tavernier R, Croubels S, De Backer P, Deprez P.Six horses without underlying cardiac disease were presented because of atrial fibrillation of between 5 and 12 months duration. These horses received an intravenous amiodarone treatment of 5mg/kg/h for 1 h followed by 0.83mg/kg/h for 23h and subsequently 1.9mg/kg/h for 30h. During treatment, clinical signs were monitored and a surface ECG and an intra-atrial electrogram were recorded. Infusion was discontinued when sinus rhythm or side effects occurred. Four horses successfully cardioverted, of which one showed symptoms of hind limb weakness and weight shifting. Two horses did not cardiovert ...
Trachsel D, Tschudi P, Portier CJ, Kuhn M, Thormann W, Scholtysik G, Mevissen M.Atrial fibrillation is a well-known heart disease in horses. The common therapy consists of administration of quinidine. More potent antiarrhythmic drugs have become available for human therapy and the use of these as alternatives to quinidine for equine antiarrhythmic therapy is a matter of interest. Amiodarone (AMD) is used in human medicine for treatment of many arrhythmias, including atrial fibrillation. Its disposition in horses has not yet been investigated. The purpose of this study was to measure the effect of single intravenous doses of amiodarone (5 and 7 mg/kg) on the surface electr...
Ohmura H, Hiraga A, Takahashi T, Kai M, Jones JH.To determine prevalence of atrial fibrillation (AF) immediately after racing among racehorses that finished well behind the winners and examine potential risk factors for AF in these horses. Methods: Case-control study. Methods: 39,302 racehorses representing 404,090 race starts in races sanctioned by the Japan Racing Association between 1988 and 1997. Methods: Horses that finished > or = 4 (turf races) or 5 (dirt races) seconds behind the winner or that did not complete the race were examined for AF within 5 minutes after the race. Logistic regression and chi2 analyses were used to determine ...
Reef VB, Bain FT, Spencer PA.Forty-three horses with mitral regurgitation (MR) and congestive heart failure were examined, using M-mode, 2-dimensional real-time and Doppler echocardiography. There was no breed or sex predisposition when compared to the general hospital population. The mean +/- s.d. age of affected horses was 7.6 +/- 8.1 years. Horses with MR and congestive heart failure had significant increases in mean values for left ventricular chamber size, left atrial size and heart rate and significant decreases in interventricular septal and left ventricular free wall thickness. Significant increases in pulmonary a...
Marr CM, Reef VB, Reimer JM, Sweeney RW, Reid SW.Two-dimensional and M-mode echocardiograms were recorded from 41 horses before they were successfully treated for atrial fibrillation. In addition, these examinations were performed in a subgroup of 20 horses after treatment, and the results were compared with pretreatment values. Atrial fibrillation in this group of horses was associated with a reduction of mean left ventricular fractional shortening (mean 31% +/- 5.24%), and 22 of the 41 horses were below the reference range. The remaining mean M-mode variables were within the normal reference range, although 12 horses had increased left ven...
Muir WW, Reed SM, McGuirk SM.Intravenous administration of quinidine gluconate converted atrial fibrillation (AF) to sinus rhythm in 9 of 12 horses. Twelve horses that were diagnosed by ECG to have AF were administered up to 11 mg of quinidine gluconate/kg of body weight in 1.0- to 1.5-mg/kg bolus injections every 10 to 15 minutes. The total dose of quinidine administered IV ranged from 1.8 to 5.8 g. Increased ventricular rate, apprehension, and mild depression were observed during treatment. Other signs of toxicosis were not observed. One horse was successfully treated with IV administered quinidine gluconate on 3 occasi...
Collatos C, Clark ES, Reef VB, Morris DD.A foal with vegetative bacterial endocarditis affecting the wall of the left atrium was treated successfully with cefotaxime, erythromycin, and rifampin. Bacterial isolates included Escherichia coli from blood and Rhodococcus equi from a P-type osteomyelitic lesion of the left third metatarsal bone and from synovial fluid from the left metatarsophalangeal joint. Cardiac complications included cardiomegaly and atrial fibrillation, which responded to treatment with digoxin and quinidine sulfate. Cardiac function was considered normal 18 months after treatment. Bacteriologic cure of osteoarthriti...
Kiryu K, Nakamura T, Kaneko M, Oikawa M, Yoshihara T.Twenty thoroughbred race horses were selected for postmortem cardiopathological study of sudden cardiac death; ten of the twenty horses died suddenly. In order to define accurately the morphological changes observed in these ten hearts, ten other thoroughbred race horses considered to have normal hearts were selected as a control group and studied by postmortem coronary angiography. Of the ten horses that died suddenly, eight were witnessed to have died either during or shortly after training or racing. The death was instantaneous except in one horse, which showed ventricular tachycardia and d...
van Loon G.Arrhythmias are common in horses. Sinus arrhythmia and first- and second-degree atrioventricular block are frequently found physiologic arrhythmias, but should immediately disappear after stress or exercise. Atrial premature depolarizations are usually not associated with poor performance, but are a potential trigger for atrial fibrillation. Atrial fibrillation results in an abnormal ventricular response during exercise and poses a risk for collapse in some horses. This arrhythmia can usually be treated by quinidine sulfate or transvenous electrical cardioversion. Ventricular premature depolar...
Morris DD, Fregin GF.Seventy-seven horses with atrial fibrillation (AF) were treated orally with quinidine sulfate (QS) at the University of Pennsylvania, School of Veterinary Medicine, Thirty-seven horses (48%) had adverse reactions to QS, the most common of which were nasal mucosal edema, anorexia, colic, and diarrhea. The mean highest daily QS dose was slightly greater in horses showing toxicity (P less than 0.1) and their conversion rate was less (P less than 0.05). A schedule of gradually increasing QS dose was time consuming, costly and not associated with fewer adverse reactions. Horses were compared by the...
De Clercq D, van Loon G, Baert K, Tavernier R, Croubels S, De Backer P, Deprez P.Good results have been obtained with a human amiodarone (AD) i.v. protocol in horses with chronic atrial fibrillation (AF) and a pharmacokinetic study is required for a specific i.v. amiodarone treatment protocol for horses. Objective: To study the efficacy of this pharmacokinetic based i.v. AD protocol in horses with chronic AF. Methods: Six horses with chronic AF were treated with an adapted AD infusion protocol. The protocol consisted of 2 phases with a loading dose followed by a maintenance infusion. In the first phase, horses received an infusion of 6.52 mg AD/kg bwt/h for 1 h followed by...
Kiryu K, Nakamura T, Kaneko M, Oikawa M, Yoshihara T.Twenty thoroughbred race horses were selected for postmortem cardiopathological study of sudden cardiac death; ten of the twenty horses died suddenly. In order to define accurately the morphological changes observed in these ten hearts, ten other thoroughbred race horses considered to have normal hearts were selected as a control group and studied by postmortem coronary angiography. Of the ten horses that died suddenly, eight were witnessed to have died either during or shortly after training or racing. The death was instantaneous except in one horse, which showed ventricular tachycardia and d...
Navas de Solís C, Reef VB, Slack J, Jose-Cunilleras E.To evaluate horses with atrial fibrillation for hypercoagulability; plasma D-dimer concentrations, as a marker of a procoagulant state; and a relationship between coagulation profile results and duration of atrial fibrillation or presence of structural heart disease. Methods: Case-control study. Methods: Plasma samples from 42 horses (25 with atrial fibrillation and 17 without cardiovascular or systemic disease [control group]). Methods: Results of hematologic tests (ie, plasma fibrinogen and D-dimer concentrations, prothrombin and activated partial thromboplastin times, and antithrombin activ...
Marr CM, Reef VB, Reimer JM, Sweeney RW, Reid SW.Two-dimensional and M-mode echocardiograms were recorded from 41 horses before they were successfully treated for atrial fibrillation. In addition, these examinations were performed in a subgroup of 20 horses after treatment, and the results were compared with pretreatment values. Atrial fibrillation in this group of horses was associated with a reduction of mean left ventricular fractional shortening (mean 31% +/- 5.24%), and 22 of the 41 horses were below the reference range. The remaining mean M-mode variables were within the normal reference range, although 12 horses had increased left ven...
Trachsel D, Tschudi P, Portier CJ, Kuhn M, Thormann W, Scholtysik G, Mevissen M.Atrial fibrillation is a well-known heart disease in horses. The common therapy consists of administration of quinidine. More potent antiarrhythmic drugs have become available for human therapy and the use of these as alternatives to quinidine for equine antiarrhythmic therapy is a matter of interest. Amiodarone (AMD) is used in human medicine for treatment of many arrhythmias, including atrial fibrillation. Its disposition in horses has not yet been investigated. The purpose of this study was to measure the effect of single intravenous doses of amiodarone (5 and 7 mg/kg) on the surface electr...
Gehlen H, Bubeck K, Rohn K, Stadler P.The heart rate and the pulmonary artery wedge pressure (PWP) was measured in 10 healthy warmblood horses and in six warmblood horses with atrial fibrillation (AF) at rest and during standardised treadmill exercise. During treadmill exercise, the increase in heart rate was significantly higher in the horses with AF than in the healthy horses. Horses with AF showed a significantly higher increase in PWP at treadmill velocities of 5m/s and faster, than did the healthy horses. The differences in PWP between both groups increased with treadmill strain. The present study demonstrates that there is a...
Collatos C, Clark ES, Reef VB, Morris DD.A foal with vegetative bacterial endocarditis affecting the wall of the left atrium was treated successfully with cefotaxime, erythromycin, and rifampin. Bacterial isolates included Escherichia coli from blood and Rhodococcus equi from a P-type osteomyelitic lesion of the left third metatarsal bone and from synovial fluid from the left metatarsophalangeal joint. Cardiac complications included cardiomegaly and atrial fibrillation, which responded to treatment with digoxin and quinidine sulfate. Cardiac function was considered normal 18 months after treatment. Bacteriologic cure of osteoarthriti...
Walders W, Gehlen H.This study evaluated a device for blood pressure measurement using high definition oscillometry (HDO) for its acceptability and practicability in the horse. Furthermore, we evaluated whether this device can determine differences in blood pressure between healthy horses and horses with heart diseases and between different measurement times. Methods: The study population consisted of 60 horses (aged 4-31 years). All horses underwent clinical examination, conventional echocardiography (including cardiac output measurement at the pulmonary artery), repeated noninvasive blood pressure measurement a...
Muir WW, Reed SM, McGuirk SM.Intravenous administration of quinidine gluconate converted atrial fibrillation (AF) to sinus rhythm in 9 of 12 horses. Twelve horses that were diagnosed by ECG to have AF were administered up to 11 mg of quinidine gluconate/kg of body weight in 1.0- to 1.5-mg/kg bolus injections every 10 to 15 minutes. The total dose of quinidine administered IV ranged from 1.8 to 5.8 g. Increased ventricular rate, apprehension, and mild depression were observed during treatment. Other signs of toxicosis were not observed. One horse was successfully treated with IV administered quinidine gluconate on 3 occasi...
Jesty SA, Kraus MS, Johnson AL, Gelzer AR, Bartol J.Accessory bypass tracts are rarely documented in horses. Here, we present a case of an accessory bypass tract which was initially masked by the presence of atrial fibrillation. Evidence of ventricular pre-excitation was recognized after cardioversion to normal sinus rhythm and the horse was diagnosed with Wolff-Parkinson-White Syndrome. In people, atrial fibrillation in the presence of an accessory bypass tract is considered dangerous due to the risk of sudden cardiac death. Although we did not consider this horse safe to ride, he continues to compete successfully and has not had recurrence of...
Hanka J, van den Hoven R, Schwarz B.Cor pulmonale is considered an uncommon complication in horses with recurrent airway obstruction (RAO). This case report describes the history, clinical and further examination findings, treatment, progression and outcome of a horse diagnosed with cor pulmonale and paroxysmal atrial fibrillation of 2 days duration due to a severe exacerbation of RAO. To our best knowledge, this is the first report of RAO induced pulmonary hypertension in a horse causing atrial fibrillation. However, even severe cardiac changes due to respiratory dysfunction seem to be largely reversible in horses.
Gehlen H, Bubeck K, Rohn K, Stadler P.The aim of this study was to investigate the potential haemodynamic effects of valvular insufficiency and recurrent airway obstruction (RAO) in horses with atrial fibrillation (AF). Therefore in ten healthy horses (group 1) and 40 horses with AF a clinical examination, a lung examination, echocardiography and right heart catheterization for measurement of intracardic and pulmonary pressures were performed. According to the clinical findings the horses with AF were subdivided into 4 groups (group 2: AF; group 3: AF/valvular insufficiency; group 4: AF/RAO; group 5: AF/valvular insufficiency/RAO)...
Wingfield WE, Miller CW, Voss JL, Bennett DG, Breukels J.Echocardiography is a non-invasive, safe means of assessing intracardiac structures and their motion. In the normal motion of the mitral valve there is anterior motion noted during atrial systole. In 3 horses with atrial fibrillation the mitral valve motion had no anterior motion to correspond with atrial contractions. Quinidine returned the electrocardiogram of one horse to a sinus rhythm after which echocardiography demonstrated the reappearance of the anterior motion of the mitral valve.
Muir WW, McGuirk SM.Hemodynamic measurements were obtained from 17 horses with atrial fibrillation or flutter. Eight horses had atrial fibrillation of unknown duration. In 7 horses, atrial fibrillation developed during anesthesia. Atrial flutter developed during recovery from anesthesia in 2 horses. Hemodynamic measurements were considered normal in 7 of 8 conscious horses with atrial fibrillation. Cardiac output was decreased and pulmonary arterial blood pressure and right atrial pressure were increased in 1 conscious horse which had signs of congestive heart failure. Arterial blood pressure decreased in 5 of 7 ...
van Loon G, De Clercq D, Tavernier R, Amory H, Deprez P.Transvenous electrical cardioversion was attempted in a horse with drug refractory atrial fibrillation. A temporary pacing catheter and two defibrillation catheters were inserted transvenously into the right ventricular apex, the right atrium and the pulmonary artery, respectively. Under general anaesthesia 100, 200, 300 and 360 J monophasic shocks were delivered between both defibrillation catheters but sinus rhythm could not be restored. Immediately after the 200, 300 and 360 J shock, transient third-degree atrioventricular block occurred for a period of, respectively, 15, 40 and 55 s. These...
De Clercq D, van Loon G, Baert K, Tavernier R, Croubels S, De Backer P, Deprez P.Six horses without underlying cardiac disease were presented because of atrial fibrillation of between 5 and 12 months duration. These horses received an intravenous amiodarone treatment of 5mg/kg/h for 1 h followed by 0.83mg/kg/h for 23h and subsequently 1.9mg/kg/h for 30h. During treatment, clinical signs were monitored and a surface ECG and an intra-atrial electrogram were recorded. Infusion was discontinued when sinus rhythm or side effects occurred. Four horses successfully cardioverted, of which one showed symptoms of hind limb weakness and weight shifting. Two horses did not cardiovert ...
Reef VB, Bain FT, Spencer PA.Forty-three horses with mitral regurgitation (MR) and congestive heart failure were examined, using M-mode, 2-dimensional real-time and Doppler echocardiography. There was no breed or sex predisposition when compared to the general hospital population. The mean +/- s.d. age of affected horses was 7.6 +/- 8.1 years. Horses with MR and congestive heart failure had significant increases in mean values for left ventricular chamber size, left atrial size and heart rate and significant decreases in interventricular septal and left ventricular free wall thickness. Significant increases in pulmonary a...
Ohmura H, Hiraga A, Takahashi T, Kai M, Jones JH.To determine prevalence of atrial fibrillation (AF) immediately after racing among racehorses that finished well behind the winners and examine potential risk factors for AF in these horses. Methods: Case-control study. Methods: 39,302 racehorses representing 404,090 race starts in races sanctioned by the Japan Racing Association between 1988 and 1997. Methods: Horses that finished > or = 4 (turf races) or 5 (dirt races) seconds behind the winner or that did not complete the race were examined for AF within 5 minutes after the race. Logistic regression and chi2 analyses were used to determine ...
Decloedt A, Van Steenkiste G, Vera L, Buhl R, van Loon G.Atrial fibrillation (AF) is the most common clinically relevant arrhythmia in horses, with a reported prevalence up to 2.5%. The pathophysiology has mainly been investigated in experimental animal models and human medicine, with limited studies in horses. Atrial fibrillation results from the interplay between electrical triggers and a susceptible substrate. Triggers consist of atrial premature depolarizations due to altered automaticity or triggered activity, or local (micro)reentry. The arrhythmia is promoted by atrial myocardial ion channel alterations, Ca2+ handling alterations, structural ...
Bellei MH, Kerr C, McGurrin MK, Kenney DG, Physick-Sheard P.To describe management of anesthesia for transvenous electrical cardioversion (TVEC) in horses and report perianesthetic complications. Methods: Retrospective case series. Methods: 62 horses with atrial fibrillation and without underlying cardiac disease and 60 horses without atrial fibrillation. Methods: Medical records of horses with atrial fibrillation anesthetized for TVEC were reviewed, as were records of horses without atrial fibrillation anesthetized for magnetic resonance imaging (MRI). The TVEC group horses were compared with MRI group horses for incidence of intraoperative bradycardi...
Schwarzwald CC, Bonagura JD, Luis-Fuentes V.Quinidine is effective for treatment of atrial fibrillation (AF) in horses, but often accelerates ventricular response rate. Diltiazem effectively controls heart rate response to AF in other species. This investigation determined the effects of diltiazem on cardiac rate and rhythm, left ventricular (LV) function, central hemodynamics, and peripheral blood flow in normal, standing, nonsedated horses. A dose-finding study was performed. Afterward, 8 healthy horses were treated with diltiazem IV every 30 minutes to achieve cumulative dosages of 0 (saline control), 1, 1.5, and 2 mg/kg. Plasma dilt...
Decloedt A, Schwarzwald CC, De Clercq D, Van Der Vekens N, Pardon B, Reef VB, van Loon G.Although atrial fibrillation (AF) can be successfully treated in horses, recurrence occurs frequently. In humans, atrial function after cardioversion can predict recurrence. Objective: To examine the prognostic value of atrial mechanical function at 24 hours after cardioversion and other potential predictor variables for AF recurrence in horses. Methods: 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 A...
Decloedt A, Broux B, De Clercq D, Deprez P, Van Steenkiste G, Vera L, Ven S, van Loon G.Based on its pharmacokinetic profile and electrophysiological effects in healthy horses, sotalol potentially could be used as a long-term PO antiarrhythmic drug in horses. Objective: To evaluate the effect of sotalol on heart rate (HR), QT interval, atrial fibrillatory rate, and success of cardioversion in horses with naturally occurring chronic atrial fibrillation (AF). Methods: Twenty-eight horses referred for transvenous electrical cardioversion of AF were treated with 2 mg/kg sotalol PO q12h for 3 days before cardioversion, and 13 horses underwent the same protocol without sotalol administ...
Peters ST, Hopkins A, Stewart S, Slack J, de Solis CN.To describe the clinical findings and management of myocardial injury secondary to blunt thoracic trauma and rib fracture in an adult horse. Methods: A 6-year-old Warmblood gelding presented for treatment of blunt thoracic trauma. Sonographic examination of the thorax revealed a complete, mildly comminuted fracture of the left 5th rib with a fragment overlying the left atrium and coronary artery, hemothorax, and subjective left ventricular dyskinesis. Evidence of myocardial injury included atrial fibrillation, ventricular ectopy, and increased plasma cardiac troponin I concentration. The rib f...
Meijler FL, Kroneman J, van der Tweel I, Herbschleb JN, Heethaar RM, Borst C.RR interval sequences during spontaneous atrial fibrillation in eight horses were analyzed as in previous studies in patients and dogs using histograms and serial auto-correlograms. In patients and dogs with spontaneous atrial fibrillation, ventricular rhythms were always random. In the horses, the histograms were skewed with median RR intervals of approximately 1,000 ms. A striking finding in these animals was the presence of long RR intervals up to 5,000 ms in duration. The shortest RR intervals lasted 400 to 600 ms. In contrast to findings in dogs and patients, the serial autocorrelograms s...
