Atrial function in horses pertains to the mechanical and electrical activities of the atria, the upper chambers of the heart, which are integral to the overall cardiac cycle. The atria are responsible for receiving blood from the body and lungs and facilitating its movement into the ventricles. Proper atrial function ensures efficient cardiac output and circulation. In equine cardiology, evaluating atrial function involves assessing parameters such as atrial size, contractility, and electrical conduction patterns. Changes or impairments in atrial function can be indicative of underlying cardiac conditions, such as atrial fibrillation or other arrhythmias. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, assessment methods, and clinical implications of atrial function in horses.
Fenner MF, Gatta G, Sattler S, Kuiper M, Hesselkilde EM, Adler DMT, Smerup M, Schotten U, Sørensen U, Diness JG, Jespersen T, Verheule S....Small-conductance Ca2+-activated K+ (KCa2) channels have been proposed as a possible atrial-selective target to pharmacologically terminate atrial fibrillation (AF) and to maintain sinus rhythm. However, it has been hypothesized that the importance of the KCa2 current-and thereby the efficacy of small-conductance Ca2+-activated K+ current (I K,Ca) inhibition-might be negatively related to AF duration and the extent of AF-induced remodeling. Unassigned: To address the hypothesis of the efficacy of I K,Ca inhibition being dependent on AF duration, the anti-arrhythmic properties of the I K,Ca inh...
Van Steenkiste G, Carlson J, Decloedt A, Vera L, Buhl R, Platonov PG, van Loon G.To compare the atrial fibrillatory rate (AFR) derived from a local right atrial intracardiac recording (RA-FR) and from a single-lead surface electrocardiogram (ECG) during atrial fibrillation (AF) and to evaluate the correlation with transvenous electrical cardioversion (TVEC) threshold (in Joules), number of shocks and cardioversion success rate in horses. Methods: ECGs and clinical records of horses with AF treated by TVEC. Horses were included if a simultaneous recording of the right atrial intracardiac electrogram and a modified base-apex ECG were available. Methods: Clinical records of h...
Decloedt A, Van Steenkiste G, Vera L, Buhl R, van Loon G.Atrial fibrillation (AF) is suspected by an irregularly irregular rhythm during auscultation at rest and should be confirmed by electrocardiography. Heart rate monitoring is potentially interesting for AF detection by horse owners, based on the disproportionally high heart rate during exercise or increased heart rate variability. Echocardiography and laboratory analysis are useful to identify underlying cardiac disease. Horses with severe cardiac disease should not undergo cardioversion due to the risk of recurrence. Cardioversion is recommended especially in horses performing high intensity e...
Buhl R, Nissen SD, Winther MLK, Poulsen SK, Hopster-Iversen C, Jespersen T, Sanders P, Carstensen H, Hesselkilde EM.Limited information is available on paroxysmal atrial fibrillation (PAF) in the horse. Indeed, undiagnosed PAF could result in poor performance. Due to the intermittent occurrence, PAF is difficult to diagnose. However, implanting a small ECG device (implantable loop recorder, ILR) subcutaneously, allows the continuous and automatic detection of PAF. Objective: The aim was to investigate the potential of ILRs as a tool for diagnosing PAF in horses with poor performance. Methods: Prospective field study. Methods: Twelve racing Standardbred trotters with intermittent reduced performance (mean ag...
Huang YH, Alexeenko V, Tse G, Huang CL, Marr CM, Jeevaratnam K.Atrial fibrillation is the most frequent arrhythmia in both equine and human athletes. Currently, this condition is diagnosed via electrocardiogram (ECG) monitoring which lacks sensitivity in about half of cases when it presents in paroxysmal form. We investigated whether the arrhythmogenic substrate present between the episodes of paroxysmal atrial fibrillation (PAF) can be detected using restitution analysis of normal sinus-rhythm ECGs. In this work, ECG recordings were obtained during routine clinical work from control and horses with PAF. The extracted QT, TQ, and RR intervals were used fo...
Adler DMT, Hopster K, Hopster-Iversen C, Fenner M, Buhl R, Jacobsen S.Thoracotomy is an uncommon procedure in horses but remains essential in a variety of cases of pleuropneumonia, pericarditis, thoracic trauma or diaphragmatic herniation, and for experimental thoracic and cardiac procedures. This study aimed at developing an experimental surgical procedure allowing access to the entire circumference of the heart and describing the effect of thoracotomy on pulmonary gas exchange in these horses. The study consisted of two arms, arm one (undergoing thoracotomy), was a terminal experimental study that included 11 Standardbred horses with experimentally induced (by...
Fenner MF, Carstensen H, Dalgas Nissen S, Melis Hesselkilde E, Scott Lunddahl C, Adler Hess Jensen M, Loft-Andersen AV, Sattler SM, Platonov P....Inhibition of the G-protein gated ACh-activated inward rectifier potassium current, IK,ACh may be an effective atrial selective treatment strategy for atrial fibrillation (AF). Therefore, the anti-arrhythmic and electrophysiological properties of a novel putatively potent and highly specific IK,ACh inhibitor, XAF-1407 (3-methyl-1-[5-phenyl-4-[4-(2-pyrrolidin-1-ylethoxymethyl)-1-piperidyl]thieno[2,3-d]pyrimidin-6-yl]azetidin-3-ol), were characterised for the first time in vitro and investigated in horses with persistent AF. The pharmacological ion channel profile of XAF-1407 was investigated us...
Eberhardt C, Mitchell KJ, Schwarzwald CC.The mechanical function of the left atrium (LA) plays a pivotal role in modulation of left ventricular filling. Assessment of LA function might be a clinically useful prognostic tool for horses with mitral regurgitation or atrial fibrillation. However, the most accurate, reliable, and clinically useful methods to assess LA myocardial function are yet to be determined. The objective of this study was to describe the methods for quantification of LA wall motion using two-dimensional speckle tracking (2DST) echocardiography in healthy Warmblood horses to quantify measurement variability, to calcu...
Alexeenko V, Fraser JA, Bowen M, Huang CL, Marr CM, Jeevaratnam K.Equine athletes have a pattern of exercise which is analogous to human athletes and the cardiovascular risks in both species are similar. Both species have a propensity for atrial fibrillation (AF), which is challenging to detect by ECG analysis when in paroxysmal form. We hypothesised that the proarrhythmic background present between fibrillation episodes in paroxysmal AF (PAF) might be detectable by complexity analysis of apparently normal sinus-rhythm ECGs. In this retrospective study ECG recordings were obtained during routine clinical work from 82 healthy horses and from 10 horses with a ...
Linz D, Hesselkilde E, Kutieleh R, Jespersen T, Buhl R, Sanders P.Atrial fibrillation is triggered by the pulmonary veins in humans. Although atrial fibrillation is known to occur in other species, the mechanisms of disease in these are not known. Here we present evidence for pulmonary vein triggers in the horse, where 3D HD Grid mapping was undertaken in the conscious state in the absence of fluoroscopy.
Vernemmen I, De Clercq D, Decloedt A, Vera L, Van Steenkiste G, van Loon G.The number of atrial premature depolarisations (APDs) is a known risk factor for atrial fibrillation (AF) recurrence in humans. Objective: To evaluate if the number of APDs over a 24-h period 5Â days post cardioversion predicts AF recurrence within 1Â year in horses, taking the multifactorial nature of AF into account. Methods: Retrospective case series. Methods: Eighty horses met these inclusion criteria: first AF episode, no AF recurrence within 5Â days post cardioversion, cardioversion by transvenous electrical cardioversion (TVEC), 24-h ECG recording and echocardiographic examination 5Â da...
Hesselkilde EZ, Carstensen H, Flethøj M, Fenner M, Kruse DD, Sattler SM, Tfelt-Hansen J, Pehrson S, Braunstein TH, Carlson J, Platonov PG....Large animal models are important in atrial fibrillation (AF) research, as they can be used to study the pathophysiology of AF and new therapeutic approaches. Unlike other animal models, horses spontaneously develop AF and could therefore serve as a bona fide model in AF research. We therefore aimed to study the electrical, functional and structural remodelling caused by chronic AF in a horse model. Nine female horses were included in the study, with six horses tachypaced into self-sustained AF and three that served as a time-matched sham-operated control group. Acceleration in atrial fibrilla...
Schwarzwald CC.This article provides an overview on the principles of transthoracic echocardiography in horses. Indications for echocardiography, equipment, and technical considerations are discussed and a systematic approach for a complete echocardiographic examination in horses is described. Methods for assessment of chamber dimensions, allometric scaling of measurements, assessment of systolic and diastolic ventricular function, assessment of atrial function, hemodynamic assessment, and evaluation of valvular regurgitation are explained, focusing on traditional 2-dimensional (2D), motion-mode, and Doppler...
Van Steenkiste G, De Clercq D, Vera L, Decloedt A, van Loon G.Atrial tachycardia including focal atrial tachycardia and macroreentrant atrial tachycardia (atrial flutter), are occasionally found in horses. Diagnosis, treatment and follow-up of these arrhythmias has been inadequately described. Objective: To describe the findings on surface electrocardiography (ECG), intra-atrial electrogram recording and tissue Doppler imaging (TDI), the response to treatment by transvenous electrical cardioversion (TVEC), and TDI follow-up, of sustained atrial tachycardia in horses. Methods: Case series. Methods: Records from horses with sustained atrial tachycardia tre...
Carstensen H, Hesselkilde EZ, Haugaard MM, Flethøj M, Carlson J, Pehrson S, Jespersen T, Platonov PG, Buhl R.The atrial fibrillatory rate is a potential biomarker in the study of antiarrhythmic drug effects on atrial fibrillation (AF). The purpose of this study was to evaluate whether dose-dependent changes in the atrial fibrillatory rate can be monitored on surface electrocardiography (ECG) following treatment with dofetilide, ranolazine, and a combination of the two in an acute model of AF in horses. Eight horses were subjected to pacing-induced AF on 4 separate days. Saline (control), dofetilide, ranolazine, or a combination of dofetilide and ranolazine was administered in four incremental doses. ...
Mitchell KJ, De Clercq D, Stirn M, van Loon G, Schwarzwald CC.Homocysteine (HCY) is an amino acid produced from methionine metabolism. Plasma homocysteine concentrations ([HCY]p) are elevated (>13 μmol/L) in people with atrial fibrillation (AF) and can predict the recurrence of AF after cardioversion. This study aimed to validate a commercially available human HCY assay for use in horses to develop reference intervals for [HCY]p and compare [HCY]p in healthy horses and horses with AF. Methods: Healthy horses (n = 27) and horses with AF (n = 55, 34 of which were cardioverted using transvenous electrical cardioversion). Methods: Blood samples were a...
Takahashi Y, Ishikawa Y, Ohmura H.OBJECTIVE To compare the efficacy of quinidine and flecainide in treating naturally occurring, recent-onset atrial fibrillation (AF) in Thoroughbred racehorses. DESIGN Retrospective case series. ANIMALS 107 Thoroughbred racehorses. PROCEDURES Medical records of racehorses with AF that were treated with quinidine or flecainide between 1987 and 2014 were reviewed. Signalment, history, treatments, complications, and outcome data were collected. Horses were allocated to 2 groups according to the initial treatment: initial treatment with quinidine (group 1) or initial treatment with flecainide (gro...
Kraus M, Physick-Sheard P, Brito LF, Sargolzaei M, Schenkel FS.Admissions of Standardbred racehorses (Std) to the Ontario Veterinary College Teaching Hospital (OVCTH) for treatment of atrial fibrillation (AF) began to increase in the early 1990s. The arrhythmia has been shown to have a modest heritability (h2 ≃ 0.15), with some stallions appearing as sires or sires of mares used in breeding (broodmares) of affected horses more frequently than others. The objective of this study was to determine the marginal genetic contributions of ancestors to cohorts of Std affected with AF and their contemporary control groups, and whether these ancestors contribute ...
Buhl R, Carstensen H, Hesselkilde EZ, Klein BZ, Hougaard KM, Ravn KB, Loft-Andersen AV, Fenner MF, Pipper C, Jespersen T.Atrial fibrillation (AF) is the most common arrhythmia affecting performance in horses. However, no previous studies have quantified the performance reduction in horses suffering from AF. Objective: To quantify the effect of AF on maximum velocity (Vmax ), maximum heart rate (HRmax ), heart rate recovery (T100 ), hematologic parameters and development of abnormal QRS complexes. Methods: Nine Standardbred trotters. Methods: Two-arm controlled trial. Six horses had AF induced by means of a pacemaker and 3 served as sham-operated controls. All horses were subjected to an exercise test to fatigue ...
Hesselkilde EZ, Carstensen H, Haugaard MM, Carlson J, Pehrson S, Jespersen T, Buhl R, Platonov PG.Atrial fibrillatory cycle length has been considered one of the indices of atrial electrical remodelling during atrial fibrillation (AF), which can be assessed from surface ECG by computer-assisted calculation of atrial fibrillatory rate (AFR). Horses have been suggested as a bona fide model for AF studies since horses too, develop lone AF, however data on AF characteristics in horses are extremely sparse and non-invasive characterization of AF complexity using surface ECG processing has not been reported. Objective: The aim was to study characteristics of induced AF and its modification by fl...
Carstensen H, Kjær L, Haugaard MM, Flethøj M, Hesselkilde EZ, Kanters JK, Pehrson S, Buhl R, Jespersen T.Antiarrhythmic compounds against atrial fibrillation (AF) often have reduced efficacy and may display cardiac and/or noncardiac toxicity. Efficacy can be improved by combining 2 compounds with distinct mechanisms, and it may be possible to use lower doses of each compound, thereby reducing the likelihood of adverse side effects. The purpose of this study was to investigate whether the effective doses of dofetilide and ranolazine can be reduced if the drugs are combined. Dofetilide, ranolazine, and a combination of these were administered in 4 incremental dosing regimens to horses with acutely ...
Kraus M, Physick-Sheard PW, Brito LF, Schenkel FS.The number of Standardbred racehorses admitted to the Ontario Veterinary College Teaching Hospital (Guelph, Canada) for treatment of atrial fibrillation (AF) has been on the rise since the early 1990s. A small number of sires have been contributing to a large proportion of cases, indicating there may be a genetic predisposition to the arrhythmia in this breed. Objective: The objectives of this study were to determine the heritability of AF in Standardbred horses and whether heritability of the arrhythmia differs across gaits and/or sexes. Methods: Heritability study based on retrospective revi...
Broux B, De Clercq D, Decloedt A, Ven S, Vera L, van Steenkiste G, Mitchell K, Schwarzwald C, van Loon G.Atrial fibrillation (AF) is the most common pathological arrhythmia in horses. After successful treatment, recurrence is common. Heart rate monitors are easily applicable in horses and some devices offer basic heart rate variability (HRV) calculations. If HRV can be used to distinguish between AF and sinus rhythm (SR), this could become a monitoring tool for horses at risk for recurrence of AF. Objective: The purpose of this study was to assess whether in horses AF (before cardioversion) and SR (after cardioversion) can be differentiated based upon HRV parameters. Methods: Cohort study with in...
Heliczer N, Mitchell K, Lorello O, Dauvillier J, Burger D, Schwarzwald CC, Navas de Solis C.A 20-year-old warmblood breeding stallion presented to a University practice for semen collection and evaluation was incidentally diagnosed with atrial fibrillation (AF). Electrocardiogram recordings during breeding revealed inappropriately rapid tachycardia and occasional ventricular premature depolarizations/aberrant ventricular conduction. Transvenous electrical cardioversion was performed. After successful cardioversion the horse displayed supraventricular ectopy and atrial contractile dysfunction and was administered sotalol hydrochloride in an attempt to decrease the risk of AF recurrenc...
Broux B, De Clercq D, Decloedt A, Van Der Vekens N, Verheyen T, Ven S, Pardon B, van Loon G.The electrocardiographic differentiation between atrial (APDs) and ventricular (VPDs) premature depolarizations is important. P wave prematurity and normal QRS and T wave morphology generally are used as discriminating criteria for APDs. Objective: The aim of this study was to determine whether P, Q, R, S, and T wave amplitude, PQ interval, QRS and P wave duration and P and T wave morphology differ between APDs and sinus beats. To determine the relationship between the RR coupling interval and the change in S wave amplitude between sinus beats and APDs. Methods: Case-control study. From a modi...
Van Der Vekens N, Hunter I, Timm A, Decloedt A, De Clercq D, Deprez P, Goetze JP, van Loon G.Equine atrial natriuretic peptide (ANP) plasma concentrations are correlated with left atrial size. However, species-specific assays are lacking and the results from human assays are poorly reproducible. A new methodology called processing independent analysis (PIA) that measures the total proANP product in plasma has proven to be successful in human medicine, but has never been used in horses. The aims were to establish an equine proANP reference interval by measurement of the total proANP product using PIA and to examine the proANP concentrations in horses with atrial dilatation. Sample stab...
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...
McGurrin MKJ.Atrial fibrillation is the most common performance-limiting arrhythmia in the horse. Detailed cardiovascular evaluation will help guide prognosis and treatment. Many affected horses have lone atrial fibrillation (no predisposing cardiac abnormalities). These horses have a good prognosis for return to performance if sinus rhythm can be restored. The main therapeutic option continues to be quinidine, which has been used for over 60 years. Transvenous electrical cardioversion has proven to be a successful alternative. Other therapeutic options are being explored, but are currently limited.
Huang YH, Alexeenko V, Tse G, Huang CL, Marr CM, Jeevaratnam K.Atrial fibrillation is the most frequent arrhythmia in both equine and human athletes. Currently, this condition is diagnosed via electrocardiogram (ECG) monitoring which lacks sensitivity in about half of cases when it presents in paroxysmal form. We investigated whether the arrhythmogenic substrate present between the episodes of paroxysmal atrial fibrillation (PAF) can be detected using restitution analysis of normal sinus-rhythm ECGs. In this work, ECG recordings were obtained during routine clinical work from control and horses with PAF. The extracted QT, TQ, and RR intervals were used fo...
HOLT JP, RHODE EA, PEOPLES SA, KINES H.Studies of left ventricular volume and pressure have been carried out in the control state in four classes of intact anesthetized mammals (horses, cattle, swine, and dogs), body weights of which varied 54-fold. On the basis of these studies of both large and small hearts, extending over a wide range, a pattern of function for the left ventricle of all mammals has been described. Mathematical equations are given describing the interrelationships between left ventricular end-diastolic volume and end-systolic volume, stroke volume, cardiac output, stroke-work, heart rate, and total peripheral res...
Nath LC, Elliott AD, Weir J, Curl P, Rosanowski SM, Franklin S.Atrial fibrillation (AF) impacts performance and horse and jockey safety. Understanding the outcomes of AF identified postrace will better inform regulatory policy. Objective: To investigate the outcomes after episodes of AF identified postrace and determine whether affected horses are at increased risk of additional episodes compared to the general racing population. Methods: Total of 4684 Thoroughbred racehorses. Methods: Race records for Thoroughbred horses racing in Hong Kong from 2007 to 2017 were reviewed. Horses that performed below expectation were examined by cardiac auscultation and ...
Alexeenko V, Fraser JA, Bowen M, Huang CL, Marr CM, Jeevaratnam K.Equine athletes have a pattern of exercise which is analogous to human athletes and the cardiovascular risks in both species are similar. Both species have a propensity for atrial fibrillation (AF), which is challenging to detect by ECG analysis when in paroxysmal form. We hypothesised that the proarrhythmic background present between fibrillation episodes in paroxysmal AF (PAF) might be detectable by complexity analysis of apparently normal sinus-rhythm ECGs. In this retrospective study ECG recordings were obtained during routine clinical work from 82 healthy horses and from 10 horses with a ...
Ohmura H, Nukada T, Mizuno Y, Yamaya Y, Nakayama T, Amada A.To determine a safe and efficacious dose of flecainide acetate for treating equine atrial fibrillation (Af), the safe dosage level was determined by injecting 1, 2, or 3 mg/kg i.v. of 1% flecainide acetate solution at a rate of 0.2 mg/kg/min to five clinically healthy horses. Clinical signs and the ECG were monitored (HR, PR, QRS, and QT intervals) and blood was taken to measure the plasma flecainide concentration pre- and post-administration. No abnormal signs were observed in the 1- or 2-mg/kg groups, while agitation was observed in three of five horses in the 3-mg/kg group. The QRS, and QT ...
Buhl R, Nissen SD, Winther MLK, Poulsen SK, Hopster-Iversen C, Jespersen T, Sanders P, Carstensen H, Hesselkilde EM.Limited information is available on paroxysmal atrial fibrillation (PAF) in the horse. Indeed, undiagnosed PAF could result in poor performance. Due to the intermittent occurrence, PAF is difficult to diagnose. However, implanting a small ECG device (implantable loop recorder, ILR) subcutaneously, allows the continuous and automatic detection of PAF. Objective: The aim was to investigate the potential of ILRs as a tool for diagnosing PAF in horses with poor performance. Methods: Prospective field study. Methods: Twelve racing Standardbred trotters with intermittent reduced performance (mean ag...
Vernemmen I, De Clercq D, Decloedt A, Vera L, Van Steenkiste G, van Loon G.The number of atrial premature depolarisations (APDs) is a known risk factor for atrial fibrillation (AF) recurrence in humans. Objective: To evaluate if the number of APDs over a 24-h period 5Â days post cardioversion predicts AF recurrence within 1Â year in horses, taking the multifactorial nature of AF into account. Methods: Retrospective case series. Methods: Eighty horses met these inclusion criteria: first AF episode, no AF recurrence within 5Â days post cardioversion, cardioversion by transvenous electrical cardioversion (TVEC), 24-h ECG recording and echocardiographic examination 5Â da...
Carstensen H, Hesselkilde EZ, Haugaard MM, Flethøj M, Carlson J, Pehrson S, Jespersen T, Platonov PG, Buhl R.The atrial fibrillatory rate is a potential biomarker in the study of antiarrhythmic drug effects on atrial fibrillation (AF). The purpose of this study was to evaluate whether dose-dependent changes in the atrial fibrillatory rate can be monitored on surface electrocardiography (ECG) following treatment with dofetilide, ranolazine, and a combination of the two in an acute model of AF in horses. Eight horses were subjected to pacing-induced AF on 4 separate days. Saline (control), dofetilide, ranolazine, or a combination of dofetilide and ranolazine was administered in four incremental doses. ...
Kraus M, Physick-Sheard PW, Brito LF, Schenkel FS.The number of Standardbred racehorses admitted to the Ontario Veterinary College Teaching Hospital (Guelph, Canada) for treatment of atrial fibrillation (AF) has been on the rise since the early 1990s. A small number of sires have been contributing to a large proportion of cases, indicating there may be a genetic predisposition to the arrhythmia in this breed. Objective: The objectives of this study were to determine the heritability of AF in Standardbred horses and whether heritability of the arrhythmia differs across gaits and/or sexes. Methods: Heritability study based on retrospective revi...
McGurrin MKJ.Atrial fibrillation is the most common performance-limiting arrhythmia in the horse. Detailed cardiovascular evaluation will help guide prognosis and treatment. Many affected horses have lone atrial fibrillation (no predisposing cardiac abnormalities). These horses have a good prognosis for return to performance if sinus rhythm can be restored. The main therapeutic option continues to be quinidine, which has been used for over 60 years. Transvenous electrical cardioversion has proven to be a successful alternative. Other therapeutic options are being explored, but are currently limited.
van Loon G, Tavernier R, Duytschaever M, Fonteyne W, Deprez P, Jordaens L.A transvenous, screw-in electrode was implanted in the right atrium of a healthy pony and connected with an implantable pulse generator programmed to deliver bursts of electrical stimuli to the atrium. Initially, cessation of burst pacing resulted in short (less than 1 minute), self-terminating episodes of atrial fibrillation. As burst pacing continued, the episodes of induced atrial fibrillation became longer. After 3 weeks of continuous atrial pacing, atrial fibrillation became sustained (56 hours). This model of pacing induced atrial fibrillation can be used to study the mechanisms leading ...
Pascoe JR, Hiraga A, Hobo S, Birks EK, Yarbrough TB, Takahashi T, Hada T, Aida H, Steffey EP, Jones JH.Eight horses were fitted surgically with 8 ultrasonic sonomicrometer crystals each attached to their left ventricular pericardia and a left atrial catheter. Three horses returned to treadmill performance with a maximum rate of oxygen consumption similar to their presurgical values. These horses were evaluated to determine how well sonomicrometer estimates of cardiac output agreed with those obtained by a steady-state method, the Fick principle. Variance between the 2 was similar to the coefficient of variation (approximately 12.5%) of the Fick estimates. We conclude that left ventricular sonom...
Schwarzwald CC, Hamlin RL, Bonagura JD, Nishijima Y, Meadows C, Carnes CA.Although atrial arrhythmias are clinically important in horses, atrial electrophysiology has been incompletely studied. Objective: Standard electrophysiologic methods can be used to study drug effects in horses. Specifically, the effects of diltiazem on atrioventricular (AV) nodal conduction are rate-dependent and allow control of ventricular response rate during rapid atrial pacing in horses undergoing quinidine treatment. Methods: Fourteen healthy horses. Methods: Arterial blood pressure, surface electrocardiogram, and right atrial electrogram were recorded during sinus rhythm and during pro...
Carstensen H, Nissen SD, Saljic A, Hesselkilde EM, van Hunnik A, Hohl M, Sattler SM, Fløgstad C, Hopster-Iversen C, Verheule S, Böhm M, Schotten U....Atrial fibrillation (AF) is more prevalent in athletes, and currently, the mechanisms are not fully understood. Atrial fibrillation inducibility and stability was investigated in trained and untrained Standardbred racehorses. The horses underwent echocardiography for evaluation of atrial size. High-density mapping during AF was performed, and the presence of structural remodeling, as well as the expression of inflammatory and pro-inflammatory markers in the atria, was studied. Atrial fibrillation sustained significantly longer after tachypacing in the trained horses, whereas no difference in A...
Decloedt A, de Clercq D, van der Vekens N, Verheyen T, van Loon G.Atrial fibrillation cycle length (AFCL) is an indicator of atrial electrical remodelling during atrial fibrillation (AF). Objective: To compare AFCL measured invasively from an intra-atrial electrogram (AFCLEGM ) with AFCL measured noninvasively by atrial colour tissue Doppler imaging (AFCLTDI ). Methods: Prospective descriptive clinical study. Methods: Measurements were performed in 31 episodes of AF or flutter in 29 horses (588 ± 61 kg bwt, 9 ± 3 years old) admitted for transvenous electrical cardioversion. The AFCLEGM was measured from an intracardiac electrogram using a bipolar sensi...
Kjeldsen ST, Nissen SD, Buhl R, Hopster-Iversen C.Atrial fibrillation (AF) is the most common arrhythmia in horses causing poor performance. As in humans, the condition can be intermittent in nature, known as paroxysmal atrial fibrillation (pAF). This review covers the literature relating to pAF in horses and includes references to the human literature to compare pathophysiology, clinical presentation, diagnostic tools and treatment. The arrhythmia is diagnosed by auscultation and electrocardiography (ECG), and clinical signs can vary from sudden loss of racing performance to reduced fitness or no signs at all. If left untreated, pAF may prom...
Fenner MF, Gatta G, Sattler S, Kuiper M, Hesselkilde EM, Adler DMT, Smerup M, Schotten U, Sørensen U, Diness JG, Jespersen T, Verheule S....Small-conductance Ca2+-activated K+ (KCa2) channels have been proposed as a possible atrial-selective target to pharmacologically terminate atrial fibrillation (AF) and to maintain sinus rhythm. However, it has been hypothesized that the importance of the KCa2 current-and thereby the efficacy of small-conductance Ca2+-activated K+ current (I K,Ca) inhibition-might be negatively related to AF duration and the extent of AF-induced remodeling. Unassigned: To address the hypothesis of the efficacy of I K,Ca inhibition being dependent on AF duration, the anti-arrhythmic properties of the I K,Ca inh...
Decloedt A, Van Steenkiste G, Vera L, Buhl R, van Loon G.Atrial fibrillation (AF) is suspected by an irregularly irregular rhythm during auscultation at rest and should be confirmed by electrocardiography. Heart rate monitoring is potentially interesting for AF detection by horse owners, based on the disproportionally high heart rate during exercise or increased heart rate variability. Echocardiography and laboratory analysis are useful to identify underlying cardiac disease. Horses with severe cardiac disease should not undergo cardioversion due to the risk of recurrence. Cardioversion is recommended especially in horses performing high intensity e...
Gelzer AR, Moïse NS, Vaidya D, Wagner KA, Jalife J.Atrial fibrillation (AF) is common in healthy horses. We studied the temporal organization of AF to test the hypothesis that the arrhythmia is governed by a high degree of periodicity and therefore is not random in the horse. Further, we surmised that concealed conduction of AF impulses in the AV node results in an inverse relationship between AF frequency and ventricular frequency. Results: Fast Fourier transform (FFT) analysis of atrial activity was done on signal-averaged ECGs (n = 11) and atrial electrograms (n = 3) of horses with AF at control (C), after quinidine sulfate (22 mg/kg by mou...
De Clercq D, van Loon G, Tavernier R, Verbesselt R, Deprez P.To investigate effects of IV administration of propafenone for naturally occurring and experimentally induced chronic atrial fibrillation in horses. Methods: 2 horses with naturally occurring atrial fibrillation and 4 horses with pacing-induced atrial fibrillation. Methods: Horses received a bolus of propafenone (2 mg/kg, IV over 15 minutes). If atrial fibrillation persisted after 20 minutes, a continuous infusion of propafenone (7 microg/kg/min) was given for 120 minutes. Before, during, and after treatment, plasma propafenone concentrations, hematologic and serum biochemical values, and elec...
Adler DMT, Hopster K, Hopster-Iversen C, Fenner M, Buhl R, Jacobsen S.Thoracotomy is an uncommon procedure in horses but remains essential in a variety of cases of pleuropneumonia, pericarditis, thoracic trauma or diaphragmatic herniation, and for experimental thoracic and cardiac procedures. This study aimed at developing an experimental surgical procedure allowing access to the entire circumference of the heart and describing the effect of thoracotomy on pulmonary gas exchange in these horses. The study consisted of two arms, arm one (undergoing thoracotomy), was a terminal experimental study that included 11 Standardbred horses with experimentally induced (by...
Mitchell KJ, De Clercq D, Stirn M, van Loon G, Schwarzwald CC.Homocysteine (HCY) is an amino acid produced from methionine metabolism. Plasma homocysteine concentrations ([HCY]p) are elevated (>13 μmol/L) in people with atrial fibrillation (AF) and can predict the recurrence of AF after cardioversion. This study aimed to validate a commercially available human HCY assay for use in horses to develop reference intervals for [HCY]p and compare [HCY]p in healthy horses and horses with AF. Methods: Healthy horses (n = 27) and horses with AF (n = 55, 34 of which were cardioverted using transvenous electrical cardioversion). Methods: Blood samples were a...
Takahashi Y, Ishikawa Y, Ohmura H.OBJECTIVE To compare the efficacy of quinidine and flecainide in treating naturally occurring, recent-onset atrial fibrillation (AF) in Thoroughbred racehorses. DESIGN Retrospective case series. ANIMALS 107 Thoroughbred racehorses. PROCEDURES Medical records of racehorses with AF that were treated with quinidine or flecainide between 1987 and 2014 were reviewed. Signalment, history, treatments, complications, and outcome data were collected. Horses were allocated to 2 groups according to the initial treatment: initial treatment with quinidine (group 1) or initial treatment with flecainide (gro...
Kraus M, Physick-Sheard P, Brito LF, Sargolzaei M, Schenkel FS.Admissions of Standardbred racehorses (Std) to the Ontario Veterinary College Teaching Hospital (OVCTH) for treatment of atrial fibrillation (AF) began to increase in the early 1990s. The arrhythmia has been shown to have a modest heritability (h2 ≃ 0.15), with some stallions appearing as sires or sires of mares used in breeding (broodmares) of affected horses more frequently than others. The objective of this study was to determine the marginal genetic contributions of ancestors to cohorts of Std affected with AF and their contemporary control groups, and whether these ancestors contribute ...
Mifune H, Suzuki S, Noda Y, Mohri S, Mochizuki K.In the pig, cattle and horse, the right and left atria and ventricles were examined by immunohistochemistry, and the right atrial and auricular cardiocytes were studied by transmission electron microscopy. Moreover, ANP-granules in the cardiocytes were analyzed by ultrastructural morphometry. Immunohistochemically, the most intensely ANP-reacted cardiocytes were localized in the right auricle, particularly more prominent in the pig and cattle than in the horse. Ultrastructurally, ANP-granules were located principally in the perinuclear region associated with the Golgi apparatus and throughout ...
Decloedt A, de Clercq D, van der Vekens N, Verheyen T, Ven S, van Loon G.Shortening of atrial fibrillation cycle length (AFCL) is a marker of atrial electrical remodelling due to atrial fibrillation (AF). Objective: To investigate the effect of administration of detomidine on AFCL measured invasively from an intra-atrial electrogram (AFCLEGM) and noninvasively by tissue Doppler imaging (AFCLTDI). We hypothesised that detomidine would have no effect on AFCL but would improve the ease of TDI measurements and facilitate noninvasive AFCL determination. Methods: Prospective clinical study. Methods: Measurements were performed before and after i.v. administration of 7.5â...
Broux B, De Clercq D, Decloedt A, Van Der Vekens N, Verheyen T, Ven S, Pardon B, van Loon G.The electrocardiographic differentiation between atrial (APDs) and ventricular (VPDs) premature depolarizations is important. P wave prematurity and normal QRS and T wave morphology generally are used as discriminating criteria for APDs. Objective: The aim of this study was to determine whether P, Q, R, S, and T wave amplitude, PQ interval, QRS and P wave duration and P and T wave morphology differ between APDs and sinus beats. To determine the relationship between the RR coupling interval and the change in S wave amplitude between sinus beats and APDs. Methods: Case-control study. From a modi...
