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Topic:Atrial Function

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.
Sustained atrial tachycardia in horses and treatment by transvenous electrical cardioversion.
Equine veterinary journal    February 13, 2019   Volume 51, Issue 5 634-640 doi: 10.1111/evj.13073
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...
Effects of dofetilide and ranolazine on atrial fibrillatory rate in a horse model of acutely induced atrial fibrillation.
Journal of cardiovascular electrophysiology    January 28, 2019   Volume 30, Issue 4 596-606 doi: 10.1111/jce.13849
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. ...
Plasma homocysteine concentrations in healthy horses and horses with atrial fibrillation.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    May 31, 2018   Volume 20, Issue 4 276-284 doi: 10.1016/j.jvc.2018.04.007
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...
Treatment of recent-onset atrial fibrillation with quinidine and flecainide in Thoroughbred racehorses: 107 cases (1987-2014).
Journal of the American Veterinary Medical Association    May 19, 2018   Volume 252, Issue 11 1409-1414 doi: 10.2460/javma.252.11.1409
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...
Marginal ancestral contributions to atrial fibrillation in the Standardbred racehorse: Comparison of cases and controls.
PloS one    May 15, 2018   Volume 13, Issue 5 e0197137 doi: 10.1371/journal.pone.0197137
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 ...
Effect of induced chronic atrial fibrillation on exercise performance in Standardbred trotters.
Journal of veterinary internal medicine    May 10, 2018   Volume 32, Issue 4 1410-1419 doi: 10.1111/jvim.15137
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 ...
Effect of flecainide on atrial fibrillatory rate in a large animal model with induced atrial fibrillation.
BMC cardiovascular disorders    December 8, 2017   Volume 17, Issue 1 289 doi: 10.1186/s12872-017-0720-1
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...
Antiarrhythmic Effects of Combining Dofetilide and Ranolazine in a Model of Acutely Induced Atrial Fibrillation in Horses.
Journal of cardiovascular pharmacology    October 27, 2017   Volume 71, Issue 1 26-35 doi: 10.1097/FJC.0000000000000541
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 ...
Estimates of heritability of atrial fibrillation in the Standardbred racehorse.
Equine veterinary journal    May 10, 2017   Volume 49, Issue 6 718-722 doi: 10.1111/evj.12687
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...
Heart rate variability parameters in horses distinguish atrial fibrillation from sinus rhythm before and after successful electrical cardioversion.
Equine veterinary journal    April 24, 2017   Volume 49, Issue 6 723-728 doi: 10.1111/evj.12684
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...
Atrial fibrillation management in a breeding stallion.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    March 21, 2017   Volume 19, Issue 3 299-307 doi: 10.1016/j.jvc.2017.02.001
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...
Atrial Premature Depolarization-Induced Changes in QRS and T Wave Morphology on Resting Electrocardiograms in Horses.
Journal of veterinary internal medicine    May 21, 2016   Volume 30, Issue 4 1253-1259 doi: 10.1111/jvim.13957
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...
Total plasma proANP increases with atrial dilatation in horses.
The Veterinary record    November 27, 2015   Volume 177, Issue 24 624 doi: 10.1136/vr.103316
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...
ECG of the Month. Persistent atrial tachycardia after cardioversion in a horse.
Journal of the American Veterinary Medical Association    September 19, 2015   Volume 247, Issue 7 751-753 doi: 10.2460/javma.247.7.751
Barrell EA, Fiorenza LR, Perkins GA, Kraus MS.No abstract available
Risk factors for recurrence of atrial fibrillation in horses after cardioversion to sinus rhythm.
Journal of veterinary internal medicine    April 27, 2015   Volume 29, Issue 3 946-953 doi: 10.1111/jvim.12606
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...
The diagnosis and management of atrial fibrillation in the horse.
Veterinary medicine (Auckland, N.Z.)    February 26, 2015   Volume 6 83-90 doi: 10.2147/VMRR.S46304
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.
Atrial natriuretic peptide vs. N-terminal-pro-atrial natriuretic peptide for the detection of left atrial dilatation in horses.
Equine veterinary journal    November 24, 2014   Volume 48, Issue 1 15-20 doi: 10.1111/evj.12362
van der Vekens N, Decloedt A, de Clercq D, Ven S, Sys S, van Loon G.Studies on the use of atrial natriuretic peptide (ANP) as a biomarker for left atrial dilatation in horses have produced variable results. Few have been performed, and the results may have been influenced by ANP instability, differences in sampling protocol and changes in the assay over time. N-Terminal proANP (NT-proANP) is a more stable molecule and might be a good alternative for clinical use. Objective: To compare ANP and NT-proANP in terms of the detection of left atrial dilatation and to determine the influence of sample storage at temperatures of -80 and -20°C. Methods: Prospective cli...
Influence of detomidine on atrial fibrillation cycle length measured by intracardiac electrogram recording and by colour tissue Doppler imaging in horses.
Equine veterinary journal    November 24, 2014   Volume 48, Issue 1 21-26 doi: 10.1111/evj.12366
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...
Breed predisposition and heritability of atrial fibrillation in the Standardbred horse: a retrospective case-control study.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    May 19, 2014   Volume 16, Issue 3 173-184 doi: 10.1016/j.jvc.2014.03.006
Physick-Sheard P, Kraus M, Basrur P, McGurrin K, Kenney D, Schenkel F.To assess evidence for genetic contributions to atrial fibrillation (AF) in the Standardbred horse. Methods: Equine referrals to the Ontario Veterinary College Health Sciences Centre (OVCHSC) for 1985-2009, and age and gait matched breed registry controls. Methods: Breeds presenting ≥ 5 times annually were tabulated (admission year and diagnosis; total 40,039; AF 396; no AF 39,643), and breed and year effects examined. Heritability and inbreeding coefficients were determined for Standardbred AF cases and racing contemporaries, and odds ratios for AF were calculated for frequently occurring s...
Atrial fibrillation cycle length and atrial size in horses with and without recurrence of atrial fibrillation after electrical cardioversion.
Journal of veterinary internal medicine    February 24, 2014   Volume 28, Issue 2 624-629 doi: 10.1111/jvim.12322
De Clercq D, Decloedt A, Sys SU, Verheyen T, Van Der Vekens N, van Loon G.Atrial fibrillation (AF) cycle length (CL) and atrial size have been used in humans to characterize electrical and structural remodeling to predict outcome of cardioversion of AF and risk for AF recurrence (rAF). Objective: Atrial fibrillation cycle length can be determined in horses with AF, and AFCL and atrial size are related to risk for rAF. Methods: Eighteen horses with naturally occurring AF that were successfully converted to sinus rhythm (SR) by transvenous electrical cardioversion (TVEC). Methods: Prospective study. Horses with severe valvular regurgitation, left atrial enlargement, o...
Analytic validation and comparison of three commercial immunoassays for measurement of plasma atrial/A-type natriuretic peptide concentration in horses.
Research in veterinary science    November 7, 2013   Volume 96, Issue 1 180-186 doi: 10.1016/j.rvsc.2013.10.011
Trachsel DS, Schwarzwald CC, Grenacher B, Weishaupt MA.Measurement of atrial/A-type natriuretic peptide (ANP) concentrations may be of use for assessment of cardiac disease, and reliable data on the analytic performance of available assays are needed. To assess the suitability for clinical use of commercially available ANP assays, intra-assay and inter-assay coefficient of variation and dilution parallelism were calculated for three immunoassays (RIAPen, RIAPhoen, and an ELISAPen) using blood samples from healthy and diseased horses to cover a wide range of ANP concentrations. Further, agreement between assays was assessed using linear regression ...
Noninvasive determination of atrial fibrillation cycle length by atrial colour tissue Doppler imaging in horses.
Equine veterinary journal    August 30, 2013   Volume 46, Issue 2 174-179 doi: 10.1111/evj.12108
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...
Long-term follow-up of atrial function after cardioversion of atrial fibrillation in horses.
Veterinary journal (London, England : 1997)    June 30, 2013   Volume 197, Issue 3 583-588 doi: 10.1016/j.tvjl.2013.05.032
Decloedt A, Verheyen T, Van Der Vekens N, Sys S, De Clercq D, van Loon G.Atrial fibrillation (AF) causes atrial electrical and contractile remodelling in horses. The aim of this study was to quantify left atrial (LA) contractile function and its time course of recovery after cardioversion of naturally-occurring AF in horses. The study population included 42 AF horses which were successfully treated using transvenous electrical cardioversion TVEC (n=39) or quinidine sulfate (n=3), with trivial or mild mitral regurgitation present in 25 horses. Thirty-seven healthy horses were used as controls. AF duration was estimated based on the history and previous examinations....
The ECG in cardiovascular-relevant animal models of electrophysiology.
Herzschrittmachertherapie & Elektrophysiologie    June 6, 2013   Volume 24, Issue 2 84-91 doi: 10.1007/s00399-013-0260-z
Kaese S, Frommeyer G, Verheule S, van Loon G, Gehrmann J, Breithardt G, Eckardt L.The most frequently used animal species in experimental cardiac electrophysiology are mice, rabbits, and dogs. Murine and human electrocardiograms (ECGs) show salient differences, including the occurrence of a pronounced J-wave and a less distinctive T-wave in the murine ECG. Mouse models can resemble human cardiac arrhythmias, although mice differ from human in cardiac electrophysiology. Thus, arrhythmia mechanisms in mice may differ from those in humans and should be transferred to the human situation with caution. Further relevant cardiovascular animal models are rabbits, dogs, and minipigs...
Influence of atrioventricular interaction on mitral valve closure and left ventricular isovolumic contraction measured by tissue Doppler imaging.
Circulation. Cardiovascular imaging    November 28, 2012   Volume 6, Issue 1 109-116 doi: 10.1161/CIRCIMAGING.112.978692
Decloedt A, Verheyen T, Sys S, De Clercq D, Bijnens B, van Loon G.The influence of atrioventricular (AV) interaction on mitral valve closure (MVC) and left ventricular (LV) isovolumic contraction is not fully clarified. We investigated the relationship among AV delay, MVC, and LV isovolumic contraction using a horse model because of the low heart rate and physiologically long AV delay. Results: Six horses were evaluated during sinus rhythm, right ventricular pacing without preceding atrial contraction, and dual-chamber pacing at AV delays of 150 to 350 ms, programmed at a constant rate. Right parasternal 4-chamber views were recorded for simultaneous measure...
Ventricular response during lungeing exercise in horses with lone atrial fibrillation.
Equine veterinary journal    October 23, 2012   Volume 45, Issue 3 309-314 doi: 10.1111/j.2042-3306.2012.00653.x
Verheyen T, Decloedt A, van der Vekens N, Sys S, De Clercq D, van Loon G.Atrial fibrillation (AF) is the most important dysrhythmia affecting performance in horses and has been associated with incoordination, collapse and sudden death. Limited information is available on ventricular response during exercise in horses with lone AF. Objective: To investigate ventricular response in horses with lone AF during a standardised lungeing exercise test. Methods: A modified base-apex electrocardiogram was recorded at rest and during a standardised lungeing exercise test from 43 horses diagnosed with lone AF. During the test horses walked for 7 min, trotted for 10 min, ca...
The use of phenytoin in two horses following conversion from atrial fibrillation.
New Zealand veterinary journal    February 15, 2012   Volume 60, Issue 3 210-212 doi: 10.1080/00480169.2011.643751
Dicken M, Gordon SJ, Mayhew IG.No abstract available
Transverse tubules are a common feature in large mammalian atrial myocytes including human.
American journal of physiology. Heart and circulatory physiology    August 12, 2011   Volume 301, Issue 5 H1996-H2005 doi: 10.1152/ajpheart.00284.2011
Richards MA, Clarke JD, Saravanan P, Voigt N, Dobrev D, Eisner DA, Trafford AW, Dibb KM.Transverse (t) tubules are surface membrane invaginations that are present in all mammalian cardiac ventricular cells. The apposition of L-type Ca(2+) channels on t tubules with the sarcoplasmic reticulum (SR) constitutes a "calcium release unit" and allows close coupling of excitation to the rise in systolic Ca(2+). T tubules are virtually absent in the atria of small mammals, and therefore Ca(2+) release from the SR occurs initially at the periphery of the cell and then propagates into the interior. Recent work has, however, shown the occurrence of t tubules in atrial myocytes from sheep. As...
Plasma atrial natriuretic peptide concentrations in horses with heart disease: a pilot study.
Veterinary journal (London, England : 1997)    July 22, 2011   Volume 192, Issue 2 166-170 doi: 10.1016/j.tvjl.2011.06.035
Trachsel DS, Grenacher B, Weishaupt MA, Schwarzwald CC.Atrial natriuretic peptide (ANP) is a cardiovascular biomarker that might be useful in assessing the severity of cardiac disease in horses. Plasma ANP concentrations (Cp(ANP)) were compared between horses with heart disease but normal chamber size and function (Group A; n=6), horses with heart disease associated with left atrial (LA) enlargement, LA dysfunction, and/or left ventricular (LV) enlargement (Group B; n=5), and horses with no clinically apparent cardiovascular disease (Group C; n=13). The median (min-max) for Cp(ANP) was significantly higher in Group B (53.5 (36.0-70.7) pg/mL), comp...
ECG of the month. Atrial premature complexes in a horse.
Journal of the American Veterinary Medical Association    December 3, 2009   Volume 235, Issue 11 1288-1289 doi: 10.2460/javma.235.11.1288
Diez E, Estepa JC, Aguilera-Tejero E.No abstract available