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.
Bertone JJ, Traub-Dargatz JL, Wingfield WE.Atrial fibrillation in a pregnant, lactating, 15-year-old mare nursing a 70-day-old foal was converted to normal sinus rhythm, using quinidine sulfate. The maximum concentration of quinidine was 4.3 mg/L in the mare's milk and was 2.6 mg/L in the mare's serum. Treatment with quinidine did not interrupt the pregnancy. Six months after treatment, the mare developed acute volvulus of the large colon and died. At necropsy, the mare did not have macroscopic or microscopic cardiac lesions. The fetus was macroscopically and histologically normal.
Moore EN, Spear JF.We tested the multiple-wavelet hypothesis by studying the initiation and maintenance of atrial fibrillation in normal mules, horses, cows, calves, and goats. Persistence of atrial fibrillation in animals with a large atrial mass was compared with results in adult goats and calves having a smaller atrial mass. Atrial stimulation in clinically normal cows, mules, calves, and goats was accomplished using an intra-atrial stimulating catheter with rapid atrial pacing (30/s). Once initiated, atrial fibrillation persisted for 95,120,125 min, 3 days, and 8 weeks in five adult cows, respectively. In co...
Meijler FL, van der Tweel I.Atrial fibrillation is one of the most common cardiac arrhythmias in humans. It also occurs quite frequently in dogs and horses. Comparative study of this arrhythmia may contribute to better understanding of the pathophysiological mechanisms involved. In this study, we present a quantitative analysis of atrial fibrillation in humans, dogs, horses, and in a kangaroo, making use of histograms and serial autocorrelograms of the ventricular rhythm with and without digitalis medication. Increase in the size of the animal and thus in the size of the heart is accompanied by a decrease in ventricular ...
Holmes JR.This paper discusses certain aspects of circulatory physiology, including foetal circulation and the role of the thorax, and gives parameters for total blood volume, cardiac output, stroke volume and the distribution of blood between the pulmonary and peripheral circulation within the horse. The reader is taken on a journey around the circulatory system, beginning in the left atrium, into which richly oxygenated blood runs from the pulmonary veins. From here the blood is squeezed via the mitral valve into the left ventricular pump, where it is forced under high pressure through the peripheral ...
Button C, Scrutchfield WL, Clark RG, Knauer KW, Schmitz DG.A variety of atrial dysrhythmias including paroxysmal atrial tachycardia, atrial tachycardia with 2nd-grade atrioventricular block, atrial fibrillation, and atrial flutter developed in a 5-year-old Quarter Horse gelding. Quinidine and propranolol were not successful in restoring normal sinus rhythm. Sinus rhythm was re-established during digoxin therapy, but later reverted to atrial dysrhythmia. At necropsy, multiple, discrete pale areas were found on both atria and the interatrial myocardium. Histologic examination of these lesions demonstrated myocytolysis and replacement by fibrous connecti...
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.
Brown CM, Holmes JR.The paper reports observations on the duration of various phases of the cardiac cycle using a bipole ECG record as a time base from which to measure the timing of pressure changes in the chambers of the heart and great vessels. From the findings the likely sequence of mechanical events during the cardiac cycle in the atria and ventricles is described.
Vanselow B, McCarthy M, Gay CC.The occurrence and timing of heart sounds were examined from phonocardiograms taken from the mitral, aortic and tricupsid recording areas in each of 18 horses. 10 sound events could be identified with each cardiac cycle. Atrial contraction produced up to 3 sound events. The first heart sound consisted of 4 components whereas the second sound was single. Two sound events were associated with the 3rd heart sound in early diastole. The occurrence of third and fourth heart sound components varied between horses and between recording areas. The mitral recording area was considered most satisfactory...
Rose RJ, Davis PE.Three young Standardbred pacers with atrial fibrillation were treated with quinidine sulphate (QS) by stomach tube. They were given 10g QS every 2 hours until cardioversion was achieved. Total doses varied between 20 and 30 g. No premedication was given nor any follow up treatment after return to sinus rhythm. All horses were given 3 months rest after the treatment, and when electrocardiographed then, and at 6 months, showed normal sinus rhythm. As all 3 horses won races after cardioversion and showed subsequent normal electrocardiograms it seems likely that atrial fibrillation can occur witho...
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...
Bertone JJ, Traub-Dargatz JL, Wingfield WE.Atrial fibrillation in a pregnant, lactating, 15-year-old mare nursing a 70-day-old foal was converted to normal sinus rhythm, using quinidine sulfate. The maximum concentration of quinidine was 4.3 mg/L in the mare's milk and was 2.6 mg/L in the mare's serum. Treatment with quinidine did not interrupt the pregnancy. Six months after treatment, the mare developed acute volvulus of the large colon and died. At necropsy, the mare did not have macroscopic or microscopic cardiac lesions. The fetus was macroscopically and histologically normal.
Kuwahara M, Hiraga A, Nishimura T, Tsubone H, Sugano S.This study has demonstrated the power spectral analysis of heart rate variability in a horse with atrial fibrillation. A large peak in the high frequency (HF) area of the power spectrum appeared in the horse. Hourly heart rate, the low frequency (LF) power, the HF power, and LF/HF ratio were almost constant during the recording period. The values of HF and LF power in the horse with atrial fibrillation were much larger than those in normal horses. The normalized unit of HF (HF n.u.) was much larger than that of LF (LF n.u.). Furthermore, the LF/HF ratio was very small in the horse. These resul...
Scheck JL.A stallion was presented for surgical treatment of limbal squamous cell carcinoma. Excision with a conjunctival pedicle flap was done to prevent ocular invasion and preserve vision. A complication was the diagnosis of atrial fibrillation, which was not converted to sinus rhythm due to the potential complication of treatment with quinidine sulfate. Traitement d’un carcinome épidermoïde oculaire chez un étalon atteint de fibrillation auriculaire. Un étalon a été présenté pour une chirurgie d’un carcinome épidermoïde limbique. Après l’excision, un lambeau à pédicule conjonctiva...
White R, Nath L, Hebart M, Franklin S.P wave indices are used as non-invasive electrocardiographic markers of atrial remodelling in humans. Few studies have investigated their use in animals. The aim of this study was to measure P wave duration and P wave dispersion (Pd) in healthy standardbred horses and investigate variables that might influence these measurements. A 12-lead electrocardiogram was recorded at rest and P wave indices were calculated in 53 horses. A general linear model was used to investigate the main effects: age, bodyweight, sex, resting heart rate, presence of a murmur, exercise status and the number of years r...
Ter Woort F, Stefanovski D, Reef VB.Hyperthyroidism is a predisposing factor for atrial fibrillation (AF) in humans. The relationship between high thyroid hormone (TH) and AF in horses has not been evaluated. Objective: The aim of this study is to identify whether (1) high TH concentrations were present in horses with AF, (2) other cardiovascular effects were observed in horses with high TH and AF, and (3) TH status affected recurrence rate. Methods: Twenty-three horses presented with naturally occurring AF. Methods: Prospective case-control clinical study. Thyroid hormone concentration was measured in horses presenting with AF....
Button C, Scrutchfield WL, Clark RG, Knauer KW, Schmitz DG.A variety of atrial dysrhythmias including paroxysmal atrial tachycardia, atrial tachycardia with 2nd-grade atrioventricular block, atrial fibrillation, and atrial flutter developed in a 5-year-old Quarter Horse gelding. Quinidine and propranolol were not successful in restoring normal sinus rhythm. Sinus rhythm was re-established during digoxin therapy, but later reverted to atrial dysrhythmia. At necropsy, multiple, discrete pale areas were found on both atria and the interatrial myocardium. Histologic examination of these lesions demonstrated myocytolysis and replacement by fibrous connecti...
Langsetmo I, Weigle GE, Erickson HH, Fedde MR.Exercising horses have extremely high right and left atrial pressures. Limitation in ventricular function (i.e. relaxation) may play a role in these high pressures. We studied relaxation characteristics of the right ventricular myocardium and the impact of frusemide (2.0 mg/kg bwt i.v.) on these characteristics in horses exercising at 8, 10, 12 and 14 m/s. Exercise tests were performed 4 h after administration of frusemide. Right ventricular (RV) pressure was analysed using Fast Fourier Transform techniques to remove non cardiac components of the pressure signal. Mean right atrial (RA) pressur...
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.
Wijnberg ID, van der Kolk JH, van Garderen E, Binkhorst GJ.A 18-year-old Dutch Warmblood mare was referred for colic. Upon arrival, lethargy, blindness, head pressing, ataxia, and circling were the main clinical signs. On rectal examination a hard mass and oedema around the cranial mesenteric artery were palpated. Plasma liver enzyme activities and the ammonia level were elevated. Atrial fibrillation with a pulse frequency of 36-52 beats per minute was noticed. On both sides a holosystolic murmer with the maximum intensity on the right side could be auscultated. Postmortem examination revealed eccentric hypertrophy of the right atrium and a pale spott...
Gehlen H, Bubeck K, Stadler P.In 12 healthy warmblood horses (six trained and six untrained) the pulmonary wedge pressure and heart frequency was measured at rest and during a standardised exercise test on a treadmill. The mean pulmonary wedge pressure at rest was 14.53 +/- 2.36 mmHg. There was no significant difference in pulmonary wedge pressure either at rest or during exercise between trained and untrained horses. During walking (1.8 m/s) the mean pulmonary wedge pressure was 19.62 +/- 4.03 mmHg, during trotting (4 und 5 m/s) it was between 22.38 +/- 3.92 mmHg and 25.28 +/- 3.7 mmHg. During canter (6 m/s) and gallop (8...
Hinchcliff KW, McKeever KH.The effect of blood volume repletion after frusemide administration on the right atrial and pulmonary artery pressure responses of horses to exercise has not been reported. We examined right atrial and pulmonary artery pressure and plasma atrial natriuretic peptide concentration (ANP) responses to an incremental exercise test in 6 Standardbred mares. Horses were treated, in a 3 way cross over design, with isotonic saline, frusemide (1 mg/kg bwt, i.v.), and frusemide followed 3 h later by lactated Ringer's solution (12 ml/kg bwt, i.v.). Three and a half hours after saline or frusemide administr...
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...
Holmes JR.This paper discusses certain aspects of circulatory physiology, including foetal circulation and the role of the thorax, and gives parameters for total blood volume, cardiac output, stroke volume and the distribution of blood between the pulmonary and peripheral circulation within the horse. The reader is taken on a journey around the circulatory system, beginning in the left atrium, into which richly oxygenated blood runs from the pulmonary veins. From here the blood is squeezed via the mitral valve into the left ventricular pump, where it is forced under high pressure through the peripheral ...
Burns JJ, MacMillan KM, John EE.Atrial fibrillation (AF) is the most clinically relevant cardiac arrhythmia identified in the Standardbred racehorse. However, there is limited literature regarding athletic ability in Standardbred racehorses following AF conversion. To investigate this issue, the objectives of this review were to: i) determine the success rate in using quinidine sulphate to treat AF in a population of hospitalized equine patients in Atlantic Canada between January 2008 and December 2019; and ii) measure return to athletic ability (using racetrack earnings and top-3 finishes) following cardioversion with quini...
Wijnberg ID, van der Kolk JH.Atrial fibrillation is a disorder of cardiac rhythmicity, and its importance in the horse depends on the underlying cause and the function of the horse. Before the decision is taken to start treatment, it has first to be ascertained whether treatment is worthwhile and whether the horse is an appropriate candidate for treatment. This article gives a short overview of current opinion on the cause and treatment of atrial fibrillation in the horse. The most used treatment at the moment, oral chinidine sulphate, is discussed. The hemodynamic consequences of atrial fibrillation and the response of a...
Kjeldsen ST, Nissen SD, Christensen NC, Haugaard SL, Schneider MJ, Vinther Z, Sattler SM, Carstensen H, Jøns C, Hopster-Iversen C, Buhl R.Paroxysmal atrial fibrillation (pAF) occurs sporadically and can impair athletic performance. Gold standard for diagnosis is surface electrocardiography (ECG), however, this requires AF to be sustained. Implantable loop recorders (ILRs) are routinely used for AF detection in human medicine. While ILR placement has been studied in horses, its AF detection performance is unknown. Objective: (I) Validation of ILRs for AF detection in horses. (II) Determining pAF incidence using ILRs and estimate the positive predictive value (PPV). Methods: (I) Experimental study; (II) Longitudinal observational ...
Kuroda T, Minamijima Y, Kinman CK, Takahashi Y, Ebisuda Y, Inoue K, Ishikawa H, Mita H, Tamura N, Nukada T, Toutain PL, Ohta M.Quinidine (QND) sulfate is an effective treatment for atrial fibrillation (AF) in horses, and several dosage regimens have been proposed to address its wide variability in response and potential adverse effects. The purpose of this study was to analyze the variability in plasma quinidine concentrations using population pharmacokinetics to determine an effective and safe dosage regimen for Thoroughbred horses. Unassigned: Six healthy Thoroughbred horses were treated with 20 mg/kg quinidine sulfate dihydrate (16.58 mg/kg QND base) administered PO or 5 mg/kg quinidine hydrochloride monohydr...
Ibrahim L, Vernemmen I, Buschmann E, van Loon G, Cornillie P.The interatrial septum morphology, shaped by the septum primum and secundum fusion, results in the formation of the fossa ovalis (FO) and its limbus. Incomplete fusion can lead to a patent foramen ovale (PFO), while complete fusion may produce septal ridges and pouches (SPs), with SPs in humans linked to ischemic stroke and atrial arrhythmias. In horses, atrial tachycardia and fibrillation often originate near the FO. This study examines adult equine interatrial septum morphology to enhance understanding the region and guide electrophysiological interventions for equine cardiac arrhythmias. Po...
Libak Haugaard S, Schneider MJ, Nissen SD, Saljic A, Fruergaard Andersen P, Carstensen H, Hopster-Iversen C, Jespersen T, Larsen S, Buhl R.Mitochondrial respiration sustains the high energy demands of endurance exercise, yet the extent to which atrial, ventricular, and skeletal muscle mitochondria adapt remains uncertain. At the same time, endurance athletes face an increased risk of atrial fibrillation (AF), but the role of cardiac metabolism in arrhythmia susceptibility is poorly understood. Here, we compared mitochondrial respiration in skeletal muscle and across all four cardiac chambers between trained and untrained racehorses ( = 34) to investigate adaptations associated with long-term endurance exercise. We further examine...
Buschmann E, Van Steenkiste G, Vernemmen I, Demeyere M, Schauvliege S, Decloedt A, van Loon G.Detailed characterization of arrhythmias can be performed by multiple catheter mapping; but this has not yet been explored in horses. Objective: Perform ultrasound-guided multiple catheter mapping of the right heart during sinus rhythm and right and left atrial pacing to identify activation patterns characteristic of the origin of ectopy. Obtain His signals and effective refractory periods (ERP). Methods: Eight healthy adult horses. Methods: Experimental study. Recording catheters were placed at the terminal crest, intervenous tubercle, caudal vena cava, and coronary sinus. Right atrial pacing...
Haugaard SL, Nissen SD, Schneider MJ, Birk JB, Carstensen H, Hopster-Iversen C, Altıntaş A, Barrès R, Kjøbsted R, Wojtaszewski JFP, Herum KM....High recurrence rates after atrial fibrillation (AF) treatment may be driven by myocardial changes induced by the arrhythmia itself. Understanding the molecular mechanisms behind these changes is crucial for developing targeted therapies and improving outcomes. Objective: To characterise the cardiac transcriptome of healthy horses and explore transcriptional changes associated with persistent AF (naturally occurring and tachypacing-induced). Methods: Case-control study. Methods: RNA-sequencing was performed on atrial and ventricular tissue samples collected from six horses with naturally occur...
Haugaard SL, Schneider MJ, Kjeldsen ST, Sattler SM, Bastrup JA, Saljic A, Birk JB, Hansen C, Synnestvedt JN, van Hunnik A, Sobota V, Carstensen H....Horses are one of the few animals that spontaneously develop atrial fibrillation (AF), making them a powerful model for studying AF mechanisms and treatment effects. Despite the initial effectiveness of treatment in horses and humans, AF-induced atrial remodeling compromises its long-term success. Observational studies have suggested that metformin may reduce the risk of AF, but its effects on progressive AF-induced atrial remodeling have yet to be evaluated in a high-fidelity large animal model. Unassigned: Here, we used a longitudinal horse model of tachypacing-induced self-sustained AF to c...
Arevalo-Turrubiarte M, Edling CE, Moller-Levet C, Forbes B, Kemp V, Weir J, Marr C, Lewis R, Jeevaratnam K.The initiation and maintenance of atrial fibrillation have been associated with physiological alterations in myocardial sleeves of the pulmonary veins (PVs). Gene expression profiles of the myocardial sleeves of the PVs in healthy (n = 3) and paroxysmal atrial fibrillation (PAF) (n = 6) thoroughbred horses (Equus caballus) were studied. Tissue collected from the left superior PV, adjacent to the left atrium, was analyzed by RNA sequencing. Gene Set Enrichment Analysis demonstrated positive enrichment of gene ontology biological processes related to muscle and endothelial cell development, cell...
Nissen SD, Bastrup JA, Haugaard SL, Marion-Knudsen R, Schneider M, Kjeldsen ST, Carstensen H, Hopster-Iversen C, Nattel S, Jepps TA, Buhl R.Horses and humans are among the few mammals susceptible to spontaneous atrial fibrillation (AF), both suffering from high recurrence rates after treatment. Treatment resistance is often attributed to progressive atrial remodeling, but current treatment options fail to effectively address this aspect. Here, we introduce a novel horse model of spontaneous AF to investigate the biological pathway changes in early stages of the disease. Through data-independent acquisition mass spectrometry on biopsies from the right and left atrium and left ventricular chamber of horses with early-stage persisten...
