Topic:Cardiac Arrhythmias
Cardiac arrhythmias in horses refer to irregularities in the heart's rhythm, which can affect the efficiency of blood circulation. These arrhythmias can result from various factors, including electrolyte imbalances, structural heart changes, or systemic diseases. Common types of arrhythmias in horses include atrial fibrillation, ventricular tachycardia, and premature ventricular contractions. The presence and type of arrhythmia can influence a horse's performance and overall health. Diagnostic tools such as electrocardiography (ECG) are used to identify and assess these irregular heart rhythms. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, diagnosis, and management of cardiac arrhythmias in equine medicine.
Intravenous administration of quinidine and metoprolol for treatment of atrial fibrillation in 2 neonatal foals. Atrial fibrillation (AF) is a rarely reported arrhythmia in otherwise healthy newborn foals, with a single case of cardioversion using procainamide administration described in the literature. Two neonatal Thoroughbred colts were presented to an equine hospital because of an irregularly irregular tachyarrhythmia and poor latching when trying to nurse. History, physical examination, and initial diagnostic testing including ECG and echocardiography confirmed AF without structural heart disease. The 1st foal converted into normal sinus rhythm after treatment with IV metoprolol and quinidine. The 2...
Einthoven’s triangle adapted for horses: Proposal for the Delta configuration. Reliable ECGs are crucial for diagnosing arrhythmias, yet a lack of standardization impedes arrhythmia diagnosis and treatment in horses. Objective: To objectively determine an optimal position of Einthoven's triangle for ECG recordings in horses at rest, which can form the basis for standardized ECG recording and improve diagnosis and treatment of arrhythmias. Methods: The study involved 72 healthy, warmblood horses aged between 3 and 20 years. Methods: In view of future 12-lead studies and vectorcardiography, requiring an orthogonal system, Einthoven's triangle was positioned around the he...
Long-term use of an implantable loop recorder for ECG recording in horses. Potential arrhythmias recorded by cardiac monitors using the built-in human algorithm are as follows: total number of episodes, ventricular tachycardia, asystole, bradycardia, atrial tachycardia, atrial fibrillation and the percentage of time spent in atrial tachycardia or atrial fibrillation. Long-term use of an insertable cardiac monitor (loop recorder) has been reported in one horse earlier, but its accurate role as a diagnostic tool is still unclear. The aim of the present study was to investigate the long-term applicability of the Reveal XT cardiac monitor for recording cardiac arrhythmia...
Feasibility of transthoracic echocardiographic guidance for multicatheter electrophysiological mapping studies in horses. Improved characterization of arrhythmias is based on minimally invasive catheterizations. However, these catheterizations have been poorly explored in horses because apart from 3-dimensional (3D) mapping systems, continuous guidance of the catheter's position with adequate detail is difficult using current imaging modalities. Objective: Position multiple electrophysiology catheters simultaneously at predetermined strategical positions in the heart using transthoracic echocardiographic guidance. Methods: Eight adult healthy horses. Methods: Observational study. Two electrophysiological studies ...
Intracardiac ultrasound-guided transseptal puncture in horses: Outcome, follow-up, and perioperative anticoagulant treatment. Cardiac catheterizations in horses are mainly performed in the right heart, as access to the left heart traditionally requires an arterial approach. Transseptal puncture (TSP) has been adapted for horses but data on follow-up and closure of the iatrogenic atrial septal defect (iASD) are lacking. Objective: To perform TSP and assess postoperative complications and iASD closure over a minimum of 4 weeks. Methods: Eleven healthy adult horses. Methods: Transseptal puncture was performed under general anesthesia. Serum cardiac troponin I concentrations were measured before and after puncture. Wee...
Histological evaluation of cardiac remodelling in equine athletes. Approximately 1-2 per 100,000 young athletes die from sudden cardiac death (SCD) and extreme exercise may be associated with myocardial scar and arrhythmias. Racehorses have a high prevalence of atrial fibrillation (AF) and SCD but the presence of myocardial scar and inflammation has not been evaluated. Cardiac tissues from the left (LAA) and right (RAA) atrial appendages, left ventricular anterior (LVAPM) and posterior (LVPPM) papillary muscles, and right side of the interventricular septum (IVS-R) were harvested from racehorses with sudden cardiac death (SCD, n = 16) or other fatal injur...
Validation and clinical application of implantable loop recorders for diagnosis of atrial fibrillation in horses. 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 ...
Assessment of a Teaching Module for Cardiac Auscultation of Horses by Veterinary Students. Auscultation of heart sounds is an important veterinary skill requiring an understanding of anatomy, physiology, pathophysiology and pattern recognition. This cross-sectional study was developed to evaluate a targeted, audio-visual training resource for veterinary students to improve their understanding and auscultation of common heart conditions in horses. Fourth- and fifth-year 2021 and 2022 Bachelor of Veterinary Science students at the University of Queensland (UQ) were provided the learning resource and surveyed via online pre- and post-intervention surveys. Results were quantitatively an...
Successful caudal vena cava and pulmonary vein isolation in healthy horses using 3D electro-anatomical mapping and a contact force-guided ablation system. 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...
Sepsis-induced cardiomyopathy in animals: From experimental studies to echocardiography-based clinical research. The term "sepsis-induced cardiomyopathy" (SIC) is used to describe transient cardiac dysfunction in septic patients. However, there is no universally accepted definition of SIC; a reduction in left ventricular ejection fraction (LVEF) is often used. In addition to systolic dysfunction, diastolic dysfunction is now recognized as an essential component of SIC. It can be emphasized that previous animal experiments played an essential role in revealing SIC and hemodynamic instability in sepsis and septic shock. The diagnostic and prognostic capabilities of echocardiography for the assessment of SI...
Application of the Alivecor KardiaMobile smartphone modulated ECG device for use in horses. Electrocardiography is the method used to monitor the electrical impulses in the heart. These diagnostics are increasingly making use of smartphone-based technologies. The objective of this research was to determine whether the Alivecor KardiaMobile (ECG) smartphone-modulated electrocardiographic device, a novel ECG device, can be used to obtain reliable electrocardiogram (ECG) readings in horses. The device was initially tested in 36 Nooitgedacht pony mares to determine the best site of application, method of skin preparation, and ECG device orientation for reliable ECG tracings. Once the mos...
Premature depolarisations in horses competing in United States Eventing Association and Fédération Equestre Internationale-sanctioned 3-day events. Injuries and sudden death during the cross-country (XC) phase of eventing have raised interest in the frequency and types of cardiac arrhythmias occurring in these equine athletes. Objective: To characterise the frequency and types of rhythm disturbances and examine possible risk factors for premature depolarisations (PDs) occurring during the XC phase of United States Eventing Association (USEA) and Fédération Equestre Internationale (FEI)-sanctioned events. Methods: Prospective, cross-sectional study. Methods: Continuous electrocardiographic (ECG) recordings were obtained from horses prior...
Medical causes of poor performance and their associations with fitness in Standardbred racehorses. Poor performance is a multifactorial syndrome of racehorses, commonly associated with subclinical disorders, which can be diagnosed by exercise testing. Objective: Describe the prevalence of medical causes of poor performance in Standardbreds unassociated with lameness, and evaluate their relationships with fitness variables measured by exercise treadmill test. Methods: Hospital population of 259 nonlame Standardbred trotters referred for poor performance. Methods: The horses' medical records were retrospectively reviewed. Horses underwent a diagnostic protocol including resting examination, p...
Long-Term Training Increases Atrial Fibrillation Sustainability in Standardbred Racehorses. 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...
The Reporting of Racehorse Fatalities in New Zealand Thoroughbred Flat Racing in the 2011/12-2021/22 Seasons. Race day fatalities as a consequence of catastrophic musculoskeletal injury and cardiac failure are both a welfare concern and provide a challenge for the social perceptions of equine welfare within the racing industry. To reduce race day fatalities, the risk factors under New Zealand racing conditions need to be identified. The aim of this study was to examine race and horse-level risk factors for fatalities in New Zealand Thoroughbred flat racing using retrospective race day data from the 2011/12-2021/22 racing seasons. Horse and race-level factors associated with a suspected cardiac failure...
Heart rate variability during high-speed treadmill exercise and recovery in Thoroughbred racehorses presented for poor performance. Heart rate variability (HRV) analysis measures the inter-beat interval variation of successive cardiac cycles. Measurement of these indices has been used to assess cardiac autonomic modulation and for arrhythmia identification in exercising horses. Objective: To report HRV indices during submaximal exercise, strenuous exercise and recovery, and explore relationships with clinical conditions (arrhythmias, lameness, equine gastric ulcer syndrome [EGUS], lower airway inflammation and upper respiratory tract obstructions [URTOs]) in Thoroughbred racehorses. Methods: Retrospective, observational cr...
Frequency of cardiac arrhythmias in horses during straight and untethered swimming. Cardiac arrhythmias have not been previously reported in horses while swimming. Objective: To describe the type and frequency of encountered arrhythmias during repetitive swimming cycles. Methods: Descriptive observational study. Methods: Sixteen horses swam five pool lengths (75 m), each separated by an active recovery walk. Continuous electrocardiograms (ECGs) were recorded (n = 80) and analysed during the pre-swim, swim and active-recovery periods. Arrhythmias were categorised as sinus arrhythmia (SA), sinus block, sinus pause (compensatory and non-compensatory), second degree atriovent...
Cartilaginous Intrusion of the Atrioventricular Node in a Quarter Horse with a High Burden of Second-Degree AV Block and Collapse: A Case Report. Second-degree atrioventricular (AV) block is the most common cardiac arrhythmia in horses, affecting 40-90% depending on breed. Usually, the AV blocks occur while the horses are resting and disappear upon exercise and are, therefore, considered to be uneventful for horses. However, if the AV blocks occur frequently, this may result in syncope and collapse. Identifying the cause of second-degree AV block is difficult and often subscribed to high vagal tone. In this report, we present an eight-year-old Quarter horse with a high burden of second-degree AV blocks and multiple collapses. The clinic...
Retrospective review of atrial fibrillation in Standardbred racehorses at a tertiary care facility in Atlantic Canada. 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...
Cardiac ion channel expression in the equine model – In-silico prediction utilising RNA sequencing data from mixed tissue samples. Understanding cardiomyocyte ion channel expression is crucial to understanding normal cardiac electrophysiology and underlying mechanisms of cardiac pathologies particularly arrhythmias. Hitherto, equine cardiac ion channel expression has rarely been investigated. Therefore, we aim to predict equine cardiac ion channel gene expression. Raw RNAseq data from normal horses from 9 datasets was retrieved from ArrayExpress and European Nucleotide Archive and reanalysed. The normalised (FPKM) read counts for a gene in a mix of tissue were hypothesised to be the average of the expected expression in e...
Detection of the origin of atrial tachycardia by 3D electro-anatomical mapping and treatment by radiofrequency catheter ablation in horses. Atrial tachycardia (AT) can be treated by medical or electrical cardioversion but the recurrence rate is high. Three-dimensional electro-anatomical mapping, recently described in horses, might be used to map AT to identify a focal source or reentry mechanism and to guide treatment by radiofrequency ablation. Objective: To describe the feasibility of 3D electro-anatomical mapping and radiofrequency catheter ablation to characterize and treat sustained AT in horses. Methods: Nine horses with sustained AT. Methods: Records from horses with sustained AT referred for radiofrequency ablation at Ghen...
Risk Factors for Exercise-Associated Sudden Cardiac Death in Thoroughbred Racehorses. Cardiac arrhythmias resulting in sudden cardiac death (SCD) are an important cause of racehorse fatalities. The objective of this study was to determine risk factors for SCD in Thoroughbreds by evaluating a sample with a policy of mandatory post-mortem following racing or training fatalities. Risk factors were compared between case horses with SCD (n = 57) and control horses with other fatal injury (OFI, n = 188) by univariable and multivariable logistic regression. Survival in years for horses with SCD was compared to OFI using the Kaplan−Meier method with log rank test. The following varia...
Clinical Effects of the Immunization Protocol Using Loxosceles Venom in Naïve Horses. Bites of brown spiders ( spp.) are responsible for dermonecrotic lesions and potentially systemic envenoming that can lead to death. The only effective therapy is the use of the antivenom, usually produced in horses. However, little is known about the consequences of the systematic use of the venom and adjuvants and of the bleedings on antivenom-producing horses. Thus, the aim of this study was to evaluate the clinical changes in horses in their first immunization protocol for antivenom production. Eleven healthy horses, never immunized, were evaluated in three different periods: T0 (before ...
Electrocardiographic characteristics of trained and untrained standardbred racehorses. Long-term exercise induces cardiac remodeling that potentially influences the electrical properties of the heart. Objective: We assessed whether training alters cardiac conduction in Standardbred racehorses. Methods: Two hundred one trained and 52 untrained Standardbred horses. Methods: Cross-sectional study. Resting ECG recordings were analyzed to assess heart rate (HR) along with standard ECG parameters and for identification of atrial and ventricular arrhythmias. An electrophysiological study was performed in 13 horses assessing the effect of training on sinoatrial (SA) and atrioventricular...
Paroxysmal Atrial Fibrillation in Horses: Pathophysiology, Diagnostics and Clinical Aspects. 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...
Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence. Transvenous electrical cardioversion (TVEC) is 1 of the main treatment options for atrial fibrillation (AF) in horses. Large-scale studies on factors affecting success and prognosis have primarily been performed in Standardbred populations. Objective: To determine factors affecting cardioversion success, cardioversion difficulty and recurrence in a predominant Warmblood study sample. Methods: TVEC records of 199 horses. Methods: Retrospective study of TVEC procedures of horses admitted for AF without severe echocardiographic abnormalities. Horse and procedural factors for success and cumulativ...
Detecting paroxysmal atrial fibrillation from normal sinus rhythm in equine athletes using Symmetric Projection Attractor Reconstruction and machine learning. Atrial fibrillation (AF) is a common cardiac arrhythmia in both human and equine populations. It is associated with adverse outcomes in humans and decreased athletic performance in both populations. Paroxysmal atrial fibrillation (PAF) presents with intermittent, self-terminating AF episodes, and is difficult to diagnose once sinus rhythm resumes. Unassigned: We aimed to detect PAF subjects from normal sinus rhythm equine electrocardiograms (ECGs) using the Symmetric Projection Attractor Reconstruction (SPAR) method to encapsulate the waveform morphology and variability as the basis of a machi...
Validation of an equine fitness tracker: ECG quality and arrhythmia detection. Cardiac arrhythmias in exercising horses are the focus of much interest, both in terms of what is considered normal and potential associations with poor performance and sudden cardiac death. One barrier to performing large-scale studies is the lack of an easily applicable device, to allow recording of large numbers of high-quality exercising electrocardiograms (ECGs). The Equimetre is a new wearable device which records a single lead ECG, amongst other parameters. Validation of such wearable devices is essential before further studies are undertaken. Objective: To evaluate the quality of ECG u...
Atrial fibrillatory rate as predictor of recurrence of atrial fibrillation in horses treated medically or with electrical cardioversion. The recurrence rate of atrial fibrillation (AF) in horses after cardioversion to sinus rhythm (SR) is relatively high. Atrial fibrillatory rate (AFR) derived from surface ECG is considered a biomarker for electrical remodelling and could potentially be used for the prediction of successful AF cardioversion and AF recurrence. Objective: Evaluate if AFR was associated with successful treatment and could predict AF recurrence in horses. Methods: Retrospective multicentre study. Methods: Electrocardiograms (ECG) from horses with persistent AF admitted for cardioversion with either medical treatmen...
Application of an electrocardiography device (iECG) for heart rhythm analysis after exercise in Thoroughbred horses. AliveCor is a smartphone electrocardiography device (iECG) providing automated heart rate (HR) and rhythm determination. Atrial fibrillation (AF) in horses often is paroxysmal and rapid ECG acquisition is needed for diagnostic confirmation. iECGs were collected post-race from 15 horses with AF and 64 horses in sinus rhythm (SR). Results of manual assessment were compared to 3 commercial algorithms for HR and rhythm. Agreement between manually derived HR (HRM ) and HR derived by the AliveECG Vet (HRVET ) and Kardia version-1 (KV1 HR) and Kardia advanced (KADV HR) algorithms was quantified by th...