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.
Suspected vagal reflex and hyperkalaemia inducing asystole in an anaesthetised horse. A 10-year-old 466 kg mustang gelding presented to an equine referral hospital for surgical repair of nasal, frontal and lacrimal bone fractures from an unknown trauma. Surgical repair was performed under general anaesthesia, including a right-sided maxillary regional anaesthetic block with mepivacaine hydrochloride. Progressive hyperkalaemia was documented perianaesthetically (T-3 mins; 134 mins after induction; potassium 6.4 mmol/L (ref 3.5-5.1 mmol/L). Perianaesthetic bradycardia was attributed to alpha -2 agonist infusion administration, and other characteristic ECG changes (flattened ...
Circulating Hypothalamic-Pituitary-Adrenal Axis Hormones and Insulin Concentrations in Horses and Ponies. Mechanisms resulting in breed predispositions to insulin dysregulation (ID) are poorly characterized. Cortisol antagonizes insulin, and free, biologically active cortisol can be increased in ID. Breed-related differences in serum free cortisol fraction (FCF) could contribute to ID, but FCF has not been quantified in equidae predisposed to ID, such as ponies. To compare FCF and other hypothalamic-pituitary-adrenal (HPA) axis hormones between horses and ponies during health and ID. We hypothesized: (1) FCF is higher in ponies than horses in health, and is higher still in ponies with ID and obes...
Successful application of closed loop stimulation pacemakers with remote monitoring in 3 miniature donkeys with syncope. Rate-adaptive single chamber pacemakers with accelerometer, closed loop stimulation (CLS), and remote monitoring functionality (Eluna 8 SR-T, Biotronik, SE & Co, Germany) were implanted in 3 miniature donkeys with third-degree atrioventricular block and syncope. After recovery, different pacemaker programming modes were tested at rest, during stress without physical exercise and during physical exercise. Pacing rates were compared to actual atrial rates and showed that CLS functionality allowed physiological heart rate adaptation. A transmitter installed in the stable provided wireless connect...
Fundamentals of arrhythmogenic mechanisms and treatment strategies for equine atrial fibrillation. Atrial fibrillation (AF) is the most common pathological arrhythmia in horses. Although it is not usually a life-threatening condition on its own, it can cause poor performance and make the horse unsafe to ride. It is a complex multifactorial disease influenced by both genetic and environmental factors including exercise training, comorbidities or ageing. The interactions between all these factors in horses are still not completely understood and the pathophysiology of AF remains poorly defined. Exciting progress has been recently made in equine cardiac electrophysiology in terms of diagnosis ...
Evaluation of Cardiac Arrhythmias before, during, and after Treadmill Exercise Testing in Poorly Performing Standardbred Racehorses. The incidence of significant arrhythmias in sport horses and knowledge about their exact influence on athletic performance need to be clarified. The aims of the present study are to report the prevalence of cardiac arrhythmias during maximal treadmill exercise in poorly performing Standardbreds, and to investigate the possible relationship of demographic, cardiac and performance indices on premature complexes (PCs). Electrocardiographic Holter recordings before, during and after treadmill exercise testing of 158 poorly performing Standardbreds were analyzed retrospectively. Fifty horses did no...
Agreement of Bioreactance Cardiac Output Monitoring With Thermodilution in Healthy Standing Horses. Bioreactance is the continuous analysis of transthoracic voltage variation in response to an applied high frequency transthoracic current and was recently introduced for non-invasive cardiac output measurement (NICOM). We evaluated NICOM compared to thermodilution (TD) in adult horses. Six healthy horses were used for this prospective, blinded, experimental study. Cardiac output (CO) measurements were performed simultaneously using TD and the bioreactance method. Different cardiac output scenarios were established using xylazine (0.5 mg/kg IV) and dobutamine (1.5-3 mcg/kg/min). Statistical ana...
A randomised, controlled trial to determine the effect of levothyroxine on Standardbred racehorses. The use of thyroid supplement is pervasive in athletic horses although its effects on measures of performance are not known. Objective: One purpose of this study was to determine whether supra-physiologic doses of levothyroxine affect the velocities at which blood lactate was greater than 4 mmol/L (VLa4 ) and heart rate was over 150 (V150 ) and 200 (V200 ) beats per minute respectively. Additionally, a survey of post-race blood samples was also conducted to determine whether high thyroxine concentrations were common in racehorses. Methods: A randomised, crossover, trial was performed in six h...
Increased fibroblast accumulation in the equine heart following persistent atrial fibrillation. Fibroblasts maintain the extracellular matrix homeostasis and may couple to cardiomyocytes through gap junctions and thereby increase the susceptibility to slow conduction and cardiac arrhythmias, such as atrial fibrillation (AF). In this study, we used an equine model of persistent AF to characterize structural changes and the role of fibroblasts in the development of an arrhythmogenic substrate for AF. Methods: Eleven horses were subjected to atrial tachypacing until self-sustained AF developed and were kept in AF for six weeks. Horses in sinus rhythm (SR) served as control. In terminal open...
Exercise-Associated Sudden Death in Finnish Standardbred and Coldblooded Trotters – A Case Series With Pedigree Analysis. Exercise-associated sudden deaths (EASDs) are deaths occurring unexpectedly during or immediately after exercise. Sudden cardiac death (SCD) is one cause of EASD. Cardiac arrhythmias caused by genetic variants have been linked to SCD in humans. We hypothesize that genetic variants may be associated with SCD in animals, including horses. Genetic variants are transmitted to offspring and their frequency might increase within a family. Therefore, the frequency of such variants might increase with the inbreeding factor. Higher inbreeding could have a negative impact on racing performance. Pedigree...
Heritability estimates of atrial fibrillation in Thoroughbred racehorses in Hong Kong and Australia. Atrial fibrillation (AF) is the most common performance-limiting arrhythmia of racehorses. A genetic contribution has been suggested in Standardbred racehorses but has not been investigated in Thoroughbreds. The objective of this study was to determine the heritability of AF in Thoroughbred racehorses. Methods: Horses racing between 2007 and 2019 in Hong Kong and Australia that had AF detected postrace via auscultation (n = 463 cases) were compared with five randomly selected racing contemporaries (n = 2,315 controls). The ASReml-R programme was used to fit an animal model to the AF data t...
Quantification of left atrial contractile function using two-dimensional speckle tracking echocardiography in horses after conversion of atrial fibrillation to sinus rhythm. In horses, persistent atrial dysfunction is a prognostic indicator of recurrence of atrial fibrillation (AF). The objective of this study was to quantify left atrial (LA) contractile function in Warmblood horses after successful cardioversion of AF to sinus rhythm, using standard two-dimensional echocardiography (2DE) and two-dimensional speckle tracking (2DST) analyses, and to provide proof-of-concept for use of 2DST to detect LA contractile dysfunction in horses. Methods: Nineteen Warmblood horses with AF and successful transvenous electrical cardioversion (TVEC) or medical cardioversion usi...
Transthoracic echocardiography and its limitations in the diagnosis of congenital supernumerary aortic valve in a Thoroughbred. Aortic valve malformation is a common congenital abnormality reported in human medicine. The malformation is characterised by an increased or decreased number of cusps. Anatomical variations of the aortic valve that have been documented in humans include unicuspid, bicuspid, quadricuspid and quinticuspid valves. Two reports described a quadricuspid aortic valve in horses associated with either a ventricular septal defect (VSD) or tetralogy of Fallot. In this case report we describe the clinical and echocardiographic findings of a horse with a quadricuspid aortic valve as single congenital abno...
Single-Chamber Cardiac Pacemaker Implantation in a Donkey with Complete AV Block: A Long-Term Follow-Up. A five-month-old African jenny was presented with a history of exercise intolerance and syncopal episodes. Severe bradycardic arrhythmia due to a high-grade second-degree atrioventricular (AV) block with progression to complete AV block was diagnosed. The jenny underwent a transvenous single-chamber pacemaker implantation. The implantation procedure was performed in a lateral recumbency and the ventricular lead was inserted through the jugular vein. Positioning of the lead was guided by echocardiography. The pacemaker was programmed to VVI mode with a minimal ventricular rate of 40 pulses per ...
Evaluation of electrocardiographic repolarization parameters after administration of trimethoprim-sulfadiazine, detomidine, or their combination in horses. To determine whether administration of trimethoprim-sulfadiazine (TMS), detomidine (DET), or TMS plus DET would be associated with changes in ECG repolarization parameters in horses. Methods: 9 healthy adult horses. Methods: Each horse received 4 treatments in a blinded, randomized, crossover study design as follows: TMS, 16 to 24 mg/kg, IV; DET, 0.015 to 0.02 mg/kg, IV; TMS plus DET; and saline (0.9% NaCl) solution. Surface ECG traces were obtained over 24 hours, and repolarization parameters were measured at predefined time points after each treatment and compared with a 2-way ANOVA for repe...
Effect of racing on cardiac troponin I concentration and associations with cardiac rhythm disturbances in Standardbred racehorses. Accumulating evidence indicates intense exercise can be associated with myocardial damage. Investigating the impact of maximal effort on myocardium and exploring possible association of injury with rhythm disturbance requires a high-sensitivity cardiac troponin assay. The objectives of this study were: (1) to determine the effect of racing on serum cardiac troponin I (cTnI) in Standardbred horses using a high-sensitivity assay; (2) to determine the 99th percentile of cTnI in healthy horses and investigate the effect of demographic variables on cTnI prevailing pre-race in Standardbred horses us...
Incidence, recurrence, and outcome of postrace atrial fibrillation in Thoroughbred horses. 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 ...
Morphometric analysis of cardiac conduction fibers in horses and dogs, a comparative histological and immunohistochemical study with findings in human hearts. The principal function of the ventricular conduction system is rapid electrical activation of the ventricles. The aim of this study is to conduct a morphometric study to pinpoint the morphological parameters that define cardiac conduction cells, allowing us to distinguish them from other cells. Five male horse hearts and five male dog hearts were used in the study. The hearts were fixed in a 5% formaldehyde solution. Histological sections of 5 μm thickness were acquired and stained with hematoxylin-eosin and Masson's trichrome and cardiac conduction cells and their junctions were identified ...
Inhibition of Small-Conductance Calcium-Activated Potassium Current (I K,Ca) Leads to Differential Atrial Electrophysiological Effects in a Horse Model of Persistent Atrial Fibrillation. 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...
Right atrial-related structures in horses of interest during electrophysiological studies. Arrhythmias are common in horses, but catheter-based minimally invasive electrophysiological studies and therapeutic interventions have been poorly explored in equine medicine, partly due to the lack of detailed anatomical knowledge of the equine heart. Objective: To describe the dimensions and anatomical features of some electrophysiologically important landmarks of the right atrium in detail and assess their correlation with bodyweight and aortic diameter. Methods: Ex vivo cadaveric study. Methods: Twenty-one hearts of Warmblood horses, subjected to euthanasia for noncardiovascular reasons, ...
Relationship between atrial fibrillatory rate based on analysis of a modified base-apex surface electrocardiogram analysis and the results of transvenous electrical cardioversion in horses with spontaneous atrial fibrillation. 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...
Evaluation of a novel ambulatory electrocardiogram monitor (the Carnation Ambulatory Monitor) for use in horses. Short-term electrocardiogram (ECG) examinations of horses may not detect paroxysmal arrhythmias. Twenty-four hour Holter equipment can be unwieldy and inconvenient for long-term use. This study evaluated a novel long-term ECG patch recorder, the Carnation Ambulatory Monitor (CAM) in horses, determining ideal placement, practicality, durability and performance. Methods: Twenty-one adult mixed-breed horses. Methods: Prospective observational study. Three horses had ECG patches fitted at selected sites (phase 1); the two most promising sites were used for further wear testing (phase 2) and the b...
Atrial fibrillation in horses Part 2: Diagnosis, treatment and prognosis. 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...
Evaluation of a smartphone-based electrocardiogram device accuracy in field and in hospital conditions in horses. Due to compactness and cheapness, smartphone ECG (sECG) could be very useful to equine practitioners. However, previous studies have evaluated the accuracy of sECG in hospitalised horses only. Different conditions in the field could influence the accuracy of the device. The aim of this study is to compare the accuracy of sECG in field and in hospital conditions. Methods: This is a prospective study. Paired standard base-apex ECG (stECG) and sECG were recorded in hospitalised horses and in subjects examined in field conditions. ECGs were analysed for heart rate and rhythm, presence/type of arrh...
Heart rate variability analysis in horses for the diagnosis of arrhythmias. Heart rate variability (HRV) analysis has been performed on ECG-derived data sets for more than 170 years but is currently undergoing a rapid evolution, thanks to the expansion of the human and veterinary medical technology sector. Traditional HRV analysis was initially performed to identify changes in vago-sympathetic balance, while the most recent focus has expanded to include the use of complex computer algorithms, neural networks and machine learning technology to identify cardiac arrhythmias, particularly atrial fibrillation (AF). Some of these techniques have recently been translated for...
Prevalence of cardiac arrhythmias and R-R interval variation in healthy Thoroughbred horses during official Chuckwagon races and recovery. The prevalence and severity of cardiac arrhythmias in healthy racehorses undergoing competition is not well defined. The aim was to characterize arrhythmias in Thoroughbreds participating in official Chuckwagon races and to determine normal beat-to-beat (R-R) variability during supramaximal exercise. Electrocardiograph (ECG) recordings were obtained during pre-race, race, and active-recovery from 82 clinically healthy Thoroughbreds. ECG recordings were analyzed for arrhythmias and mean percent R-R deviation. Plasma lactate and high-sensitivity troponin (hs-cTnT) were also measured. Fifty-two E...
Asymmetric dimethylarginine-A potential cardiac biomarker in horses. Asymmetric dimethylarginine (ADMA) is a cardiac biomarker in humans, symmetric dimethylarginine (SDMA) a renal biomarker in humans, cats, and dogs. The purpose of this prospective study was to investigate if measuring serum ADMA and SDMA concentrations via ELISA allows detection of cardiac disease in horses in a routine laboratory setting. In this context, reference values in horses were established. Methods: Seventy-eight horses with no known medical history were compared to 23 horses with confirmed structural cardiac disease with/or without arrhythmias. Horses underwent physical examination,...
Implantable loop recorders can detect paroxysmal atrial fibrillation in Standardbred racehorses with intermittent poor performance. 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...
Cardiac arrhythmias in poorly performing Standardbred and Norwegian-Swedish Coldblooded trotters undergoing high-speed treadmill testing. The significance of cardiac arrhythmias and their possible association with upper airway obstruction are frequently considered in the clinical investigation of poor performance. The specific aims of this retrospective study of a group of poorly performing Standardbred and Norwegian-Swedish Coldblooded trotters were to: (1) describe the overall frequency and frequency distributions of arrhythmias; (2) describe arrhythmia characteristics including percent prematurity, relative recovery cycle lengths and QRS morphology; (3) describe variability of normal RR intervals; and (4) explore possible ass...