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.
Exercise-associated rhythm disturbances in poorly performing Thoroughbreds: risk factors and association with racing performance. Exercise-associated cardiac rhythm disturbances are common, but there is a lack of evidence-based criteria on which to distinguish clinically relevant rhythm disturbances from those that are not. Objective: To describe and characterise rhythm disturbances during clinical exercise testing; to explore potential risk factors for these rhythm disturbances and to determine whether they influenced future racing. Methods: Retrospective cohort using a convenience sample. Methods: Medical records were reviewed from two clinical services to identify horses with poor performance and/or respiratory noise ...
Morphological variations of the conduction system in the atrioventricular zone and its clinical relationship in different species. Atrioventricular node is responsible for delaying the passage of the electrical impulse to ventricles in order to protect them from fast depolarizations coming from the atria. The importance of this study is to identify the morphological variations of the components of atrioventricular zone that affect the conduction system and its clinical relationship in different species of mammals. We analyzed ten human hearts, nine from horses, eight from pigs, and five from dogs without a clinical history of cardiac pathologies. Histological section thickness of 5 μm were obtained with a microtome and ...
Catheter-based electrical interventions to study, diagnose and treat arrhythmias in horses: From refractory period to electro-anatomical mapping. Minimally-invasive catheter-based interventional cardiology is a mainstay for the diagnosis and treatment of arrhythmias in human medicine. Very accurate imaging using fluoroscopy, CT and MRI is essential during interventional cardiology procedures. Because these imaging techniques are either not possible or provide too little anatomical detail in horses, echocardiography is currently the best technique to visualize catheters in horses. Over the past decades, catheter-based techniques have been applied to induce arrhythmias using pacing and to perform arrhythmia research using electrophysiolog...
Atrial fibrillation in horses part 1: Pathophysiology. Atrial fibrillation (AF) is the most common clinically relevant arrhythmia in horses, with a reported prevalence up to 2.5%. The pathophysiology has mainly been investigated in experimental animal models and human medicine, with limited studies in horses. Atrial fibrillation results from the interplay between electrical triggers and a susceptible substrate. Triggers consist of atrial premature depolarizations due to altered automaticity or triggered activity, or local (micro)reentry. The arrhythmia is promoted by atrial myocardial ion channel alterations, Ca2+ handling alterations, structural ...
Stall-side screening potential of a smartphone electrocardiogram recorded over both sides of the thorax in horses. Comparisons between smartphone ECG (SpECG) recordings obtained from the right and left sides of the thorax have not been reported in animals. Objective: To evaluate the screening potential of a SpECG obtained from both sides of the thorax and to compare the degree of agreement between the SpECG and a reference ECG (rECG) for measurement of the duration of baseline electrical deflections recorded over both sides of the thorax. Methods: Fifty horses admitted to the equine hospital, university-owned horses, and horses from an endurance riding facility. Methods: Prospective observational study. Si...
Detection of atrial fibrillation with implantable loop recorders in horses. Cardiac arrhythmias in horses are diagnosed by auscultation or electrocardiogram (ECG), which results in a low sensitivity for detecting arrhythmias that occur sporadically. Implantable loop recorders (ILRs) are small ECG devices placed subcutaneously, to automatically detect arrhythmias in human patients. Objective: To test ILRs ability to detect atrial fibrillation (AF) in horses. Furthermore, we hypothesised that anatomical location of the implant site might influence signal quality. Signal quality was evaluated both during exercise and over time. Methods: Experimental study. Methods: In fi...
Ventricular arrhythmias in horses: Diagnosis, prognosis and treatment. Ventricular arrhythmias (VAs) are often incidental or coincidental with systemic disease. Ventricular arrhythmias are also the most likely cause of many sudden cardiac deaths in horses. This dichotomy creates challenges in the management of horses with VAs. This review presents current knowledge of diagnosis, prognosis and treatment of VAs in horses.
Alterations of cardiac and renal biomarkers in horses naturally infected with theileria equi. Equine theileriosis due to Theileria equi is probably the most widespread and pathogenic disease of equines, which comes with major cardiac and renal complications. This study was undertaken to investigate the biomarkers of cardiac and renal functions in horses infected with T. equi and determine the association between these parameters and the level of parasitemia. Giemsa-stained blood smears from 300 horses with ages of 3-4 years old were examined for detection of T. equi on erythrocytes. Moreover, multiplex PCR was employed for confirmation of the diagnosis in the 28 positive cases. Based o...
Pathological bradyarrhythmia in horses. Pathological bradyarrhythmia is rare in horses but should be especially considered when presented with a horse that has signs consistent with episodic weakness or collapse. This paper reviews the literature describing our current knowledge of, and possible mechanisms causing, clinically significant bradyarrhythmia in horses.
Comparison between smartphone electrocardiography and standard three-lead base apex electrocardiography in healthy horses. Cardiac arrhythmias are commonly auscultated during routine physical examinations in horses and determining the underlying electrical abnormality using an ECG is important. The most commonly used device is a three-lead base apex system (Televet), however few practitioners carry this for routine visits. With recognition of the utility of smartphone-based ECGs in humans, dogs and ruminants, the AliveCor single-lead bipolar smartphone-based ECG has gained popularity. The objective of this study was to determine if AliveCor and Televet ECG measurements were comparable in healthy horses using multi...
Endocardial electro-anatomic mapping in healthy horses: Normal sinus impulse propagation in the left and right atrium and the ventricles. Understanding the depolarisation pattern of the equine heart under normal physiologic conditions, and its relationship to the surface electrocardiogram (ECG), is of uppermost importance before any further research can be done about the pathophysiology of complex arrhythmias. In the present study, a 3D electro-anatomical mapping system was used to evaluate the qualitative and quantitative depolarisation patterns and correlation to the surface ECG of both the atrial and ventricular endocardium in seven healthy horses in sinus rhythm under general anaesthesia. Bipolar activation maps of the endoc...
Acute, subacute and chronic sequelae of horses accidentally exposed to monensin-contaminated feed. Monensin is highly toxic to horses and inadvertent ingestion can result in cardiac injury and death. Objective: To describe sequelae of monensin ingestion and to determine clinical predictors of outcome. Methods: Observational clinical study. Methods: Physical examination, electrocardiogram and echocardiography were performed on 76 horses accidentally exposed to monensin-contaminated feed. Four horses were examined within 14 days of exposure (acute period), 29 horses were examined between 15 and 45 days post-exposure (subacute period) and 70 horses were examined 4-10 months after exposure ...
Assessment of left ventricular function in horses with aortic regurgitation by 2D speckle tracking. Aortic regurgitation (AR) may lead to left ventricular (LV) dilatation, cardiac arrhythmias and heart failure. Close follow-up of horses with AR is therefore paramount to detect onset of cardiac decompensation. The aim of this study was to examine whether two-dimensional speckle tracking (2DST) can be used to detect altered myocardial function in horses with chronic AR compared to control horses. Speckle tracking was performed on short axis and long axis images of the LV in 29 healthy Warmblood horses and 57 Warmblood horses with AR. Radial, circumferential and longitudinal strain, strain rate...
Pulmonary vein firing initiating atrial fibrillation in the horse: Oversized dimensions but similar mechanisms. Atrial fibrillation is triggered by the pulmonary veins in humans. Although atrial fibrillation is known to occur in other species, the mechanisms of disease in these are not known. Here we present evidence for pulmonary vein triggers in the horse, where 3D HD Grid mapping was undertaken in the conscious state in the absence of fluoroscopy.
Three dimensional ultra-high-density electro-anatomical cardiac mapping in horses: methodology. Ultra-high-density cardiac mapping allows very accurate characterisation of atrial and ventricular electrophysiology and activation timing. Objective: To describe the technique and evaluate the feasibility of magnetic electro-anatomical mapping of the equine heart. Methods: In vivo experimental method development. Methods: A mapping system using an 8.5F bidirectional deflectable catheter with a deployable mini-basket (3-22 mm) containing 64 electrodes divided over eight splines was evaluated. Based upon predefined beat acceptance criteria, the system automatically acquires endocardial electro...
Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses. The number of atrial premature depolarisations (APDs) is a known risk factor for atrial fibrillation (AF) recurrence in humans. Objective: To evaluate if the number of APDs over a 24-h period 5 days post cardioversion predicts AF recurrence within 1 year in horses, taking the multifactorial nature of AF into account. Methods: Retrospective case series. Methods: Eighty horses met these inclusion criteria: first AF episode, no AF recurrence within 5 days post cardioversion, cardioversion by transvenous electrical cardioversion (TVEC), 24-h ECG recording and echocardiographic examination 5 da...
Longitudinal study of electrical, functional and structural remodelling in an equine model of atrial fibrillation. Large animal models are important in atrial fibrillation (AF) research, as they can be used to study the pathophysiology of AF and new therapeutic approaches. Unlike other animal models, horses spontaneously develop AF and could therefore serve as a bona fide model in AF research. We therefore aimed to study the electrical, functional and structural remodelling caused by chronic AF in a horse model. Nine female horses were included in the study, with six horses tachypaced into self-sustained AF and three that served as a time-matched sham-operated control group. Acceleration in atrial fibrilla...
Histological and morphometric study of the components of the sinus and atrioventricular nodes in horses and dogs. The cardiac nodes are the source of the electrical impulse that is transmitted to the heart, the aim of this work is study the histological and morphometric characteristics of the different components of the sinus and atrioventricular nodes in horses and dogs that help to know the physiopathology of these nodes. A group of ten horse hearts and five dog hearts were used. The region of the sinus and atrioventricular nodes was sectioned serially, and the block of tissue removed for study. The samples were assessed using a morphometric analysis with the Image-Pro Plus 7.1 software and the acquisit...
Accelerated Idioventricular Rhythm Associated With Isoflurane Administration in a Foal: A Case Report. A 2-day-old filly was referred to the hospital with abdominal pain and constipation. The foal presented tachycardia, tachypnea, hypoxemia, hyperlactatemia, and abdominal distension. Meconium impaction was diagnosed, and the filly underwent abdominal surgery. Diazepam and butorphanol were administered for anesthesia premedication, but sedative effects were mild. Xylazine was used to enhance sedation and ketamine was subsequently administered for induction. The foal showed swallow reflex and head movement when intubation was attempted. Consequently, isoflurane on oxygen was provided via an anest...
Percutaneous transcatheter closure of an aorto-cardiac fistula in a six-year-old Warmblood mare with atrial fibrillation. This report describes a rare case of an aorto-cardiac fistula in a six-year-old French Warmblood mare presented with atrial fibrillation, decreased performance, ventral oedema, bounding arterial pulsation and pathological jugular venous pulse. A 2.7-cm-diameter fistula connected the right aortic sinus of Valsalva to the right atrium. Atrial fibrillation was likely due to volume overload of the right heart due to left-to-right shunting. The horse was treated by percutaneous transcatheter closure of the fistula delivered under general anaesthesia using a transarterial approach. The operation was...
Two Methods for 24-hour Holter Monitoring in Horses: Evaluation of Recording Performance at Rest and During Exercise. Continuous electrocardiography (ECG) monitoring is the gold standard for diagnosing arrhythmias that occur intermittently or under exercise. The aim of this study was to compare two different methods for 24-hour Holter monitoring in horses, a 7-electrode system (7-ES) versus a 4-electrode system (4-ES), assessing the recording performance at rest and during exercise. Six standardbred horses were included in the present prospective study. Two different methods for 24-hour Holter monitoring were used in each horse with a washout period of one week between each recording method. In the first 15 ...
Utility and accuracy of a smartphone-based electrocardiogram device as compared to a standard base-apex electrocardiogram in the horse. Evaluate accuracy and utility of a smartphone-based ECG device compared to a standard base-apex lead ECG in horses. Methods: ECGs were acquired prospectively from 28 client-owned horses at 2 equine referral hospitals. Twenty-five pairs of 30-s ECG recordings were acquired simultaneously from 23 horses with a smartphone ECG device (a bi-polar single lead recorder coupled to a smartphone with an ECG application) and with a standard base-apex lead ECG; 2 horses provided two pairs of simultaneously acquired ECGs. In one horse, the ECGs pairs were recorded immediately sequentially. An additional 7 ...
Cardiac Pathology and Genomics of Sudden Death in Racehorses From New York and Maryland Racetracks. Postmortem evaluation of racehorses has focused primarily on musculoskeletal injuries; however, horses also die suddenly on the track (sudden death [SD]). Although cardiac conditions are frequently suspected as a cause of death, SD racehorses are often autopsy negative; however, previous studies have been limited due to inconsistent or insufficient cardiac sampling and lack of controls. SD in New York (NY) and Maryland (MD) racehorses was evaluated in an observational case vs control study comparing clinical information, postmortem evaluation including cardiac dissection, and cardiac conductio...
Cardiac Therapeutics in Horses. Many cardiac therapeutics lack significant evidence of benefit in the horse, and in many cases their use is based on extrapolation of evidence from other species. In recent years there has been a push to develop a better understanding of both the pharmacodynamics and pharmacokinetics of these drugs. Recent data have described the use of antiarrhythmic agents including sotalol, flecainide, and amiodarone. Data about the use of ACE inhibitors in the management of congestive heart failure are encouraging and support their use in certain cases, wheras evidence for other medicines, such as pimobend...
Equine Electrocardiography. Analyzing electrocardiographic (ECG) recordings, making a diagnosis and assessment of any arrhythmias present, is an important part of the workup of many equine cases. Accurate analysis requires a good-quality recording, free of as many artifacts as possible, with clear P-QRS-T complex morphology. For sustained arrhythmias, short-term recordings are sufficient to make the appropriate diagnosis before instigating treatment. Longer-term recordings are essential for arrhythmias that are paroxysmal, intermittent, or occurring infrequently, while exercising ECGs are required for arrhythmias associa...
Cardiovascular Causes of Poor Performance and Exercise Intolerance and Assessment of Safety in the Equine Athlete. Horses have a high prevalence of resting arrhythmias, cardiac murmurs, and valvular regurgitation, and training can increase the prevalence. This makes it challenging for equine veterinarians who are asked to evaluate horses for poor performance to determine the clinical relevance of some findings. In addition, cardiac disease has the potential to cause collapse or sudden death, putting both the horse and rider at risk. Further diagnostics, such as echocardiograms and resting and exercising ECGs can help to sort out the impact of an abnormality found on resting physical examination. However un...
Cardiac Arrhythmias in Horses. Arrhythmias are common in horses. Sinus arrhythmia and first- and second-degree atrioventricular block are frequently found physiologic arrhythmias, but should immediately disappear after stress or exercise. Atrial premature depolarizations are usually not associated with poor performance, but are a potential trigger for atrial fibrillation. Atrial fibrillation results in an abnormal ventricular response during exercise and poses a risk for collapse in some horses. This arrhythmia can usually be treated by quinidine sulfate or transvenous electrical cardioversion. Ventricular premature depolar...
Assessment of the Cardiovascular System in Horses During Prepurchase and Insurance Examinations. Arrhythmias detected on prepurchase examination should be confirmed with an ECG. Exercising ECG determines if the arrhythmia is overdriven during exercise or is a safety concern. An echocardiogram is needed in all horses with a grade 3/6 or louder mid to late systolic, holosystolic, or pansystolic murmur or any holodiastolic decrescendo murmur to identify the cardiac abnormality and its hemodynamic impact. Most horses with arrhythmias and murmurs have a normal performance career and life expectancy and are insurable. Risks for sudden death and congestive heart failure associated with the commo...
Measurement of plasma endothelin-1 concentration in healthy horses and horses with cardiac disease during rest and after exercise. Cardiac biomarkers are important tools for monitoring disease progress and can monitor progression of therapy. Endothelin-1 (ET-1) has been studied for its use as a cardiac biomarker in human and small animal medicine while in horses with cardiac disease it has not been evaluated yet. The objective of the present study was to determine the concentration of plasma ET-1 in healthy horses and compare it with ET-1 concentration in horses with cardiac disease during rest and after exercise. Fifty four horses admitted to the Equine Clinic of Free University of Berlin were used in the present study, ...