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.
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, ...
Heritability of metabolic traits associated with equine metabolic syndrome in Welsh ponies and Morgan horses. Equine metabolic syndrome (EMS) is a complex clinical disorder with both environmental and genetic factors contributing to EMS phenotypes. Estimates of heritability determine the proportion of variation in a trait that is attributable to genetics. Objective: To provide heritability estimates for nine metabolic traits associated with EMS in two high-risk breeds. Methods: Retrospective cohort study. Methods: High-density single-nucleotide polymorphism (SNP) genotype data was used to estimate the heritability (h ) of nine metabolic traits relevant to EMS in a cohort of 264 Welsh ponies and 286 M...
The use of heart rate variability analysis to detect arrhythmias in horses undergoing a standard treadmill exercise test. Little is known about normal heart rate variability (HRV) in horses during exercise. It can be difficult to separate premature beats from normal beat-to-beat variation at higher heart rates. Objective: The aim was to quantify HRV in healthy horses during a high-speed treadmill-standardized exercise test (HSET) and to compare with the HRV in horses observed to have arrhythmias during exercise. Methods: Thirteen healthy horses (Group H), 30 horses with arrhythmias (Group A), and 11 horses with poor performance but no observed arrhythmias (Group O). Methods: Prospective, observational study. All ...
Can heart rate variability parameters derived by a heart rate monitor differentiate between atrial fibrillation and sinus rhythm? Heart rate variability (HRV) parameters, and especially RMSSD (root mean squared successive differences in RR interval), could distinguish atrial fibrillation (AF) from sinus rhythm(SR) in horses, as was demonstrated in a previous study. If heart rate monitors (HRM) automatically calculating RMSSD could also distinguish AF from SR, they would be useful for the monitoring of AF recurrence. The objective of the study was to assess whether RMSSD values obtained from a HRM can differentiate AF from SR in horses. Furthermore, the impact of artifact correction algorithms, integrated in the analyses ...
The magnitude of respiratory sinus arrhythmia of a large mammal (the horse) is like that of humans. Heart rate (FH) accelerates in inspiration and decelerates in expiration, a phenomenon known as Respiratory Sinus Arrhythmia (RSA). Although the presence of RSA has been documented in many species, how its magnitude compares among species is unknown. We asked whether the magnitude of RSA in a large mammal, the horse, differed from that of previously measured humans. From electrocardiogram and pneumography, the peaks and troughs of FH were identified breath-by-breath in four horses (Italian Saddlebred geldings) during resting wakefulness. RSA was computed as the peak-trough FH difference, in pe...
Time-dependent antiarrhythmic effects of flecainide on induced atrial fibrillation in horses. Pharmacological treatment of atrial fibrillation (AF) in horses can be challenging because of low efficacy and adverse effects. Flecainide has been tested with variable efficacy. Objective: To test whether the efficacy of flecainide is dependent on AF duration. Methods: Nine Standardbred mares. Methods: Factorial study design. All horses were instrumented with a pacemaker and assigned to a control or an AF group. On day 0, all horses were in sinus rhythm and received 2 mg/kg flecainide IV. Atrial fibrillation subsequently was induced in the AF group by pacemaker stimulation. On days 3, 9, 27, ...
Cardiac/Cardiovascular Conditions Affecting Sport Horses. Cardiac murmurs are not uncommonly detected in the equine athlete. Although most are benign in nature, differentiation and quantification of murmurs due to valvular regurgitation are important for prognosis and recommendations. Arrhythmias can be associated with structural disease or occur independently and may range in severity from minimal clinical effect to poor performance to presenting a safety risk to rider and horse. This article discusses commonly encountered cardiac conditions in the sport horse. Physical examination, diagnostic approach, valvular disease, and arrhythmias with an impa...
Plasma homocysteine concentrations in healthy horses and horses with atrial fibrillation. 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). 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. 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. 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 ...
Effects of trimethoprim-sulfadiazine and detomidine on the function of equine Kv 11.1 channels in a two-electrode voltage-clamp (TEVC) oocyte model. The long QT syndrome (LQTS) is a channelopathy that can lead to severe arrhythmia and sudden cardiac death. Pharmacologically induced LQTS is caused by interaction between drugs and potassium channels, especially the K 11.1 channel. Due to such interactions, numerous drugs have been withdrawn from the market or are administered with precautions in human medicine. However, some compounds, such as trimethoprim-sulfonamide combinations are still widely used in veterinarian medicine. Therefore, we investigate the effect of trimethoprim-sulfadiazine (TMS), trimethoprim, sulfadiazine, and detomidine...
Investigation of ventricular pre-excitation electrocardiographic pattern in two horses: clinical presentation and potential causes. Two horses referred to the Unitat Equina, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, for unrelated clinical problems, and with no previous history of cardiac disease exhibited an intermittent ventricular pre-excitation electrocardiographic pattern during hospitalization. Both animals showed decreased plasma total and ionized magnesium concentrations, but no other relevant electrolyte disturbances were detected. Altered interventricular septal motion associated with ventricular pre-excitation beats (VPBs) was detected on M-mode echocardiography in both horses. Th...
Measurement variability of right atrial and ventricular monophasic action potential and refractory period measurements in the standing non-sedated horse. In human and veterinary medicine, monophasic action potential (MAP) analysis and determination of local refractory periods by contact electrode technique gives valuable information about local cardiac electrophysiological properties. It is used to investigate dysrhythmias and the impact of drugs on the myocardium. Precise measurement of total MAP duration is difficult, therefore the MAP duration is usually determined at a repolarization level of 90% (APD90). Until now, no studies are published about the feasibility of this technique in the standing non-sedated horse. In 6 healthy Warmblood hor...
Effect of sotalol on heart rate, QT interval, and atrial fibrillation cycle length in horses with atrial fibrillation. Based on its pharmacokinetic profile and electrophysiological effects in healthy horses, sotalol potentially could be used as a long-term PO antiarrhythmic drug in horses. Objective: To evaluate the effect of sotalol on heart rate (HR), QT interval, atrial fibrillatory rate, and success of cardioversion in horses with naturally occurring chronic atrial fibrillation (AF). Methods: Twenty-eight horses referred for transvenous electrical cardioversion of AF were treated with 2 mg/kg sotalol PO q12h for 3 days before cardioversion, and 13 horses underwent the same protocol without sotalol administ...
Analytical validation of cardiac troponin I assays in horses. Human cardiac troponin I (cTnI) assays have been used in equine medicine, often without prior analytical validation for equine use. In the absence of appropriate validation, the clinical significance of assay results is uncertain and can lead to misdiagnosis. We followed the American Society for Veterinary Clinical Pathology guidelines and investigated linearity, precision, limit of quantification (LoQ), and comparative recovery for 6 commercial cTnI assays developed for use in human medicine. Clinically acceptable linearity was observed in assays A-D, whereas assay E did not detect equine cTn...
Effect of flecainide on atrial fibrillatory rate in a large animal model with induced atrial fibrillation. 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...
Pharmacokinetics and electrophysiological effects of sotalol hydrochloride in horses. Arrhythmias in horses may require long-term anti-arrhythmic therapy. Unfortunately, oral anti-arrhythmic drugs for use in horses are currently scarce. In human patients and small animals, sotalol, a β-blocker with class III anti-arrhythmic properties, is often used for long-term treatment. Objective: To determine the pharmacokinetics of sotalol at multiple oral dosages in unfasted horses, as well as the effects on electro- and echocardiographic measurements, right atrial and ventricular monophasic action potential (MAP) and effective refractory period (ERP). Methods: Placebo controlled, doubl...
Antiarrhythmic Effects of Combining Dofetilide and Ranolazine in a Model of Acutely Induced Atrial Fibrillation in Horses. 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 ...
Molecular cloning and functional expression of the K+ channel KV7.1 and the regulatory subunit KCNE1 from equine myocardium. The voltage-gated K-channel K7.1 and the subunit KCNE1, encoded by the KCNQ1 and KCNE1 genes, respectively, are responsible for termination of the cardiac action potential. In humans, mutations in these genes can predispose patients to arrhythmias and sudden cardiac death (SCD). Objective: To characterize equine K7.1/KCNE1 currents and compare them to human K7.1/KCNE1 currents to determine whether K7.1/KCNE1 plays a similar role in equine and human hearts. Methods: mRNA encoding K7.1 and KCNE1 was isolated from equine hearts, sequenced, and cloned into expression vectors. The channel subunits ...
Erratum to: Arrhythmogenic right ventricular cardiomyopathy secondary to adipose infiltration as a cause of episodic collapse in a horse. [This corrects the article DOI: 10.1186/s13620-015-0052-3.].
Estimates of heritability of atrial fibrillation in the Standardbred racehorse. 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...