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.
[Heart disease in sports horses: Current recommendations of the 2014 ACVIM / ECEIM consensus statement]. Heart murmurs and arrhythmias are common in horses. Assessment of their clinical relevance concerning health, performance, safety and longevity of sports horses is of highest importance. A comprehensive cardiovascular examination is crucial for diagnosis and assessment of the severity of disease. Recently, an expert panel of the American College of Veterinary Internal Medicine (ACVIM) and the European College of Equine Internal Medicine (ECEIM) developed a consensus statement containing recommendations for sports horses with heart disease. This article summarizes the most relevant recommendati...
Fatal Oleander Toxicosis in Two Miniature Horses. Two young American miniature horses from the same farm were evaluated by a veterinarian due to presence of lethargy, anorexia, and cardiac arrhythmias. Both horses were treated aggressively with IV fluids and other supportive measures. The first horse died approximately 72 hr after the start of clinical signs and the second horse was humanely euthanized due to poor response to treatment. Oleander toxicosis was suspected based on the types of clinical signs present and due to several oleander plants and dried leaves present on the property. Oleander toxicosis was confirmed by the presence of ol...
Effects of anesthesia with isoflurane on plasma concentrations of adrenocorticotropic hormone in samples obtained from the cavernous sinus and jugular vein of horses. OBJECTIVE To determine effects of anesthesia on plasma concentrations and pulsatility of ACTH in samples obtained from the cavernous sinus and jugular vein of horses. ANIMALS 6 clinically normal adult horses. PROCEDURES Catheters were placed in a jugular vein and into the cavernous sinus via a superficial facial vein. The following morning (day 1), cavernous sinus blood samples were collected every 5 minutes for 1 hour (collection of first sample = time 0) and jugular venous blood samples were collected at 0, 30, and 60 minutes. On day 2, horses were sedated with xylazine hydrochloride and ane...
Cardiac and Respiratory Disease in Aged Horses. Respiratory and cardiac diseases are common in older horses. Advancing age is a specific risk factor for cardiac murmurs and these are more likely in males and small horses. Airway inflammation is the most common respiratory diagnosis. Recurrent airway obstruction can lead to irreversible structural change and bronchiectasis; with chronic hypoxia, right heart dysfunction and failure can develop. Valvular heart disease most often affects the aortic and/or the mitral valve. Management of comorbidity is an essential element of the therapeutic approach to cardiac and respiratory disease in older e...
Atrial Premature Depolarization-Induced Changes in QRS and T Wave Morphology on Resting Electrocardiograms in Horses. The electrocardiographic differentiation between atrial (APDs) and ventricular (VPDs) premature depolarizations is important. P wave prematurity and normal QRS and T wave morphology generally are used as discriminating criteria for APDs. Objective: The aim of this study was to determine whether P, Q, R, S, and T wave amplitude, PQ interval, QRS and P wave duration and P and T wave morphology differ between APDs and sinus beats. To determine the relationship between the RR coupling interval and the change in S wave amplitude between sinus beats and APDs. Methods: Case-control study. From a modi...
Exercising arrhythmias and sudden cardiac death in horses: Review of the literature and comparative aspects. Arrhythmias are common in equine athletes during and immediately after exercise. Many of these rhythm variations are not clinically relevant. In horses, a link between different exercising arrhythmias and poor performance or between exercising arrhythmias and sudden cardiac death (SCD) is strongly suspected but not fully understood or proven. SCD during races or competitions is rare, but has catastrophic consequences for the safety of the human partner and public perceptions of welfare during equestrian sports. This review summarises current knowledge of equine exercise arrhythmias and their i...
Changes in heart rate, arrhythmia frequency, and cardiac biomarker values in horses during recovery after a long-distance endurance ride. OBJECTIVE To evaluate heart rate, heart rate variability, and arrhythmia frequency as well as changes in cardiac biomarker values and their association with heart rate in horses before and after an endurance ride. DESIGN Cross-sectional study. ANIMALS 28 Arabian horses competing in a 120- or 160-km endurance ride. PROCEDURES ECG recordings were obtained from each horse before (preride) and after (recovery) an endurance ride to evaluate changes in heart rate and the SD of normal R-R intervals (SDNN) during the initial 12 hours of recovery. Frequencies of supraventricular and ventricular prematu...
Differences in the electrocardiographic QT interval of various breeds of athletic horses during rest and exercise. Quantitative measurements of cardiac repolarization, defined as the electrocardiographic QT interval, have important diagnostic implications in humans, as irregularities can trigger potentially fatal ventricular tachyarrhythmia. In both humans and horses, cardiac repolarization is influenced to some extent by heart rate, age, body weight (BW), sex, autonomic tone, and environment. In horses, there is substantial inter-breed variation in size and training, and the aims of this study were therefore to determine the best model describing the QT to RR relationship in breeds of various athletic hor...
Equine anaesthesia-associated mortality: where are we now? To review the literature concerning mortality associated with general anaesthesia in horses and to assess whether there is evidence for a reduction in mortality over the 20Â years since the Confidential Enquiry into Perioperative Equine Fatalities (CEPEF). Methods: PubMed, Scopus, Google Scholar. Search terms used: horse; pony; equine; anaesthesia; anesthesia; recovery; morbidity, and mortality. Conclusions: The most recent studies, in which isoflurane and sevoflurane have been more commonly used for anaesthesia maintenance, report fewer intraoperative cardiac arrests than older studies in whi...
The use of dexmedetomidine continuous rate infusion for horses undergoing transvenous electrical cardioversion–A case series. Five horses were presented for treatment of atrial fibrillation by transvenous electrical cardioversion (TVEC). A dexmedetomidine infusion was administered for sedation during positioning of the cardioversion catheters, and continued during general anesthesia. Shocks were applied until return to sinus rhythm. Dexmedetomidine infusion provided excellent conditions for TVEC catheter placement and procedure. Utilisation d’une perfusion continue de dexmedetomidine lors de cardioversion électrique transveineuse chez le cheval: une série de cas. Cinq chevaux présentant une fibrillation atriale ...
Arrhythmogenic right ventricular cardiomyopathy secondary to adipose infiltration as a cause of episodic collapse in a horse. A 15-year-old Clydesdale cross gelding was investigated and managed over a 2-year period for intermittent collapse. The horse presented initially after an observed episode of collapse at rest, and had a resting tachycardia, elevated Cardiac Troponin I and polycythaemia. Multiple dysrhythmias were detected on telemetric electrocardiography. Vital parameters, cardiac rhythm and red cell count returned to reference range with prolonged rest but further resting syncopal episodes were observed, and due to safety concerns and limited treatment options the horse was euthanased. Post mortem evaluation...
Pharmacokinetics of intravenously and orally administered sotalol hydrochloride in horses and effects on surface electrocardiogram and left ventricular systolic function. Arrhythmias are common in horses. Some, such as frequent atrial or ventricular premature beats, may require long-term anti-arrhythmic therapy. In humans and small animals, sotalol hydrochloride (STL) is often used for chronic oral anti-arrhythmic therapy. STL prolongs repolarization and the effective refractory period in all cardiac tissues. No information on STL pharmacokinetics or pharmacodynamics in horses is available and the aim of this study was to evaluate the pharmacokinetics of intravenously (IV) and orally (PO) administered STL and the effects on surface electrocardiogram and left ve...
Molecular Cloning and Functional Expression of the Equine K+ Channel KV11.1 (Ether à Go-Go-Related/KCNH2 Gene) and the Regulatory Subunit KCNE2 from Equine Myocardium. The KCNH2 and KCNE2 genes encode the cardiac voltage-gated K+ channel KV11.1 and its auxiliary β subunit KCNE2. KV11.1 is critical for repolarization of the cardiac action potential. In humans, mutations or drug therapy affecting the KV11.1 channel are associated with prolongation of the QT intervals on the ECG and increased risk of ventricular tachyarrhythmia and sudden cardiac death--conditions known as congenital or acquired Long QT syndrome (LQTS), respectively. In horses, sudden, unexplained deaths are a well-known problem. We sequenced the cDNA of the KCNH2 and KCNE2 genes using RACE an...
The physiological consequences of crib-biting in horses in response to an ACTH challenge test. Stereotypies are repetitive and relatively invariant patterns of behavior, which are observed in a wide range of species in captivity. Stereotypic behavior occurs when environmental demands produce a physiological response that, if sustained for an extended period, exceeds the natural physiological regulatory capacity of the organism, particularly in situations that include unpredictability and uncontrollability. One hypothesis is that stereotypic behavior functions to cope with stressful environments, but the existing evidence is contradictory. To address the coping hypothesis of stereotypies...
Right atrial and right ventricular ultrasound-guided biopsy technique in standing horses. Endomyocardial biopsies could be a valuable tool in equine cardiology for diagnosing myocardial disease, which is probably underdiagnosed in horses because of lack of specific diagnostic measures and limitations of currently available diagnostic methods. Objective: To describe a technique for serial right atrial and right ventricular endomyocardial biopsy in standing horses using a percutaneous approach through the jugular vein. Methods: Prospective study. Methods: Biopsy was performed in 10 healthy standing horses sedated with detomidine, under continuous electrocardiography monitoring. A 10 ...
Effect of dantrolene premedication on various cardiovascular and biochemical variables and the recovery in healthy isoflurane-anesthetized horses. To determine the effect of dantrolene premedication on various cardiovascular and biochemical variables and recovery in isoflurane-anesthetized horses. Methods: 6 healthy horses. Methods: Each horse was anesthetized twice with a 21- to 28-day washout period between anesthetic sessions. Food was not withheld from horses before either session. During each session, dantrolene (6 mg/kg in 2 L of water) or water (2 L) was administered via a nasogastric tube 1 hour before anesthesia was induced. Anesthesia was maintained with isoflurane for 90 minutes, during which blood gas analyses and lithium-dil...
History of research in Japan on electrocardiography in the racehorse. Since the first recording of electrocardiograms (ECGs) of a horse in Japan was carried out in 1944, studies on ECGs have been performed intensively. During the early stages of research from the 1950s to 1960s, leads to use for ECG recording were evaluated using several different approaches including unipolar leads, bipolar limb leads, and bipolar chest leads. Based on these studies, the AB lead, which is oriented along the long axis of the heart, became the standard reference method in Japan. Electrodes of the AB lead are placed on the upper 1/4th point along a straight line between the wither...
Paroxysmal atrial fibrillation and clinically reversible cor pulmonale in a horse with complicated recurrent airway obstruction. Cor pulmonale is considered an uncommon complication in horses with recurrent airway obstruction (RAO). This case report describes the history, clinical and further examination findings, treatment, progression and outcome of a horse diagnosed with cor pulmonale and paroxysmal atrial fibrillation of 2 days duration due to a severe exacerbation of RAO. To our best knowledge, this is the first report of RAO induced pulmonary hypertension in a horse causing atrial fibrillation. However, even severe cardiac changes due to respiratory dysfunction seem to be largely reversible in horses.
Myocardial insult and arrhythmias after acute hemorrhage in horses. The objectives of this investigation were to: (1) Determine if acute hemorrhage is associated with increased plasma cardiac troponin I (cTnI) concentration or cardiac arrhythmias, (2) to describe the types of arrhythmias and their clinical course in horses following acute hemorrhage, (3) to determine the ability of clinical or clinicopathological variables to predict an increase in cTnI concentration and the presence of arrhythmias, and (4) to determine the associations of cTnI and cardiac arrhythmias with outcome. Methods: Prospective observational study. Methods: Large animal veterinary teac...
The diagnosis and management of atrial fibrillation in the horse. Atrial fibrillation is the most common performance-limiting arrhythmia in the horse. Detailed cardiovascular evaluation will help guide prognosis and treatment. Many affected horses have lone atrial fibrillation (no predisposing cardiac abnormalities). These horses have a good prognosis for return to performance if sinus rhythm can be restored. The main therapeutic option continues to be quinidine, which has been used for over 60 years. Transvenous electrical cardioversion has proven to be a successful alternative. Other therapeutic options are being explored, but are currently limited.
Pharmacologic inhibition of small-conductance calcium-activated potassium (SK) channels by NS8593 reveals atrial antiarrhythmic potential in horses. Small-conductance calcium-activated potassium (SK) channels have been found to play an important role in atrial repolarization and atrial fibrillation (AF). Objective: The purpose of this study was to investigate the existence and functional role of SK channels in the equine heart. Methods: Cardiac biopsies were analyzed to investigate the expression level of the most prominent cardiac ion channels, with special focus on SK channels, in the equine heart. Subcellular distribution of SK isoform 2 (SK2) was assessed by immunohistochemistry and confocal microscopy. The electrophysiologic and anti-...
Evaluation of assays for troponin I in healthy horses and horses with cardiac disease. Cardiac troponin I (cTnI) is a marker for detection of myocardial damage in horses. Many cTnI assays exist and medical studies have shown that the clinical performance of assays differs. The aim of this study was to compare two different cTnI assays in horses. Serum samples were taken from 23 healthy horses (group 1) and 72 horses with cardiac disease (group 2). Cardiac troponin I was determined using assay 1 in laboratory A (limit of detection, LOD, 0.03 ng/mL) and assay 2 in laboratories B and C (LOD 0.01 ng/mL). In group 1, a median cTnI concentration of <0.03 (<0.03-0.04) ng/mL and <0....
Influence of detomidine on atrial fibrillation cycle length measured by intracardiac electrogram recording and by colour tissue Doppler imaging in horses. Shortening of atrial fibrillation cycle length (AFCL) is a marker of atrial electrical remodelling due to atrial fibrillation (AF). Objective: To investigate the effect of administration of detomidine on AFCL measured invasively from an intra-atrial electrogram (AFCLEGM) and noninvasively by tissue Doppler imaging (AFCLTDI). We hypothesised that detomidine would have no effect on AFCL but would improve the ease of TDI measurements and facilitate noninvasive AFCL determination. Methods: Prospective clinical study. Methods: Measurements were performed before and after i.v. administration of 7.5â...
Sudden death of a horse with supraventricular tachycardia following oral administration of flecainide acetate. To describe a case of supraventricular tachycardia and sudden death in a horse following administration of flecainide acetate. Methods: An 8-year-old Hanoverian warmblood gelding was treated for chronic, naturally occurring, supraventricular tachycardia with digoxin, procainamide hydrochloride, quinidine sulfate, and flecainide acetate. After oral administration of flecainide, polymorphic ventricular tachycardia (torsades de pointes) and ventricular fibrillation developed, leading to cardiovascular collapse and death. Conclusions: Atrial fibrillation is the most commonly diagnosed dysrhythmia ...
Antiarrhythmic and electrophysiologic effects of flecainide on acutely induced atrial fibrillation in healthy horses. Only few pharmacologic compounds have been validated for treatment of atrial fibrillation (AF) in horses. Studies investigating the utility and safety of flecainide to treat AF in horses have produced conflicting results, and the antiarrhythmic mechanisms of flecainide are not fully understood. Objective: To study the potential of flecainide to terminate acutely induced AF of short duration (≥ 15 minutes), to examine flecainide-induced changes in AF duration and AF vulnerability, and to investigate the in vivo effects of flecainide on right atrial effective refractory period, AF cycle length...
Investigation of single and paired measurements of adrenocorticotropic hormone for the diagnosis of pituitary pars intermedia dysfunction in horses. Paired measurement of ACTH concentration may be more reliable than a single measurement. Objective: To determine whether the mean of 2 measurements of ACTH concentration is more reliable in assessing pituitary pars intermedia dysfunction (PPID) than a single measurement. Methods: Paired ACTH measurements were performed on (1) 148 occasions from 124 horses being investigated for PPID, (2) 90 occasions from 76 horses with PPID that were receiving treatment with pergolide, and (3) 63 occasions from 50 horses in which there was no clinical suspicion of PPID. Histologic examination of the pars inte...
Cardiac arrhythmias and electrolyte disturbances in colic horses. Despite increased focus on cardiac arrhythmias in horses, the nature and prevalence is still poorly described. Case reports suggest that arrhythmias occurring secondary to systemic disease are seen more commonly in the clinic than arrhythmias caused by cardiac disease. The aim of this study was to investigate the prevalence of arrhythmias in colic horses referred for hospital treatment. Associations between electrolyte disturbances and arrhythmias were also investigated. Results: Heart rate was 37.4 ± 3.7 bpm in the control group, and 51.6 ± 11.8 bpm, in the colic group, which was ...
Diurnal modulation and sources of variation affecting ventricular repolarization in Warmblood horses. Irregularities in cardiac repolarization are known to predispose for arrhythmias and sudden cardiac death in humans. The QT interval is a quantitative measurement of repolarization, and clinically, the QTc (QT interval corrected for heart rate) and Tpeak to Tend intervals (TpTe) are used as repolarization markers. To support the use of these markers in horses, we sought to describe the possible influence of the environment, time of day, day-to-day effects, T wave conformation, age, body weight (BW), and horse-to-horse variation on repolarization measurements. Methods: 12 Warmblood geldings, ag...
Occurrence of cardiac arrhythmias in Standardbred racehorses. Cardiac arrhythmias are a recognised but poorly characterised problem in the Standardbred racehorse. Frequency data could aid the development of cardiac arrhythmia screening programmes. Objective: To characterise the occurrence of cardiac arrhythmias in Standardbreds prior to racing and in the late post race period using a handheld, noncontinuous recording device. Methods: Prospective, observational study, convenience sampling. Methods: Noncontinuous electrocardiographic recordings were obtained over a 12 week period from Standardbred horses competing at a single racetrack. Electrocardiograms ...