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Topic:Cardiovascular Health

Cardiovascular health in horses encompasses the study of the heart and blood vessels, focusing on their structure, function, and associated disorders. The equine cardiovascular system is responsible for the circulation of blood, delivering oxygen and nutrients to tissues, and removing waste products. Research in this area includes the examination of cardiac anatomy, the electrophysiology of the heart, and common cardiovascular conditions such as arrhythmias, valvular diseases, and heart murmurs. Diagnostic tools such as echocardiography, electrocardiography, and cardiac biomarkers are utilized to assess cardiovascular function and detect abnormalities. This page compiles peer-reviewed research studies and scholarly articles that explore the physiological mechanisms, diagnostic approaches, and therapeutic strategies related to cardiovascular health in horses.
Evaluation of Different Blood Parameters From Endurance Horses Competing at 160 km.
Journal of equine veterinary science    June 19, 2021   Volume 104 103687 doi: 10.1016/j.jevs.2021.103687
Ertelt A, Merle R, Stumpff F, Bollinger L, Liertz S, Weber C, Gehlen H.The purpose of this study was to assess a change in different blood parameters before and after a 160 km endurance race and to evaluate differences in cardiac biomarkers between horses that completed the race and horses that did not. The study population consisted of 52 healthy endurance horses. Horses participating in the study were assigned to three groups: horses that successfully completed the race ("finishers"), horses that failed to qualify at the veterinary check for primarily metabolic reasons ("metabolic") and horses that failed to qualify at the veterinary check for primarily gait re...
The effect of xylazine on intracranial pressure in anesthetized and standing horses.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    June 18, 2021   Volume 31, Issue 4 476-482 doi: 10.1111/vec.13083
Reed RA, Epstein KL, Bramski JH, Diehl KA, Ryan CA.To determine the effect of xylazine on intracranial pressure (ICP) in standing compared to isoflurane-anesthetized horses. Methods: Prospective, crossover study design. Methods: University Teaching Hospital. Methods: Six adult horses donated to the University. Horses were determined to be healthy via physical examination, complete blood count, and neurological evaluation. Methods: Horses were anesthetized, maintained on isoflurane in oxygen in left lateral recumbency, and ventilated to normocapnia. Horses were instrumented for intraparenchymal measurement of ICP, invasive blood pressure, pulse...
Blood lactate concentrations and heart rates of Colombian Paso horses during a field exercise test.
Veterinary and animal science    June 8, 2021   Volume 13 100185 doi: 10.1016/j.vas.2021.100185
Cabrera AMZ, Soto MJC, Aranzales JRM, Valencia NMC, Gutiérrez MPA.Information on performance indices in Paso horses is scarce. Field exercise tests are necessary to recreate the exertion that occurs during training and competition. To describe blood lactate concentrations and heart rates of untrained Colombian Paso horses (CPHs) in response to a field exercise test. A 30-minutes-long standardized field exercise test was carried out on 11 untrained adult CPHs of both sexes. Blood lactate concentration (BLConc) and heart rate (HR) were measured before, during each step of the test, and at recovery. The BLConc and HR were used to calculate the HR at which a BLC...
Cardiac arrhythmias in small and large animals: The more we learn, the more we realise how much we don’t know.
Veterinary journal (London, England : 1997)    May 31, 2021   Volume 273 105697 doi: 10.1016/j.tvjl.2021.105697
van Loon G, Smets P, Decloedt A.No abstract available
The use of electrical impedance tomography (EIT) to evaluate pulse rate in anaesthetised horses.
Veterinary journal (London, England : 1997)    May 14, 2021   Volume 273 105694 doi: 10.1016/j.tvjl.2021.105694
Raisis AL, Mosing M, Hosgood GL, Secombe CJ, Adler A, Waldmann AD.Electrical impedance tomography (EIT) provides clinically useful lung images; however, it would be an advantage to extract additional cardiovascular information from the data. The aim of this study was to evaluate if cardiac-related changes measured by EIT can be used to measure pulse rate (PR) under physiological as well as high and low blood pressure states in anaesthetised horses. Electrical impedance tomography data and PR from seven horses anaesthetised in dorsal recumbency were recorded over 1 min during mechanical ventilation and 1 min of apnoea. Data were collected at four measurement ...
Balloon valvuloplasty of valvular pulmonary stenosis in a neonatal foal.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    May 5, 2021   Volume 36 48-54 doi: 10.1016/j.jvc.2021.04.008
Junge HK, Glaus T, Matos JN, Meira C, Schwarz A, Hoey S, Dennler M, Schwarzwald CC, Mitchell KJ.In a 1-day old filly with a loud heart murmur, transthoracic echocardiography revealed right ventricular hypertrophy associated with severe pulmonary valvular stenosis and a transvalvular pressure gradient (between right ventricle and pulmonary artery) of 125 mmHg. Computed tomographic angiography confirmed the finding, with no evidence of other relevant concurrent abnormalities. Balloon valvuloplasty was performed using a single balloon technique. The foal recovered well from anaesthesia. Following the procedure, the right ventricle-pulmonary artery transvalvular gradient decreased to 38 mm...
Effects of head position on internal and external carotid pressures in standing sedated horses. Caffey SR, Lund CM, Farnsworth KD, Fransson BA, Ragle CA.The effects of head position on internal carotid artery (ICA) and external carotid artery (ECA) pressures in standing sedated horses were evaluated in this study. The common carotid artery (CCA) was catheterized in 6 horses using an ultrasound-guided technique to facilitate placement of a pressure transducer within the ICA and ECA at the level of the guttural pouch. Transducer position was confirmed by endoscopic visualization. Mean arterial pressure (MAP) was measured with horses in both a head-up and head-down position. The dorsal metatarsal artery was catheterized as a control. Maintaining ...
Clinical Randomized Comparison of Medetomidine and Xylazine for Isoflurane Balanced Anesthesia in Horses.
Frontiers in veterinary science    April 20, 2021   Volume 8 603695 doi: 10.3389/fvets.2021.603695
Wiederkehr A, Barbarossa A, Ringer SK, Jörger FB, Bryner M, Bettschart-Wolfensberger R. To assess drug plasma levels, preanesthetic sedation, cardiopulmonary effects during anesthesia and recovery in horses anesthetized with isoflurane combined with medetomidine or xylazine. Prospective blinded randomized clinical study. Sixty horses undergoing elective surgery. Thirty minutes after administration of antibiotics, flunixine meglumine or phenylbutazone and acepromazine horses received medetomidine 7 μg kg (group MED) or xylazine 1.1 mg kg (group XYL) slowly intravenously (IV) and sedation was assessed 3 min later. Anesthesia was induced with ketamine/diazepam and maintained wi...
Images–ECG Localization in ST-Elevation Myocardial Infarction: Spotting the Zebra Among the Horses.
Journal of the Saudi Heart Association    April 15, 2021   Volume 33, Issue 1 51-52 doi: 10.37616/2212-5043.1240
Gujral JS, Shrivastava A.No abstract available
Rider Energy Expenditure During High Intensity Horse Activity.
Journal of equine veterinary science    April 8, 2021   Volume 102 103463 doi: 10.1016/j.jevs.2021.103463
O'Reilly C, Zoller J, Sigler D, Vogelsang M, Sawyer J, Fluckey J.Despite the fact that horseback riding is a popular sport, there is little information available on horseback riding as a physical activity. The objective of this experiment was to quantify energy expenditure of participants (n=20) during three riding tests: a 45min walk-trot-canter ride (WTC), a reining pattern ride and a cutting simulation ride while wearing a telemetric gas analyzer. Total energy expenditure (tEE), mean and peak metabolic equivalents of task (MET), heart rate (HR), respiratory frequency (RF), relative oxygen consumption (relVO2), and respiratory exchange ratio (RER) were as...
Analgesic and Cardiopulmonary Effects of Epidural Romifidine and Morphine Combination in Horses.
Journal of equine veterinary science    April 5, 2021   Volume 102 103459 doi: 10.1016/j.jevs.2021.103459
Natalini CC, Paes SD, Polydoro ADS.The study aim is to compare the effects of epidural administration of two different doses of romifidine combined with morphine in horses. A prospective crossover blinded experimental design was used. Five adult healthy horses two males and three females with a mean body weight of 380 ± 45 Kg (335-425 kg), were studied. Treatments consisted of romifidine 30 μg/kg (R30) or 60 μg/kg (R60) combined with morphine 0.1 mg/kg with a washout interval of 72 hours, administered through an epidural catheter placed at the first intercoccygeal space. Heart rate (HR) and respiratory rate (f), pH, blood ga...
Horse Preferences for Insolation, Shade or Mist Curtain in the Paddock under Heat Conditions: Cardiac and Behavioural Response Analysis.
Animals : an open access journal from MDPI    March 25, 2021   Volume 11, Issue 4 933 doi: 10.3390/ani11040933
Janczarek I, Stachurska A, Wilk I, Wiśniewska A, Różańska-Boczula M, Kaczmarek B, Łuszczyński J, Kędzierski W.The horse's welfare and, consequently, the emotional arousal may be connected with stressful environmental conditions. This study aimed to determine whether horses show behavioural or physiological symptoms of thermal discomfort and if their behaviour and cardiac parameters are related to freely chosen insolated (IS), shaded (SH), or water sprayed (with a mist curtain (MC)) areas in a paddock under heat conditions (29-32 °C, 42.0 ± 1.5% humidity). Twelve adult horses freely moving in the paddock were studied during a 45 min solitary turnout. Six cardiac variables, locomotor, and non-locomoto...
Quantification of left atrial contractile function using two-dimensional speckle tracking echocardiography in horses after conversion of atrial fibrillation to sinus rhythm.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    March 24, 2021   Volume 35 108-120 doi: 10.1016/j.jvc.2021.03.004
Eberhardt C, Schwarzwald CC.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...
Prevalence and characteristics of ventricular septal defects in a non-racehorse equine population (2008-2019).
Journal of veterinary internal medicine    March 20, 2021   Volume 35, Issue 3 1573-1581 doi: 10.1111/jvim.16106
De Lange L, Vera L, Decloedt A, Van Steenkiste G, Vernemmen I, van Loon G.Ventricular septal defects (VSDs) are the most common congenital cardiac defect in horses. Objective: To identify prevalence, age, breed, and sex distribution of VSD and to describe associated clinical and ultrasonographic findings. Methods: Hospital-based population of 21 136 horses presented to the equine internal medicine department. Methods: Medical records over a 12-year period were reviewed for VSD confirmed by ultrasonography. Age, breed, sex, sport discipline, murmur, clinical signs, outcome, VSD type, VSD size, shunt velocity, cardiac dimensions, concomitant cardiac anomalies, and v...
Exodontia associated bacteremia in horses characterized by next generation sequencing.
Scientific reports    March 18, 2021   Volume 11, Issue 1 6314 doi: 10.1038/s41598-021-85484-z
Townsend KS, Johnson PJ, LaCarrubba AM, Martin LM, Ericsson AC.Bacteremia resulting from dental surgery is increasingly recognized as a health risk, especially in older and immunocompromised patients. Dentistry-associated bacteremia can lead to remote infections, as exemplified by valvular endocarditis. Emerging evidence points to a novel role played by oral cavity commensals in the pathogenesis of diabetes, respiratory disease, cardiovascular disease, and adverse pregnancy outcomes. Whether dental extraction, a commonly undertaken procedure in old horses, causes bacteremia has not been reported extensively. In a prospective clinical study using next gene...
Transthoracic echocardiography and its limitations in the diagnosis of congenital supernumerary aortic valve in a Thoroughbred.
Veterinary medicine and science    March 13, 2021   Volume 9, Issue 2 712-716 doi: 10.1002/vms3.472
Vitale V, Laurberg M, van Galen G.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...
Morphological variability of the atrioventricular valve cusps in the equine heart.
Equine veterinary journal    March 10, 2021   Volume 54, Issue 1 167-175 doi: 10.1111/evj.13434
De Silva M, Tagliavia C, Galiazzo G, Gifuni G, Caiazza M, Chiocchetti R, Grandis A.The morphometric studies of the atrioventricular valves are still limited in the horse. Objective: To investigate the anatomy of the atrioventricular valves in the horse, focusing on the morphometric features of the valvular leaflets and the tendinous cords. We hypothesised that accessory leaflets occur commonly and exist as independent structures in the atrioventricular valves of the horse. Methods: Descriptive anatomical study. Methods: Twenty normal hearts from slaughtered half-bred horses were used. The cardiac weight and circumference were recorded. The atrioventricular valves were expose...
Single-Chamber Cardiac Pacemaker Implantation in a Donkey with Complete AV Block: A Long-Term Follow-Up.
Animals : an open access journal from MDPI    March 9, 2021   Volume 11, Issue 3 746 doi: 10.3390/ani11030746
Sedlinská M, Kabeš R, Novák M, Kološ F, Melková P.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 ...
Heart Rate and Heart Rate Variability of Amateur Show Jumping Horses Competing on Different Levels.
Animals : an open access journal from MDPI    March 4, 2021   Volume 11, Issue 3 doi: 10.3390/ani11030693
Szabó C, Vizesi Z, Vincze A.Heart rate is one of the gold standards used to assess the workload level and fitness of horses. However, when slight differences need to be detected, it is not sensitive enough. Therefore, the aim of this study was to test the effect of competition level and phase of exercise on the heart rate and heart rate variability parameters in show jumpers. Fourteen horses were examined competing on three different levels: 100 cm (n = 4), 120 cm (n = 6), and 130 cm (n = 4). The length of work (min); average and maximum heart rate; average, maximum and minimum RR intervals (ms); SD1 and SD2 (ms); RMSSD ...
Evaluation of electrocardiographic repolarization parameters after administration of trimethoprim-sulfadiazine, detomidine, or their combination in horses.
American journal of veterinary research    February 26, 2021   Volume 82, Issue 3 207-217 doi: 10.2460/ajvr.82.3.207
Trachsel DS, Calloe K, J Rgensen E, Lunddahl CS, Pedersen PJ, Kanters JRK, Klaerke DA, Buhl R.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.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    February 24, 2021   Volume 35 14-24 doi: 10.1016/j.jvc.2021.02.002
Rossi TM, Kavsak PA, Maxie MG, Pearl DL, Pyle WG, Physick-Sheard PW.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...
Four weeks of high-intensity training in moderate, but not mild hypoxia improves performance and running economy more than normoxic training in horses.
Physiological reports    February 22, 2021   Volume 9, Issue 4 e14760 doi: 10.14814/phy2.14760
Mukai K, Ohmura H, Takahashi Y, Kitaoka Y, Takahashi T.We investigated whether horses trained in moderate and mild hypoxia demonstrate greater improvement in performance and aerobic capacity compared to horses trained in normoxia and whether the acquired training effects are maintained after 2 weeks of post-hypoxic training in normoxia. Seven untrained Thoroughbred horses completed 4 weeks (3 sessions/week) of three training protocols, consisting of 2-min cantering at 95% maximal oxygen consumption under two hypoxic conditions (H16, F O  = 16%; H18, F O  = 18%) and in normoxia (N21, F O  = 21%), followed by 2 weeks of post-hypoxic traini...
Morphometric analysis of cardiac conduction fibers in horses and dogs, a comparative histological and immunohistochemical study with findings in human hearts.
Research in veterinary science    February 16, 2021   Volume 135 200-216 doi: 10.1016/j.rvsc.2021.02.013
Gómez-Torres FA, Estupiñán HY, Ruíz-Saurí A.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 ...
Real-time three-dimensional echocardiography for left atrial volume assessment in Thoroughbred racehorses: Observer variability and comparison with two-dimensional echocardiography.
Equine veterinary journal    February 15, 2021   Volume 54, Issue 1 176-190 doi: 10.1111/evj.13408
Worsman FCF, Miller ZJ, Shaw DJ, Blissitt KJ, Keen JA.Left atrial size predicts cardiac morbidity and mortality in humans and dogs. Real-time three-dimensional echocardiography (3DE) may be reliable for assessing left atrial volume (LAV) in horses. Objective: To determine intra- and interobserver variability estimates of 3DE-LAV and compare it to that of 2DE-LAV estimates. Methods: Method comparison. Methods: 3DE datasets were obtained from 40 horses, then graded for quality, creating a final study population of 22 horses. The 3DE and 2DE maximum LAV (LAV ) and minimum LAV (LAV ) were measured, and left atrial emptying volume (LA EV) and left atr...
Comparison of intraoperative cardiorespiratory and behavioral responses to medetomidine combined with tramadol or butorphanol during standing laparoscopic ovariectomy in horses.
The Journal of veterinary medical science    February 11, 2021   Volume 83, Issue 4 643-647 doi: 10.1292/jvms.20-0397
Kim A, Sasaki N, Lee I, Seo JP.The purpose of this study was to assess the cardiorespiratory and behavioral responses to the combination of medetomidine and tramadol (M-T) or butorphanol (M-B) in standing laparoscopic ovariectomy in horses. One ovary was removed under M-T and the contralateral ovary was removed under M-B with at least 4 weeks between operations at random. Horses were sedated using intravenous medetomidine (5 µg/kg) followed by tramadol (1 mg/kg) or butorphanol (10 µg/kg) after 5 min. Sedation was maintained through the repeated injection of medetomidine (1 µg/kg) and tramadol (0.4 mg/kg) or medetomidine ...
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.
Frontiers in physiology    February 9, 2021   Volume 12 614483 doi: 10.3389/fphys.2021.614483
Fenner MF, Gatta G, Sattler S, Kuiper M, Hesselkilde EM, Adler DMT, Smerup M, Schotten U, Sørensen U, Diness JG, Jespersen T, Verheule S....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.
Equine veterinary journal    January 20, 2021   Volume 53, Issue 6 1210-1217 doi: 10.1111/evj.13413
Vernemmen I, Vera L, Van Steenkiste G, Deserranno B, Muylle S, Decloedt A, van Loon G.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.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    January 11, 2021   Volume 34 73-79 doi: 10.1016/j.jvc.2021.01.001
Van Steenkiste G, Carlson J, Decloedt A, Vera L, Buhl R, Platonov PG, van Loon G.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...
External Loading Characteristics of Polo Ponies and Corresponding Player Heart Rate Responses in 16-Goal Polo.
Journal of equine veterinary science    January 7, 2021   Volume 98 103368 doi: 10.1016/j.jevs.2020.103368
Best R, Standing R.When compared with other equestrian sports, Polo players engage in a high number of player-pony interactions. To ensure optimal performance of the player-pony dyad, an understanding of the workloads performed by each pony and the physiological cost placed on the rider are required. This investigation examined the relationship and interaction between Polo pony performance (speeds attained, distance covered, and movements performed) and the corresponding heart rate responses in Polo players, within and between games across a 16-goal Polo tournament. Descriptive statistics revealed Polo is played...
Atrial fibrillation in horses Part 2: Diagnosis, treatment and prognosis.
Veterinary journal (London, England : 1997)    December 22, 2020   Volume 268 105594 doi: 10.1016/j.tvjl.2020.105594
Decloedt A, Van Steenkiste G, Vera L, Buhl R, van Loon G.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...
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