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Equine veterinary journal2021; 54(2); 262-282; doi: 10.1111/evj.13518

Fundamentals of arrhythmogenic mechanisms and treatment strategies for equine atrial fibrillation.

Abstract: 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 and documentation methods such as cardiac mapping, implantable electrocardiogram (ECG) recording devices or computer-based ECG analysis that will hopefully improve our understanding of this disease. The available pharmaceutical and electrophysiological treatments have good efficacy and lead to a good prognosis for AF, but recurrence is a frequent issue that veterinarians have to face. This review aims to summarise our current understanding of equine cardiac electrophysiology and pathophysiology of equine AF while providing an overview of the mechanism of action for currently available treatments for equine AF.
© 2021 EVJ Ltd.
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Publication Date: 2021-10-21 PubMed ID: 34564902DOI: 10.1111/evj.13518Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article discusses atrial fibrillation (AF), the most common arrhythmia in horses, highlighting the various factors influencing its manifestation, the diagnostic methods and the available treatment options. The study emphasizes the progress made in equine cardiac electrophysiology and hopes to better our understanding of AF in horses, while also shedding light on the mechanisms of currently used treatments.

Understanding Atrial Fibrillation in Horses

  • This article starts by noting that AF is a prevalent issue in horses, affecting their performance and making them unsafe to ride.
  • The disease is complex and multifactorial, meaning it’s influenced by multiple factors. These include genetic predispositions, environmental factors like extended periods of exercise training, associated health conditions and the overall ageing process.
  • The intricacies of how these factors interact and contribute to AF in horses is not fully understood. Similarly, the pathophysiology, or the way the disease alters the normal functioning of hearts, remains ill-defined.

Progress in Diagnosis and Documentation

  • The field of equine cardiac electrophysiology, which studies the electric activities of the heart, has seen significant advancements. These facilities better diagnosis and documentation of the condition.
  • New methods such as cardiac mapping, which helps understand the electrical system of the heart, and implantable ECG recording devices, which monitor the heart’s electrical activity over time, have brought about better understanding and management of AF.
  • Computer-based ECG analysis is another advanced tool mentioned in the study that enhances the diagnosis process.

Treatment Strategies for Equine Atrial Fibrillation

  • Several treatment options exist with satisfactory efficacy and good prognosis, including pharmaceutics and electrophysiological procedures. However, recurrence continues to be a common problem that veterinarians need to address.
  • The review further aims to sum up the current understanding of equine cardiac electrophysics while offering an overview of how the current treatments work.

Cite This Article

APA
Premont A, Balthes S, Marr CM, Jeevaratnam K. (2021). Fundamentals of arrhythmogenic mechanisms and treatment strategies for equine atrial fibrillation. Equine Vet J, 54(2), 262-282. https://doi.org/10.1111/evj.13518

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 54
Issue: 2
Pages: 262-282

Researcher Affiliations

Premont, Antoine
  • Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
Balthes, Samantha
  • Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
Marr, Celia M
  • Rossdales Equine Hospital and Diagnostic Centre, Newmarket, UK.
Jeevaratnam, Kamalan
  • Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.

MeSH Terms

  • Animals
  • Atrial Fibrillation / therapy
  • Atrial Fibrillation / veterinary
  • Electric Countershock / veterinary
  • Electrocardiography
  • Horse Diseases / diagnosis
  • Horse Diseases / therapy
  • Horses

References

This article includes 207 references
  1. Haqqani HM, Chan KH, Gregory AT, Denniss AR. Atrial fibrillation: state of the art in 2017 - shifting paradigms in pathogenesis, diagnosis, treatment and prevention.. Heart Lung Circ 2017;26:867-9.
  2. van Loon G. Cardiac arrhythmias in horses.. Vet Clin North Am Equine Pract 2019;35:85-102.
  3. van Loon G. Dysrhythmias.. In: Marr CM, Bowen IM, editor. Cardiology of the Horse. Edinburgh: W.B. Saunders. 2010; p. 179-92.
  4. Poole D. Cardiovascular function and oxygen transport: responses to exercise and training.. In: Hinchcliff KW, Geor RJ, Kaneps AJ, editors. Equine Exercise Physiology. Edinburgh: W.B. Saunders. 1988; p. 212-45.
  5. Decloedt A, Schwarzwald CC, De Clercq D, Van Der Vekens N, Pardon B, Reef VB. Risk factors for recurrence of atrial fibrillation in horses after cardioversion to sinus rhythm.. J Vet Intern Med 2015;29:946-53.
  6. Verheyen T, Decloedt A, van der Vekens N, Sys S, De Clercq D, van Loon G. Ventricular response during lungeing exercise in horses with lone atrial fibrillation.. Equine Vet J 2013;45:309-14.
  7. Chope KB. Cardiac/cardiovascular conditions affecting sport horses.. Vet Clin North Am Equine Pract 2018;34:409-25.
  8. Ohmura H, Hiraga A, Takahashi T, Kai M, Jones JH. Risk factors for atrial fibrillation during racing in slow-finishing horses.. J Am Vet Med Assoc 2003;223:84-8.
  9. Durando MM. Cardiovascular causes of poor performance and exercise intolerance and assessment of safety in the equine athlete.. Vet Clin North Am Equine Pract 2019;35:175-90.
  10. Buhl R, Carstensen H, Hesselkilde EZ, Klein BZ, Hougaard KM, Ravn KB. Effect of induced chronic atrial fibrillation on exercise performance in Standardbred trotters.. J Vet Intern Med 2018;32:1410-9.
  11. Reef VB, Bonagura J, Buhl R, McGurrin MK, Schwarzwald CC, van Loon G. Recommendations for management of equine athletes with cardiovascular abnormalities.. J Vet Intern Med 2014;28:749-61.
  12. McGurrin MKJ. The diagnosis and management of atrial fibrillation in the horse.. Vet Med (Auckl) 2015;6:83-90.
  13. Lau DH, Schotten U, Mahajan R, Antic NA, Hatem SN, Pathak RK. Novel mechanisms in the pathogenesis of atrial fibrillation: practical applications.. Eur Heart J 2016;37:1573-81.
  14. Katz AM. Physiology of the Heart.. Philadelphia, United States: Wolters Kluwer Health; 2010.
  15. Haugaard MM, Hesselkilde EZ, Pehrson S, Carstensen H, Flethoj M, Praestegaard KF. Pharmacologic inhibition of small-conductance calcium-activated potassium (SK) channels by NS8593 reveals atrial antiarrhythmic potential in horses.. Heart Rhythm 2015;12:825-35.
  16. Hesselkilde EZ, Carstensen H, Flethoj M, Fenner M, Kruse DD, Sattler SM. Longitudinal study of electrical, functional and structural remodelling in an equine model of atrial fibrillation.. BMC Cardiovasc Disord 2019;19:228.
  17. Finley MR, Li Y, Hua F, Lillich J, Mitchell KE, Ganta S. Expression and coassociation of ERG1, KCNQ1, and KCNE1 potassium channel proteins in horse heart.. Am J Physiol Heart Circ Physiol 2002;283:H126-38.
  18. Pedersen PJ, Thomsen KB, Flak JB, Tejada MA, Hauser F, Trachsel D. Molecular cloning and functional expression of the K(+) channel KV7.1 and the regulatory subunit KCNE1 from equine myocardium.. Res Vet Sci 2017;113:79-86.
  19. Pedersen PJ, Thomsen KB, Olander ER, Hauser F, Tejada Mde L, Poulsen KL. Molecular cloning and functional expression of the equine K+ channel KV11.1 (Ether a Go-Go-Related/KCNH2 Gene) and the regulatory subunit KCNE2 from equine myocardium.. PLoS One 2015;10:e0138320.
  20. Li M, Chadda KR, Matthews GDK, Marr CM, Huang CL, Jeevaratnam K. Cardiac electrophysiological adaptations in the equine athlete-restitution analysis of electrocardiographic features.. PLoS One 2018;13:e0194008.
  21. Huang CL. Murine electrophysiological models of cardiac arrhythmogenesis.. Physiol Rev 2017;97:283-409.
  22. Chadda KR, Jeevaratnam K, Lei M, Huang CL. Sodium channel biophysics, late sodium current and genetic arrhythmic syndromes.. Pflugers Arch 2017;469:629-41.
  23. Nerbonne JM, Kass RS. Molecular physiology of cardiac repolarization.. Physiol Rev 2005;85:1205-53.
  24. Bodi I, Mikala G, Koch SE, Akhter SA, Schwartz A. The L-type calcium channel in the heart: the beat goes on.. J Clin Invest 2005;115:3306-17.
  25. Richards MA, Clarke JD, Saravanan P, Voigt N, Dobrev D, Eisner DA. Transverse tubules are a common feature in large mammalian atrial myocytes including human.. Am J Physiol Heart Circ Physiol 2011;301:H1996-2005.
  26. Fill M, Copello JA. Ryanodine receptor calcium release channels.. Physiol Rev 2002;82:893-922.
  27. Bers DM. Cardiac excitation-contraction coupling.. Nature 2002;415:198-205.
  28. Schotten U, Verheule S, Kirchhof P, Goette A. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal.. Physiol Rev 2011;91:265-325.
  29. Melnyk P, Ehrlich JR, Pourrier M, Villeneuve L, Cha TJ, Nattel S. Comparison of ion channel distribution and expression in cardiomyocytes of canine pulmonary veins versus left atrium.. Cardiovasc Res 2005;65:104-16.
  30. Ehrlich JR, Cha TJ, Zhang L, Chartier D, Melnyk P, Hohnloser SH. Cellular electrophysiology of canine pulmonary vein cardiomyocytes: action potential and ionic current properties.. J Physiol 2003;551:801-13.
  31. Feng J, Yue L, Wang Z, Nattel S. Ionic mechanisms of regional action potential heterogeneity in the canine right atrium.. Circ Res 1998;83:541-51.
  32. Burashnikov A, Mannava S, Antzelevitch C. Transmembrane action potential heterogeneity in the canine isolated arterially perfused right atrium: effect of IKr and IKur/Ito block.. Am J Physiol Heart Circ Physiol 2004;286:H2393-400.
  33. De Clercq D, Broux B, Vera L, Decloedt A, van Loon G. Measurement variability of right atrial and ventricular monophasic action potential and refractory period measurements in the standing non-sedated horse.. BMC Vet Res 2018;14:101.
  34. Amin AS, Tan HL, Wilde AA. Cardiac ion channels in health and disease.. Heart Rhythm 2010;7:117-26.
  35. Glover BM, Brugada P. Clinical Handbook of Cardiac Electrophysiology, 1st ed. 2016 edn.. Switzerland: Springer International Publishing; 2016.
  36. van Loon G, Patteson M. Electrophysiology and arrhythmogenesis.. In: Marr CM, Bowen IM, editors. Cardiology of the Horse. Edinburgh: W.B. Saunders. 2010; p. 59-73.
  37. Joyner RW, Wilders R, Wagner MB. Propagation of pacemaker activity.. Med Biol Eng Comput 2007;45:177-87.
  38. Kurtenbach S, Kurtenbach S, Zoidl G. Gap junction modulation and its implications for heart function.. Front Physiol 2014;5:82.
  39. Vandevelde K, van den Broeck W, Wang N, Vandecasteele T, van Loon G. Connexines in the horse heart.. 31st Conference of the European Association of Veterinary Anatomists. Vienna: Austria; 2016. p. 88-9.
  40. Dhein S, Seidel T, Salameh A, Jozwiak J, Hagen A, Kostelka M. Remodeling of cardiac passive electrical properties and susceptibility to ventricular and atrial arrhythmias.. Front Physiol 2014;5:424.
  41. Takla M, Huang CL, Jeevaratnam K. The cardiac CaMKII-Nav1.5 relationship: from physiology to pathology.. J Mol Cell Cardiol 2020;139:190-200.
  42. Herfst LJ, Rook MB, Jongsma HJ. Trafficking and functional expression of cardiac Na+ channels.. J Mol Cell Cardiol 2004;36:185-93.
  43. Sorgen PL, Trease AJ, Spagnol G, Delmar M, Nielsen MS. Protein(-)protein interactions with connexin 43: regulation and function.. Int J Mol Sci 2018;19:1428.
  44. Wit AL. Afterdepolarizations and triggered activity as a mechanism for clinical arrhythmias.. PACE 2018;41:883-96.
  45. Heijman J, Voigt N, Nattel S, Dobrev D. Cellular and molecular electrophysiology of atrial fibrillation initiation, maintenance, and progression.. Circ Res 2014;114:1483-99.
  46. Coumel P. Autonomic influences in atrial tachyarrhythmias.. J Cardiovasc Electrophysiol 1996;7:999-1007.
  47. Coote JH. Myths and realities of the cardiac vagus.. J Physiol 2013;591:4073-85.
  48. Rardon DP, Bailey JC. Parasympathetic effects on electrophysiologic properties of cardiac ventricular tissue.. J Am Coll Cardiol 1983;2:1200-9.
  49. Zhang Y, Mazgalev TN. Arrhythmias and vagus nerve stimulation.. Heart Fail Rev 2011;16:147-61.
  50. Burashnikov A, Antzelevitch C. Late-phase 3 EAD. A unique mechanism contributing to initiation of atrial fibrillation.. PACE 2006;29:290-5.
  51. Navas de Solis C. Exercising arrhythmias and sudden cardiac death in horses: review of the literature and comparative aspects.. Equine Vet J 2016;48:406-13.
  52. Durando M. Exercise and stress testing.. In: Marr CM, Bowen IM, editors. Cardiology of the Horse. Edinburgh: W.B. Saunders. 2010; p. 139-49.
  53. Littlejohn A, Kruger M, Button C, Hill G, Atkins R. Atrial fibrillation in horses during exercise.. Vet Rec 1973;93:446-7.
  54. Huang X, Kim TY, Koren G, Choi BR, Qu Z. Spontaneous initiation of premature ventricular complexes and arrhythmias in type 2 long QT syndrome.. Am J Physiol Heart Circ Physiol 2016;311:H1470-84.
  55. Xie Y, Sato D, Garfinkel A, Qu Z, Weiss JN. So little source, so much sink: requirements for afterdepolarizations to propagate in tissue.. Biophys J 2010;99:1408-15.
  56. Smaill BH, Zhao J, Trew ML. Three-dimensional impulse propagation in myocardium: arrhythmogenic mechanisms at the tissue level.. Circ Res 2013;112:834-48.
  57. Lau DH, Linz D, Schotten U, Mahajan R, Sanders P, Kalman JM. Pathophysiology of paroxysmal and persistent atrial fibrillation: rotors, foci and fibrosis.. Heart Lung Circ 2017;26:887-93.
  58. Moe GK. A conceptual model of atrial fibrillation.. J Electrocardiol 1968;1:145-6.
  59. Moe GK, Abildskov JA. Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge.. Am Heart J 1959;58:59-70.
  60. Moe GK, Rheinboldt WC, Abildskov JA. A computer model of atrial fibrillation.. Am Heart J 1964;67:200-20.
  61. Van Steenkiste G, De Clercq D, Boussy T, Vera L, Schauvliege S, Decloedt A. Three dimensional ultra-high-density electro-anatomical cardiac mapping in horses: methodology.. Equine Vet J 2020;52:765-72.
  62. Hesselkilde E, Linz D, Saljic A, Carstensen H, Kutieleh R, Jespersen T. First catheter-based high-density endocardial 3D electroanatomical mapping of the right atrium in standing horses.. Equine Vet J 2020;53:186-93.
  63. Linz D, Hesselkilde E, Kutieleh R, Jespersen T, Buhl R, Sanders P. Pulmonary vein firing initiating atrial fibrillation in the horse: oversized dimensions but similar mechanisms.. J Cardiovasc Electrophysiol 2020;31:1211-2.
  64. Alexeenko V, Fraser JA, Dolgoborodov A, Bowen M, Huang CL, Marr CM. The application of Lempel-Ziv and Titchener complexity analysis for equine telemetric electrocardiographic recordings.. Sci Rep 2019;9:2619.
  65. Alexeenko V, Fraser JA, Bowen M, Huang CL, Marr CM, Jeevaratnam K. The complexity of clinically-normal sinus-rhythm ECGs is decreased in equine athletes with a diagnosis of paroxysmal atrial fibrillation.. Sci Rep 2020;10:6822.
  66. Van Steenkiste G, van Loon G, Crevecoeur G. Transfer learning in ECG classification from human to horse using a novel parallel neural network architecture.. Sci Rep 2020;10:186.
  67. Schwarzwald CC. Equine echocardiography.. Vet Clin North Am Equine Pract 2019;35:43-64.
  68. De Clercq D, Decloedt A, Sys SU, Verheyen T, Van Der Vekens N, van Loon G. Atrial fibrillation cycle length and atrial size in horses with and without recurrence of atrial fibrillation after electrical cardioversion.. J Vet Intern Med 2014;28:624-9.
  69. Decloedt A, de Clercq D, van der Vekens N, Verheyen T, van Loon G. Noninvasive determination of atrial fibrillation cycle length by atrial colour tissue Doppler imaging in horses.. Equine Vet J 2014;46:174-9.
  70. Patterson E, Jackman WM, Beckman KJ, Lazzara R, Lockwood D, Scherlag BJ. Spontaneous pulmonary vein firing in man: relationship to tachycardia-pause early afterdepolarizations and triggered arrhythmia in canine pulmonary veins in vitro.. J Cardiovasc Electrophysiol 2007;18:1067-75.
  71. Hocini M, Ho SY, Kawara T, Linnenbank AC, Potse M, Shah D. Electrical conduction in canine pulmonary veins: electrophysiological and anatomic correlation.. Circulation 2002;105:2442-8.
  72. Vandecasteele T, van Loon G, Vandevelde K, De Pauw B, Simoens P, Cornillie P. Topography and ultrasonographic identification of the equine pulmonary vein draining pattern.. Vet J 2016;210:17-23.
  73. Vandecasteele T, Van Den Broeck W, Tay H, Couck L, van Loon G, Cornillie P. 3D reconstruction of the porcine and equine pulmonary veins, supplemented with the identification of telocytes in the horse.. Anat Histol Embryol 2018;47:145-52.
  74. Vandecasteele T, Cornillie P, van Steenkiste G, Vandevelde K, Gielen I, Vanderperren K. Echocardiographic identification of atrial-related structures and vessels in horses validated by computed tomography of casted hearts.. Equine Vet J 2019;51:90-6.
  75. Waldo AL. From bedside to bench: entrainment and other stories.. Heart Rhythm 2004;1:94-106.
  76. Allessie MA, Bonke FI, Schopman FJ. Circus movement in rabbit atrial muscle as a mechanism of tachycardia. II. The role of nonuniform recovery of excitability in the occurrence of unidirectional block, as studied with multiple microelectrodes.. Circ Res 1976;39:168-77.
  77. Comtois P, Kneller J, Nattel S. Of circles and spirals: bridging the gap between the leading circle and spiral wave concepts of cardiac reentry.. Europace 2005;7(Suppl 2):10-20.
  78. Hamlin RL, Klepinger WL, Gilpin KW, Smith CR. Autonomic control of heart rate in the horse.. Am J Physiol 1972;222:976-8.
  79. de Vos CB, Nieuwlaat R, Crijns HJ, Camm AJ, LeHeuzey JY, Kirchhof CJ. Autonomic trigger patterns and anti-arrhythmic treatment of paroxysmal atrial fibrillation: data from the Euro Heart Survey.. Eur Heart J 2008;29:632-9.
  80. Calo L, De Ruvo E, Sette A, Sciarra L, Scioli R, Sebastiani F. Tachycardia-induced cardiomyopathy: mechanisms of heart failure and clinical implications.. J Cardiovasc Med (Hagerstown) 2007;8:138-43.
  81. Reef VB, Levitan CW, Spencer PA. Factors affecting prognosis and conversion in equine atrial fibrillation.. J Vet Intern Med 1988;2:1-6.
  82. Morris DD, Fregin GF. Atrial fibrillation in horses: factors associated with response to quinidine sulfate in 77 clinical cases.. Cornell Vet 1982;72:339-49.
  83. Reef VB, Reimer JM, Spencer PA. Treatment of atrial fibrillation in horses: new perspectives.. J Vet Intern Med 1995;9:57-67.
  84. Ferrari R, Bertini M, Blomstrom-Lundqvist C, Dobrev D, Kirchhof P, Pappone C. An update on atrial fibrillation in 2014: from pathophysiology to treatment.. Int J Cardiol 2016;203:22-9.
  85. Slack J, Boston RC, Soma LR, Reef VB. Occurrence of cardiac arrhythmias in Standardbred racehorses.. Equine Vet J 2015;47:398-404.
  86. Vezzosi T, Sgorbini M, Bonelli F, Buralli C, Pillotti M, Meucci V. Evaluation of a smartphone electrocardiograph in healthy horses: comparison with standard base-apex electrocardiography.. J Equine Vet Sci 2018;67:61-5.
  87. Kraus MS, Rishniw M, Divers TJ, Reef VB, Gelzer AR. Utility and accuracy of a smartphone-based electrocardiogram device as compared to a standard base-apex electrocardiogram in the horse.. Res Vet Sci 2019;125:141-7.
  88. Gallant LR, Jacob SI, Tadros EM, Woodrow JS, Hines MT, Ewart SL. Rapid screening for cardiac arrhythmias in competition draft horses.. Comp Exerc Physiol 2019;15:291-8.
  89. Buhl R, Hesselkilde EM, Carstensen H, Fenner MF, Jespersen T, Tfelt-Hansen J. Detection of atrial fibrillation with implantable loop recorders in horses.. Equine Vet J 2020;53:397-403.
  90. Buhl R, Nissen SD, Winther MLK, Poulsen SK, Hopster-Iversen C, Jespersen T. Implantable Loop Recorders can detect paroxysmal atrial fibrillation in Standardbred racehorses with intermittent poor performance.. Equine Vet J 2021;53:955-963.
  91. Ehrlich JR, Cha TJ, Zhang L, Chartier D, Villeneuve L, Hebert TE. Characterization of a hyperpolarization-activated time-dependent potassium current in canine cardiomyocytes from pulmonary vein myocardial sleeves and left atrium.. J Physiol 2004;557:583-97.
  92. Yue L, Feng J, Gaspo R, Li GR, Wang Z, Nattel S. Ionic remodeling underlying action potential changes in a canine model of atrial fibrillation.. Circ Res 1997;81:512-25.
  93. Yue L, Melnyk P, Gaspo R, Wang Z, Nattel S. Molecular mechanisms underlying ionic remodeling in a dog model of atrial fibrillation.. Circ Res 1999;84:776-84.
  94. Vest JA, Wehrens XH, Reiken SR, Lehnart SE, Dobrev D, Chandra P. Defective cardiac ryanodine receptor regulation during atrial fibrillation.. Circulation 2005;111:2025-32.
  95. De Clercq D, van Loon G, Tavernier R, Duchateau L, Deprez P. Atrial and ventricular electrical and contractile remodeling and reverse remodeling owing to short-term pacing-induced atrial fibrillation in horses.. J Vet Intern Med 2008;22:1353-9.
  96. Ausma J, Litjens N, Lenders MH, Duimel H, Mast F, Wouters L. Time course of atrial fibrillation-induced cellular structural remodeling in atria of the goat.. J Mol Cell Cardiol 2001;33:2083-94.
  97. Else RW, Holmes JR. Pathological changes in atrial fibrillation in the horse.. Equine Vet J 1971;3:56-64.
  98. Kiryu K, Kaneko M, Oikawa M, Kanemaru T, Yoshihara T, Satoh H. Histopathogenesis of atrial fibrillation in the horse : cardiopathology of an additional case.. Experiment Rep Equine Health Lab 1977;54-63.
  99. Kiryu K, Amada A, Kaneko M, Satoh H. Atrial fibrillation in the horse: clinical and histopathological studies of two cases II. Formal pathogenesis.. Experiment Rep Equine Health Lab 1974;1974:70-86.
  100. Allessie M, Ausma J, Schotten U. Electrical, contractile and structural remodeling during atrial fibrillation.. Cardiovasc Res 2002;54:230-46.
  101. Luo MH, Li YS, Yang KP. Fibrosis of collagen I and remodeling of connexin 43 in atrial myocardium of patients with atrial fibrillation.. Cardiology 2007;107:248-53.
  102. Lim HS, Hocini M, Dubois R, Denis A, Derval N, Zellerhoff S. Complexity and distribution of drivers in relation to duration of persistent atrial fibrillation.. J Am Coll Cardiol 2017;69:1257-69.
  103. Ninio DM, Saint DA. The role of stretch-activated channels in atrial fibrillation and the impact of intracellular acidosis.. Prog Biophys Mol Biol 2008;97:401-16.
  104. Kakkar R, Lee RT. Intramyocardial fibroblast myocyte communication.. Circ Res 2010;106:47-57.
  105. Dawson K, Wakili R, Ordog B, Clauss S, Chen Y, Iwasaki Y. MicroRNA29: a mechanistic contributor and potential biomarker in atrial fibrillation.. Circulation 2013;127:1466-75, 1475e1461-1428.
  106. Zhou X, Dobrev D. Voltage-gated Na(+) channels: novel players in fibroblast-to-myofibroblast transition with a potential role in atrial arrhythmogenesis?. J Physiol 2012;590:4975.
  107. Decloedt A, Verheyen T, Van Der Vekens N, Sys S, De Clercq D, van Loon G. Long-term follow-up of atrial function after cardioversion of atrial fibrillation in horses.. Vet J 2013;197:583-8.
  108. Schwarzwald CC, Schober KE, Bonagura JD. Echocardiographic evidence of left atrial mechanical dysfunction after conversion of atrial fibrillation to sinus rhythm in 5 horses.. J Vet Intern Med 2007;21:820-7.
  109. Decloedt A, Van Steenkiste G, Vera L, Buhl R, van Loon G. Atrial fibrillation in horses part 1: pathophysiology.. Vet J 2020;263:105521.
  110. Wyse DG, Van Gelder IC, Ellinor PT, Go AS, Kalman JM, Narayan SM. Lone atrial fibrillation: does it exist?. J Am Coll Cardiol 2014;63:1715-23.
  111. Deem DA, Fregin GF. Atrial fibrillation in horses: a review of 106 clinical cases, with consideration of prevalence, clinical signs, and prognosis.. J Am Vet Med Assoc 1982;180:261-5.
  112. Reef VB, Bain FT, Spencer PA. Severe mitral regurgitation in horses: clinical, echocardiographic and pathological findings.. Equine Vet J 1998;30:18-27.
  113. Else RW, Holmes JR. Cardiac pathology in the horse. 1. Gross pathology.. Equine Vet J 1972;4:1-8.
  114. Miller PJ, Holmes JR. Observations on seven cases of mitral insufficiency in the horse.. Equine Vet J 1985;17:181-90.
  115. Kriz NG, Hodgson DR, Rose RJ. Changes in cardiac dimensions and indices of cardiac function during deconditioning in horses.. Am J Vet Res 2000;61:1553-60.
  116. Gehlen H, Haubold A, Stadler P. Reference values for echocardiographic parameters of trained and untrained Icelandic horses.. Dtsch Tierarztl Wochenschr 2007;114:374-7.
  117. Trachsel DS, Giraudet A, Maso D, Herve G, Hauri DD, Barrey E. Relationships between body dimensions, body weight, age, gender, breed and echocardiographic dimensions in young endurance horses.. BMC Vet Res 2016;12:226.
  118. Lightfoot G, Jose-Cunilleras E, Rogers K, Newton JR, Young LE. An echocardiographic and auscultation study of right heart responses to training in young national hunt thoroughbred horses.. Equine Vet J 2006;38(S36):153-8.
  119. Buhl R, Ersboll AK. Echocardiographic evaluation of changes in left ventricular size and valvular regurgitation associated with physical training during and after maturity in Standardbred trotters.. J Am Vet Med Assoc 2012;240:205-12.
  120. Young LE. Cardiac responses to training in 2-year-old thoroughbreds: an echocardiographic study.. Equine Vet J 1999;31(S30):195-8.
  121. Young LE, Wood JL. Effect of age and training on murmurs of atrioventricular valvular regurgitation in young thoroughbreds.. Equine Vet J 2000;32:195-9.
  122. Physick-Sheard P, Kraus M, Basrur P, McGurrin K, Kenney D, Schenkel F. Breed predisposition and heritability of atrial fibrillation in the Standardbred horse: a retrospective case-control study.. J Vet Cardiol 2014;16:173-84.
  123. Chung MK, Youn Wass SJ, Barnard J. Insights from atrial fibrillation genomics: from bedside to bench and back again.. Cardiol Rev 2019;27:302-7.
  124. Kraus M, Physick-Sheard P, Brito LF, Sargolzaei M, Schenkel FS. Marginal ancestral contributions to atrial fibrillation in the Standardbred racehorse: comparison of cases and controls.. PLoS One 2018;13:e0197137.
  125. Kraus M, Physick-Sheard PW, Brito LF, Schenkel FS. Estimates of heritability of atrial fibrillation in the Standardbred racehorse.. Equine Vet J 2017;49:718-22.
  126. Ntalla I, Weng LC, Cartwright JH, Hall AW, Sveinbjornsson G, Tucker NR. Multi-ancestry GWAS of the electrocardiographic PR interval identifies 202 loci underlying cardiac conduction.. Nat Commun 2020;11:2542.
  127. van Ouwerkerk AF, Bosada FM, van Duijvenboden K, Hill MC, Montefiori LE, Scholman KT. Identification of atrial fibrillation associated genes and functional non-coding variants.. Nat Commun 2019;10:4755.
  128. Vlachos K, Mascia G, Martin CA, Bazoukis G, Frontera A, Cheniti G. Atrial fibrillation in Brugada syndrome: current perspectives.. J Cardiovasc Electrophysiol 2020;31:975-84.
  129. Platonov PG, McNitt S, Polonsky B, Rosero SZ, Zareba W. Atrial fibrillation in long QT syndrome by genotype.. Circ Arrhythm Electrophysiol 2019;12:e007213.
  130. Evans DL, Young LE. Cardiac responses to exercise and training.. In: Marr CM, Bowen IM, editors. Cardiology of the Horse. Edinburgh: W.B. Saunders. 2010; p. 35-47.
  131. Stergiou D, Duncan E. Atrial fibrillation (AF) in endurance athletes: a complicated affair.. Curr Treat Options Cardiovasc Med 2018;20:98.
  132. Turagam MK, Velagapudi P, Alpert MA. Does exercise cause atrial fibrillation?. Int J Cardiol 2015;181:245-6.
  133. Anderson R, Richardson GD, Passos JF. Mechanisms driving the ageing heart.. Exp Gerontol 2018;109:5-15.
  134. Boengler K, Kosiol M, Mayr M, Schulz R, Rohrbach S. Mitochondria and ageing: role in heart, skeletal muscle and adipose tissue.. J Cachexia Sarcopenia Muscle 2017;8:349-69.
  135. Chadda KR, Ahmad S, Valli H, den Uijl I, Al-Hadithi AB, Salvage SC. The effects of ageing and adrenergic challenge on electrocardiographic phenotypes in a murine model of long QT syndrome type 3.. Sci Rep 2017;7:11070.
  136. Edling CE, Fazmin IT, Chadda KR, Ahmad S, Valli H, Grace AA. Ageing in Pgc-1beta(-/-) mice modelling mitochondrial dysfunction induces differential expression of a range of genes regulating ventricular electrophysiology.. Biosci Rep 2019;39:BSR20190127.
  137. Edling CE, Fazmin IT, Saadeh K, Chadda KR, Ahmad S, Valli H. Molecular basis of arrhythmic substrate in ageing murine peroxisome proliferator-activated receptor gamma co-activator deficient hearts modelling mitochondrial dysfunction.. Biosci Rep 2019;39:BSR20190403.
  138. Leroux AA, Detilleux J, Sandersen CF, Borde L, Houben RM, Al Haidar A. Prevalence and risk factors for cardiac diseases in a hospital-based population of 3,434 horses (1994-2011).. J Vet Intern Med 2013;27:1563-70.
  139. McGurrin MK, Physick-Sheard PW, Kenney DG. Transvenous electrical cardioversion of equine atrial fibrillation: patient factors and clinical results in 72 treatment episodes.. J Vet Intern Med 2008;22:609-15.
  140. Takahashi Y, Ishikawa Y, Ohmura H. Treatment of recent-onset atrial fibrillation with quinidine and flecainide in Thoroughbred racehorses: 107 cases (1987-2014).. J Am Vet Med Assoc 2018;252:1409-14.
  141. Mascia G, Perrotta L, Galanti G, Padeletti L. Atrial fibrillation in athletes.. Int J Sports Med 2013;34:379-84.
  142. De Clercq D, van Loon G, Tavernier R, Verbesselt R, Deprez P. Use of propafenone for conversion of chronic atrial fibrillation in horses.. Am J Vet Res 2009;70:223-7.
  143. Decloedt A, Broux B, De Clercq D, Deprez P, Van Steenkiste G, Vera L. Effect of sotalol on heart rate, QT interval, and atrial fibrillation cycle length in horses with atrial fibrillation.. J Vet Intern Med 2018;32:815-21.
  144. Andrade JG, Macle L, Nattel S, Verma A, Cairns J. Contemporary atrial fibrillation management: a comparison of the current AHA/ACC/HRS, CCS, and ESC guidelines.. Can J Cardiol 2017;33:965-76.
  145. Macle L, Cairns J, Leblanc K, Tsang T, Skanes A, Cox JL. 2016 focused update of the canadian cardiovascular society guidelines for the management of atrial fibrillation.. Can J Cardiol 2016;32:1170-85.
  146. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS.. Eur Heart J 2016;37:2893-962.
  147. Rose RJ, Davis PE. Paroxysmal atrial fibrillation in a racehorse.. Aust Vet J 1977;53:545-9.
  148. Machida N, Yasuda J, Too K. Three cases of paroxysmal atrial fibrillation in the Thoroughbred newborn foal.. Equine Vet J 1989;21:66-8.
  149. Holmes JR, Henigan M, Williams RB, Witherington DH. Paroxysmal atrial fibrillation in racehorses.. Equine Vet J 1986;18:37-42.
  150. Navas de Solis C, Reef VB, Slack J, Jose-Cunilleras E. Evaluation of coagulation and fibrinolysis in horses with atrial fibrillation.. J Am Vet Med Assoc 2016;248:201-6.
  151. Glendinning SA. The use of quinidine sulphate for the treatment of atrial fibrillation in twelve horses.. Vet Rec 1965;77:951-60.
  152. Grace AA, Camm AJ. Quinidine.. N Engl J Med 1998;338:35-45.
  153. Vitali Serdoz L, Rittger H, Furlanello F, Bastian D. Quinidine-a legacy within the modern era of antiarrhythmic therapy.. Pharmacol Res 2019;144:257-63.
  154. Schwarzwald CC, Hamlin RL, Bonagura JD, Nishijima Y, Meadows C, Carnes CA. Atrial, SA nodal, and AV nodal electrophysiology in standing horses: normal findings and electrophysiologic effects of quinidine and diltiazem.. J Vet Intern Med 2007;21:166-75.
  155. Hondeghem LM. Antiarrhythmic agents: modulated receptor applications.. Circulation 1987;75:514-20.
  156. Bouckaert S, Voorspoels J, Vandenbossche G, Deprez P, Remon JP. Effect of drug formulation and feeding on the pharmacokinetics of orally administered quinidine in the horse.. J Vet Pharmacol Ther 1994;17:275-8.
  157. Frey HH, Grauerholz H, Kilian M, Wintzer HJ. Pharmacokinetics and tolerance of quinidine sulfact and dihydroquinidine gluconate in the horse and dog.. Berl Munch Tierarztl Wochenschr 1974;87:245-50.
  158. McGuirk SM, Muir WW, Sams RA. Pharmacokinetic analysis of intravenously and orally administered quinidine in horses.. Am J Vet Res 1981;42:938-42.
  159. McGurrin MKJ. New treatment modalities for atrial fibrillation.. Vet Tech 2008;29:239-41.
  160. Sleeper MM. Equine cardiovascular therapeutics.. Vet Clin North Am Equine Pract 2017;33:163-79.
  161. Lekeux P, Muylle E, Henroteaux M, Bienfet V. Comparison of different treatments of atrial fibrillation in the horse.. Zentralbl Veterinarmed A 1981;28:475-80.
  162. Salvage SC, Chandrasekharan KH, Jeevaratnam K, Dulhunty AF, Thompson AJ, Jackson AP. Multiple targets for flecainide action: implications for cardiac arrhythmogenesis.. Br J Pharmacol 2018;175:1260-78.
  163. Carstensen H, Hesselkilde EZ, Fenner M, Loft-Andersen AV, Flethoj M, Kanters JK. Time-dependent antiarrhythmic effects of flecainide on induced atrial fibrillation in horses.. J Vet Intern Med 2018;32:1708-17.
  164. Dembek KA, Hurcombe SD, Schober KE, Toribio RE. Sudden death of a horse with supraventricular tachycardia following oral administration of flecainide acetate.. J Vet Emerg Crit Care (San Antonio) 2014;24:759-63.
  165. Robinson SJ, Feary DJ. Sudden death following oral administration of flecainide to horses with naturally occurring atrial fibrillation.. Aust Equine Vet 2008;27:49-51.
  166. Birettoni F, Porciello F, Rishniw M, della Rocca G, Di Salvo A, Sgorbini M. Treatment of chronic atrial fibrillation in the horse with flecainide: personal observation.. Vet Res Commun 2007;31(Suppl 1):273-5.
  167. van Loon G, Blissitt KJ, Keen JA, Young LE. Use of intravenous flecainide in horses with naturally-occurring atrial fibrillation.. Equine Vet J 2004;36:609-14.
  168. Haugaard MM, Pehrson S, Carstensen H, Flethoj M, Hesselkilde EZ, Praestegaard KF. Antiarrhythmic and electrophysiologic effects of flecainide on acutely induced atrial fibrillation in healthy horses.. J Vet Intern Med 2015;29:339-47.
  169. Hesselkilde EZ, Carstensen H, Haugaard MM, Carlson J, Pehrson S, Jespersen T. Effect of flecainide on atrial fibrillatory rate in a large animal model with induced atrial fibrillation.. BMC Cardiovasc Disord 2017;17:289.
  170. Ohmura H, Nukada T, Mizuno Y, Yamaya Y, Nakayama T, Amada A. Safe and efficacious dosage of flecainide acetate for treating equine atrial fibrillation.. J Vet Med Sci 2000;62:711-5.
  171. Risberg ÅI, McGuirk SM. successful conversion of equine atrial fibrillation using oral flecainide.. J Vet Intern Med 2006;20:207-9.
  172. Mujovic N, Dobrev D, Marinkovic M, Russo V, Potpara TS. The role of amiodarone in contemporary management of complex cardiac arrhythmias.. Pharmacol Res 2020;151:104521.
  173. Kodama I, Kamiya K, Toyama J. Amiodarone: ionic and cellular mechanisms of action of the most promising class III agent.. Am J Cardiol 1999;84:20-8.
  174. Kodama I, Kamiya K, Toyama J. Cellular electropharmacology of amiodarone.. Cardiovasc Res 1997;35:13-29.
  175. Drouin E, Lande G, Charpentier F. Amiodarone reduces transmural heterogeneity of repolarization in the human heart.. J Am Coll Cardiol 1998;32:1063-7.
  176. De Clercq D, Baert K, Croubels S, van Loon G, Maes A, Tavernier R. Evaluation of the pharmacokinetics and bioavailability of intravenously and orally administered amiodarone in horses.. Am J Vet Res 2006;67:448-54.
  177. De Clercq D, van Loon G, Baert K, Tavernier R, Croubels S, De Backer P. Effects of an adapted intravenous amiodarone treatment protocol in horses with atrial fibrillation.. Equine Vet J 2007;39:344-9.
  178. Trachsel D, Tschudi P, Portier CJ, Kuhn M, Thormann W, Scholtysik G. Pharmacokinetics and pharmacodynamic effects of amiodarone in plasma of ponies after single intravenous administration.. Toxicol Appl Pharmacol 2004;195:113-25.
  179. De Clercq D, van Loon G, Baert K, Tavernier R, Croubels S, De Backer P. Intravenous amiodarone treatment in horses with chronic atrial fibrillation.. Vet J 2006;172:129-34.
  180. Imhasly A, Tschudi PR, Gerber V. Combined Amiodarone and Chinidin Sulfate show no advantage over Chinidin Sulfate alone in equine atrial fibrillation.. Pferdeheilkunde Equine Med 2008;24:693-8.
  181. Carstensen H, Hesselkilde EZ, Haugaard MM, Flethoj M, Carlson J, Pehrson S. Effects of dofetilide and ranolazine on atrial fibrillatory rate in a horse model of acutely induced atrial fibrillation.. J Cardiovasc Electrophysiol 2019;30:596-606.
  182. Carstensen H, Kjaer L, Haugaard MM, Flethoj M, Hesselkilde EZ, Kanters JK. Antiarrhythmic effects of combining dofetilide and ranolazine in a model of acutely induced atrial fibrillation in horses.. J Cardiovasc Pharmacol 2018;71:26-35.
  183. Broux B, De Clercq D, Decloedt A, De Baere S, Devreese M, Van Der Vekens N. Pharmacokinetics of intravenously and orally administered sotalol hydrochloride in horses and effects on surface electrocardiogram and left ventricular systolic function.. Vet J 2016;208:60-4.
  184. Broux B, De Clercq D, Decloedt A, Vera L, Devreese M, Gehring R. Pharmacokinetics and electrophysiological effects of sotalol hydrochloride in horses.. Equine Vet J 2018;50:377-83.
  185. Markides V, Schilling RJ. Atrial fibrillation: classification, pathophysiology, mechanisms and drug treatment.. Heart 2003;89:939-43.
  186. Frye MA, Selders CG, Mama KR, Wagner AE, Bright JM. Use of biphasic electrical cardioversion for treatment of idiopathic atrial fibrillation in two horses.. J Am Vet Med Assoc 2002;220(1039-1045):1007.
  187. Potter BM, Scansen BA, Dunbar LK, Reed SM, Toribio RE. Transcutaneous direct current cardioversion in a foal with lone atrial fibrillation.. J Vet Cardiol 2017;19:99-105.
  188. McGurrin MK, Physick-Sheard PW, Kenney DG, Kerr C, Hanna WJ. Transvenous electrical cardioversion of equine atrial fibrillation: technical considerations.. J Vet Intern Med 2005;19:695-702.
  189. McGurrin MK, Physick-Sheard PW, Kenney DG, Kerr C, Hanna WJ, Neto FT. Transvenous electrical cardioversion in equine atrial fibrillation: technique and successful treatment of 3 horses.. J Vet Intern Med 2003;17:715-8.
  190. van Loon G, De Clercq D, Tavernier R, Amory H, Deprez P. Transient complete atrioventricular block following transvenous electrical cardioversion of atrial fibrillation in a horse.. Vet J 2005;170:124-7.
  191. van Loon G, Van Steenkiste G, Vera L, Decloedt A. Catheter-based electrical interventions to study, diagnose and treat arrhythmias in horses: from refractory period to electro-anatomical mapping.. Vet J 2020;263:9.
  192. Preiss EE, Kenney DG, McGurrin MK, Physick-Sheard PW. Influence of electrode position on cardioversion energy requirements during transvenous electrical cardioversion in horses.. Am J Vet Res 2011;72:1193-203.
  193. De Clercq D, van Loon G, Schauvliege S, Tavernier R, Baert K, Croubels S. Transvenous electrical cardioversion of atrial fibrillation in six horses using custom made cardioversion catheters.. Vet J 2008;177:198-204.
  194. Haissaguerre M, Jais P, Shah DC, Takahashi A, Hocini M, Quiniou G. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.. N Engl J Med 1998;339:659-66.
  195. Chen SA, Hsieh MH, Tai CT, Tsai CF, Prakash VS, Yu WC. Initiation of atrial fibrillation by ectopic beats originating from the pulmonary veins: electrophysiological characteristics, pharmacological responses, and effects of radiofrequency ablation.. Circulation 1999;100:1879-86.
  196. Bellei MH, Kerr C, McGurrin MK, Kenney DG, Physick-Sheard P. Management and complications of anesthesia for transvenous electrical cardioversion of atrial fibrillation in horses: 62 cases (2002-2006).. J Am Vet Med Assoc 2007;231:1225-30.
  197. Vernemmen I, De Clercq D, Decloedt A, Vera L, Van Steenkiste G, van Loon G. Atrial premature depolarisations five days post electrical cardioversion are related to atrial fibrillation recurrence risk in horses.. Equine Vet J 2020;52:374-8.
  198. Broux B, De Clercq D, Decloedt A, Ven S, Vera L, van Steenkiste G. Heart rate variability parameters in horses distinguish atrial fibrillation from sinus rhythm before and after successful electrical cardioversion.. Equine Vet J 2017;49:723-8.
  199. Broux B, De Clercq D, Vera L, Ven S, Deprez P, Decloedt A. Can heart rate variability parameters derived by a heart rate monitor differentiate between atrial fibrillation and sinus rhythm?. BMC Vet Res 2018;14:320.
  200. Welch-Huston B, Durward-Akhurst S, Norton E, Ellingson L, Rendahl A, McCue M. Comparison between smartphone electrocardiography and standard three-lead base apex electrocardiography in healthy horses.. Vet Rec 2020;187:e70.
  201. Smith JS, Ward JL, Schneider BK, Smith FL, Mueller MS, Heller MC. Comparison of standard electrocardiography and smartphone-based electrocardiography recorded at two different anatomic locations in healthy meat and dairy breed does.. Front Vet Sci 2020;7:416.
  202. Corradini I, Fernandez-Ruiz A, Barba M, Engel-Manchado J. Stall-side screening potential of a smartphone electrocardiogram recorded over both sides of the thorax in horses.. J Vet Intern Med 2020;34:2101-8.
  203. Tu HT, Spence S, Kalman JM, Davis SM. Twenty-eight day Holter monitoring is poorly tolerated and insensitive for paroxysmal atrial fibrillation detection in cryptogenic stroke.. Intern Med J 2014;44:505-8.
  204. Zhang K, Aleexenko V, Jeevaratnam K. Computational approaches for detection of cardiac rhythm abnormalities: are we there yet?. J Electrocardiol 2020;59:28-34.
  205. Dharmaprani D, Dykes L, McGavigan AD, Kuklik P, Pope K, Ganesan AN. Information theory and atrial fibrillation (AF): a review.. Front Physiol 2018;9:957.
  206. Huang YH, Alexeenko V, Tse G, Huang CLH, Marr CM, Jeevaratnam K. ECG restitution analysis and machine learning to detect paroxysmal atrial fibrillation: insight from the equine athlete as a model for human athletes.. Function 2020;2:zqaa031.
  207. Fossa AA. Beat-to-beat ECG restitution: A review and proposal for a new biomarker to assess cardiac stress and ventricular tachyarrhythmia vulnerability.. Ann Noninvasive Electrocardiol 2017;22:e12460.

Citations

This article has been cited 2 times.
  1. Natterson-Horowitz B, Wright K, Van Steenkiste G, Decloedt A, Gagnon AL, Cai X, Mazmanian A. Arrhythmias across the tree of life: comparative insights for human electrophysiology. Front Cardiovasc Med 2025;12:1652591.
    doi: 10.3389/fcvm.2025.1652591pubmed: 41567384google scholar: lookup
  2. Kuroda T, Minamijima Y, Kinman CK, Takahashi Y, Ebisuda Y, Inoue K, Ishikawa H, Mita H, Tamura N, Nukada T, Toutain PL, Ohta M. Rational quinidine dosage regimen for atrial fibrillation in Thoroughbred racehorses based on population pharmacokinetics. Front Vet Sci 2024;11:1454342.
    doi: 10.3389/fvets.2024.1454342pubmed: 39439824google scholar: lookup
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