Arrhythmias In Horses Research Articles

Intracardiac ultrasound-guided transseptal puncture in horses: Outcome, follow-up, and perioperative anticoagulant treatment.

Cardiac catheterizations in horses are mainly performed in the right heart, as access to the left heart traditionally requires an arterial approach. Transseptal puncture (TSP) has been adapted for horses but data on follow-up and closure of the iatrogenic atrial septal defect (iASD) are lacking. To perform TSP and assess postoperative complications and iASD closure over a minimum of 4 weeks. Eleven healthy adult horses. Transseptal puncture was performed under general anesthesia. Serum cardiac troponin I concentrations were measured before and after puncture. Weekly, iASD closure was monitored using transthoracic and intracardiac echocardiography. Relationship between activated clotting time and anti-factor Xa activity during postoperative enoxaparin treatment was assessed in vitro and in vivo. Transseptal puncture was successfully achieved in all horses within a median duration of 22 (range, 10-104) minutes. Balloon dilatation of the puncture site for sheath advancement was needed in 4 horses. Atrial arrhythmias occurred in 9/11 horses, including atrial premature depolarizations (N = 1), atrial tachycardia (N = 5), and fibrillation (N = 3). Serum cardiac troponin I concentrations increased after TSP, but remained under the reference value in 10/11 horses. Median time to iASD closure was 14 (1-35) days. Activated clotting time correlated with anti-factor Xa activity in vitro but not in vivo. Transseptal puncture was successfully performed in all horses. The technique was safe and spontaneous iASD closure occurred in all horses. Clinical application of TSP will allow characterization and treatment of left-sided arrhythmias in horses.

Development of an atrial transseptal puncture procedure in horses to access the left heart: An ultrasound‐guided jugular vein and transhepatic approach

AbstractBackgroundRadiofrequency ablation has been successfully applied to treat right atrial arrhythmias in horses. Ablation of left‐sided arrhythmias requires a retrograde transarterial approach which is complicated. In human medicine, the left atrium is accessed through transseptal puncture (TSP) of the fossa ovalis (FO) using a caudal approach via the femoral vein.ObjectivesTo develop a zero fluoroscopy TSP technique for horses using a jugular vein (cranial) and transhepatic (caudal) approach.Study designIn vivo experimental study.MethodsTransseptal puncture was performed in 18 horses admitted for euthanasia and donated for scientific research under general anaesthesia: using a jugular vein approach (10 horses), a transhepatic approach (2 horses) or both (6 horses). Radiofrequency energy was applied on a guidewire to perforate the FO and allow sheath advancement under intracardiac and transthoracic echocardiographic guidance. Puncture lesions were inspected post‐mortem.ResultsTransseptal puncture was successful in 17/18 horses, of which 15/16 jugular vein approaches and 5/8 transhepatic approaches. Failure was due to technical malfunction, inability to advance the guidewire toward the heart and inability to advance the sheath through the FO. Intracardiac echocardiography was essential to safely guide the puncture process. Atrial arrhythmias caused by the TSP occurred in 13/18 horses. Puncture lesions were found in the right atrium in the FO region, and left atrium ventral to pulmonary vein ostium III.Main limitationsBecause in several horses two approaches were tested consecutively, it cannot be excluded that the second TSP was performed at the previous puncture site. Due to the developmental nature of the study the approaches were not randomised and did not allow comparison.ConclusionTransseptal puncture is feasible in horses using ultrasound guidance and allows for electrophysiological exploration of the left heart. Further studies are needed to evaluate post‐operative follow‐up.

Successful caudal vena cava and pulmonary vein isolation in healthy horses using 3D electro-anatomical mapping and a contact force-guided ablation system.

Recently, treatment of equine atrial tachycardia by three-dimensional electro-anatomical mapping (3D EAM) and radiofrequency catheter ablation (RFCA) has been described. Myocardial sleeves in the caudal vena cava and pulmonary veins are a potential trigger for initiation and perpetuation of atrial tachycardia and atrial fibrillation in the horse. Isolation of these myocardial sleeves by RFCA may be an effective treatment for these arrhythmias. To describe the feasibility of 3D EAM and RFCA to isolate caudal vena cava and pulmonary veins in adult horses using 3D mapping and a contact force (CF)-guided ablation system. In vivo experiments. 3D EAM and RFCA was performed in five horses without cardiovascular disease under general anaesthesia, using the CF-guided system CARTO®3. Point-by-point RFCA aimed for isolation of caudal vena cava and pulmonary veins. Radiofrequency energy was delivered in power-controlled mode with a target power of 45 W, CF between 10 and 15 g and 30 mL/min irrigation rate, until an ablation-index of 450-500 was reached. In the right atrium, myocardial sleeves of the caudal vena cava were isolated (n = 5). In the left atrium, isolation of ostium II (n = 3), ostium III (n = 1) and ostium I, II and III en bloc (n = 1) was performed. Successful isolation was confirmed by entrance and exit block. Horses were euthanised at the end of the procedure, so long term effects such as potential reconnection of isolated veins could not be studied. This is the first description of 3D EAM and RFCA with CARTO®3 in horses, thereby showing the technical feasibility and successful caudal vena cava and pulmonary vein isolation. CF measurement allowed monitoring of catheter-tissue contact, resulting in efficient acute lesion creation as confirmed by entrance and exit block. This is a promising treatment for cardiac arrhythmias in horses.

Anaesthetic management for cardiac 3D electro‐anatomical mapping and radiofrequency catheter ablation in a horse with sustained atrial tachycardia

AbstractAtrial arrhythmias in horses are common, and novel catheter‐based treatment techniques require the horse to be under general anaesthesia. A 3‐year‐old gelding, weighing 517 kg, presented for cardiac three‐dimensional electro‐anatomical mapping and radiofrequency ablation for treatment of sustained atrial tachycardia. The current case report describes a suitable anaesthetic protocol that included medetomidine and methadone as premedication, a combination of ketamine and diazepam for co‐induction of anaesthesia and maintenance with isoflurane vaporised in an oxygen/air mixture with constant‐rate infusions of medetomidine and lidocaine. Total anaesthesia time was 205 minutes. The current protocol did not negatively impact on the procedure performed, provided good haemodynamic stability for several hours and enabled a smooth, good‐quality recovery. The horse developed a triceps myopathy postoperatively, which was successfully treated and the horse was discharged 18 days following treatment.

Stall-side screening potential of a smartphone electrocardiogram recorded over both sides of the thorax in horses.

BackgroundComparisons between smartphone ECG (SpECG) recordings obtained from the right and left sides of the thorax have not been reported in animals.ObjectivesTo evaluate the screening potential of a SpECG obtained from both sides of the thorax and to compare the degree of agreement between the SpECG and a reference ECG (rECG) for measurement of the duration of baseline electrical deflections recorded over both sides of the thorax.AnimalsFifty horses admitted to the equine hospital, university‐owned horses, and horses from an endurance riding facility.MethodsProspective observational study. Simultaneous rECG and SpECG tracings were recorded on both sides of the thorax and evaluated by 2 experienced observers for interpretability, presence and classification of arrhythmias, and duration of deflections of the electrical baseline.ResultsFifteen (15/50) horses had spontaneous arrhythmias. Excellent agreement was found between the 2 devices (κ = 0.91; P < .001; 95% confidence interval [CI] 0.79‐1.03) for the detection of arrhythmias. Significantly more P waves were of diagnostic quality from the right side (20 versus 5, P = .001) and significantly more QRS and QT intervals were of diagnostic quality from the left side (66 versus 38 and 62 versus 34, respectively, P < .001). Substantial agreement for the duration of deflections between devices only was observed for the QRS interval (SpECG left).Conclusions and Clinical ImportanceIt is important to obtain SpECG tracings from both sides of the thorax in horses. The SpECG is a useful stall‐sidearrhythmia‐screening tool for some common arrhythmias in horses.

Detection of atrial fibrillation with implantable loop recorders in horses.

BackgroundCardiac arrhythmias in horses are diagnosed by auscultation or electrocardiogram (ECG), which results in a low sensitivity for detecting arrhythmias that occur sporadically. Implantable loop recorders (ILRs) are small ECG devices placed subcutaneously, to automatically detect arrhythmias in human patients.ObjectivesTo test ILRs ability to detect atrial fibrillation (AF) in horses. Furthermore, we hypothesised that anatomical location of the implant site might influence signal quality. Signal quality was evaluated both during exercise and over time.Study designExperimental study.MethodsIn five Standardbred mares, eleven ILRs were implanted subcutaneously in up to three different positions (Front: pectoral region, Left‐6: sixth left intercostal space and Ventral: xiphoid region) and AF induced. The R‐ and T‐wave amplitudes were measured in all positions over time during AF. AF burden automatically registered by the ILRs over a 2‐month period was compared with selected Holter ECG recordings.ResultsAll three positions had stable R‐ and T‐wave amplitudes during the study period and were of sufficient quality to allow AF detection at rest. The position Left‐6 showed significantly higher R‐ and T‐wave amplitudes compared with the other positions. During submaximal exercise only the Left‐6 position was able to record ECG signals of diagnostic quality. No position yielded diagnostic signals at maximum exercise due to artefacts.Main limitationsFew horses and ILRs included and no spontaneous AF episodes were studied.ConclusionsThis preliminary study indicates that ILRs can be used for AF detection in horses, but the anatomical location is important for optimal ECG quality. Despite insufficient quality during exercise, ILRs were suitable for AF detection at rest. Therefore, the ILR may be a valuable diagnostic tool for detecting paroxysmal AF in horses.

Validation of a portable ECG monitor for the diagnosis of arrhythmias in horses compared to a standard electrocardiograph

Electrocardiography (ECG) is a main diagnostic tool for diagnostics of rhythm disturbances. Since most pathological arrhythmias are only visible during movement and exercises the registration of exercising ECG becomes a mandatory diagnostic tool for monitoring of high-performance horses. Portable ECG monitor, developed together with specialists of National Technical University of Ukraine “Igor Sikorsky Kyiv Polytechnic Institute” is an electrocardiograph with telemetric data transmission system and four electrodes providing six-lead real-time ECG recordings at rest and during exercise. The objective of current study was validation of portable ECG monitor for diagnostics of arrhythmias in horses compared to a standard electrocardiograph. With this aim the ECG was performed by both devices simultaneously on animals with normal rhythm and rhythm disturbances. The ECG traces were therefore analyzed and compared. 14 horses of Ukrainian riding, Friesian, and Arabian breeds were divided in two groups: experimental one with arrhythmias, and control one with normal rhythm. ECG was performed by both devices simultaneously during rest, exercise, and post-exercise period. Electrocardiographic parameters were measured manually using on-screen calipers. Obtained data was analyzed using GraphPad Prism software by linear regression method for continuous parameters (HR, duration of QRS complex, PR, and QT intervals, and amplitude of P and S waves). For nominal parameters (rhythm, excitability, and conduction disorders) the analysis of sensitivity and specificity was performed. A total of 196 ECG records were analysed. Electrocardiographic intervals had high correlation: for HR and PR interval the correlation coefficient amounted to 0.98, for QRS complex and QT interval – to 0.97, for P and S waves – to 0.96. Among detected rhythm disturbances were physiological (second degree AV block first Mobitz type and SA block) and pathological arrhythmias (SVT and SVPCs). The sensitivity and specificity for rhythm, excitability, and conduction disorders of the portable ECG monitor compared to a standard electrocardiograph was 100 %. The portable ECG monitor allows to easily perform ECG registration during rest and exercises and to detect arrhythmias and other ECG abnormalities with accuracy, compared to a standard electrocardiograph.

The use of heart rate variability analysis to detect arrhythmias in horses undergoing a standard treadmill exercise test.

BackgroundLittle 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.ObjectivesThe 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.AnimalsThirteen healthy horses (Group H), 30 horses with arrhythmias (Group A), and 11 horses with poor performance but no observed arrhythmias (Group O).MethodsProspective, observational study. All horses performed a HSET with simultaneous electrocardiograph (ECG) recorded. The ECGs were corrected for artifacts, and arrhythmias noted. Percent instantaneous beat‐to‐beat cycle length variation (% R‐R variation) was calculated, and HRV analyses were performed on trot, canter, and recovery segments.ResultsGroup H showed between −4.4 and +3.8% R‐R variation during trot and between −6.1 and +5.4% R‐R variation during the canter phase of the HSET. Group A had significantly larger maximum and 1st percentile R‐R shortening and lengthening compared with Group H and Group O during the recovery phase where most arrhythmias were observed. During recovery, a cutoff of 6% maximum % R‐R shortening predicted the presence of arrhythmia with 88% sensitivity and 97% specificity and likelihood ratio of 26.Conclusions and Clinical ImportanceHealthy horses have little instantaneous R‐R variation during exercise. If a cardiac cycle shortens more than 6% from the previous cycle during the recovery phase, this R‐R interval is likely to represent an arrhythmic event.

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. 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). Placebo controlled, double-blinded experiment. Six healthy, unfasted Warmblood horses were given either 0, 2, 3 or 4 mg/kg bodyweight (bwt) sotalol orally (PO) twice daily (bid) for 9 days in a randomised cross-over design. Echocardiography and surface electrocardiography were performed and plasma concentrations of sotalol and right atrial and right ventricular MAPs and ERPs were determined at steady-state conditions. Statistical analysis was performed using a repeated measures univariate analysis with post hoc Bonferroni corrections. Calculated mean steady-state plasma concentrations determined by nonlinear mixed-effect modelling were 287 (range 234-339), 409 (359-458) and 543 (439-646) ng/mL for 2, 3 and 4 mg/kg bwt sotalol PO bid respectively. Sotalol significantly increased the QT interval and ERPs, but, despite increasing plasma concentrations, higher dosages did not result in a progressive increase in QT interval or ERPs. Echocardiographic and other electrocardiographic measurements did not change significantly. MAP durations at 90% repolarisation were not significantly different during sotalol treatment. Besides transient local sweating, no side effects were noted. Study size and ad libitum feeding of hay. Sotalol at a dose of 2, 3 and 4 mg/kg bwt PO bid increases the QT interval and ERP and might be a useful drug for long-term anti-arrhythmic therapy in horses.

Cardiac arrhythmias and electrolyte disturbances in colic horses.

BackgroundDespite 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.The study population consisted of eight control horses and 22 referred colic horses. A Holter electrocardiography (ECG) was recorded during the first 24 hours of admission. The ECG’s were analysed by a software program followed by manual visual inspection. Arrhythmias registered included second degree atrioventricular (AV) blocks, supraventricular premature complexes (SVPCs), and ventricular premature complexes (VPCs). Blood was collected at admission and again between 12 and 24 hours after ECG was applied, and analysed for concentrations of potassium, sodium, ionised calcium, chloride, glucose, and L-lactate.ResultsHeart rate was 37.4 ± 3.7 bpm in the control group, and 51.6 ± 11.8 bpm, in the colic group, which was significantly different (P < 0.0001). AV blocks and SVPCs were found in both groups, however only colic horses showed VPCs. No significant difference between the two groups was found for AV blocks, SVPCs, and VPCs (P = 0.08 - 0.76). The mean levels of potassium, sodium, ionized calcium, and chloride were significantly lower in the colic group compared to the control group at admission. Mean levels of glucose and L-lactate were significantly elevated in the colic group (P < 0.05).ConclusionsThis study describes prevalence of cardiac arrhythmias and electrolytes concentrations in colic horses compared to healthy controls. Although we only observed VPCs in the colic horses, no significant differences between colic horses and controls were found. Despite the colic horses having electrolyte changes at admission no correlation was found between the electrolyte disturbances and cardiac arrhythmias. Although no clear conclusions can be drawn from the present study, the results indicate that relatively mild colic per se is not pro-arrhythmogenic, whereas severe colic probably are more likely to result in ventricular arrhythmia.

Evaluation of Cardiac Phenotype in Horses with Type 1 Polysaccharide Storage Myopathy

Type 1 polysaccharide storage myopathy (PSSM1), an equine glycogen storage disorder caused by a gain of function mutation (R309H) in the gene encoding glycogen synthase (GYS1), is associated with the accumulation of amylase-resistant alpha-crystalline polysaccharide inclusions within skeletal muscle. Several glycogenoses in humans have a cardiac phenotype, and reports exist of horses with PSSM and polysaccharide inclusions in cardiac muscle. To investigate the hypothesis that horses with PSSM1 display a cardiac phenotype. Our objectives were to compare plasma cardiac troponin I (cTnI) concentration and the incidence of cardiac arrhythmias in PSSM1 homozygotes, heterozygotes, and control horses. One hundred and twenty-five Belgian and Percheron horses under the same management were genotyped for the R309H GYS1 mutation. From these, 8 age-, breed-, and sex-matched cohorts of each genotype were identified. Plasma cTnI concentration and incidence of cardiac arrhythmias (determined by 24-hour Holter ECG) were compared between the groups. Although some PSSM1-affected horses had mildly increased plasma cTnI concentrations, there was no significant difference in cTnI concentrations between groups. There were no significant differences in the incidence of ectopic beats, cardiac conduction intervals or mean heart rate between groups. We found no evidence of clinically relevant cardiac myocyte injury or arrhythmias in horses with PSSM1. Additional study is required to determine whether myocardial function may be compromised in this disorder.

The prevalence and nature of cardiac arrhythmias in horses following general anaesthesia and surgery

BackgroundThe prevalence and nature of arrhythmias in horses following general anaesthesia and surgery is poorly documented. It has been proposed that horses undergoing emergency surgery for gastrointestinal disorders may be at particular risk of developing arrhythmias. Our primary objective was to determine the prevalence and nature of arrhythmias in horses following anaesthesia in a clinical setting and to establish if there was a difference in the prevalence of arrhythmias between horses with and without gastrointestinal disease undergoing surgery. Our secondary objective was to assess selected available risk factors for association with the development of arrhythmias following anaesthesia and surgery.MethodsHorses with evidence of gastrointestinal disease undergoing an exploratory laparotomy and horses with no evidence of gastrointestinal disease undergoing orthopaedic surgery between September 2009 and January 2011 were recruited prospectively. A telemetric electrocardiogram (ECG) was fitted to each horse following recovery from anaesthesia and left in place for 24 hours. Selected electrolytes were measured before, during and after surgery and data was extracted from clinical records for analysis. Recorded ECGs were analysed and the arrhythmias characterised. Multivariable logistic regression was used to identify risk factors associated with the development of arrhythmias.ResultsSixty-seven horses with gastrointestinal disease and 37 without gastrointestinal disease were recruited. Arrhythmias were very common during the post-operative period in both groups of horses. Supra-ventricular and bradyarrhythmias predominated in both groups. There were no significant differences in prevalence of any type of arrhythmias between the horses with or without gastrointestinal disease. Post-operative tachycardia and sodium derangements were associated with the development of any type of arrhythmia.ConclusionsThis is the first study to report the prevalence of arrhythmias in horses during the post-operative period in a clinical setting. This study shows that arrhythmias are very common in horses following surgery. It showed no differences between those horses with or without gastrointestinal disease. Arrhythmias occurring in horses during the post-anaesthetic period require further investigation.

Cardiac troponin I and the occurrence of cardiac arrhythmias in horses with experimentally induced endotoxaemia

The aim of this study was to determine whether experimentally-induced endotoxaemia induced elevations in plasma cardiac troponin I (cTnI) concentrations in horses and how this might affect the incidence of cardiac arrhythmias. Eight Standardbred horses received an intravenous continuous rate infusion of endotoxin (total dose 500 ng/kg) for 6 h while being monitored using electrocardiography (ECG). Blood samples were collected before the start of the endotoxin infusion, every 60 min during the infusion, then 1, 2, 3, 8, 10 and 24 h post-infusion, and analysed for cTnI concentrations. One horse was excluded from the study owing to a high initial cTnI concentration. Endotoxin infusion induced an increase in cTnI concentrations in all horses, reaching mean peak concentration of 0.135±0.094 μg/L by 1 h post-infusion. The cTnI concentrations then decreased and were no longer significantly different from pre-infusion concentrations at 6, 10 and 24 h post-infusion. The number of ventricular events was generally low during the infusion period, but increased during the first 3 h post-infusion in 6/7 horses. In conclusion, elevated cTnI concentrations could be detected early after an endotoxaemic insult using an ultrasensitive cTnI assay, with peak cTnI concentrations preceding the occurrence of ventricular events on ECG.

The prevalence of cardiac arrhythmias in horses of the Sanandaj area

Cardiac arrhythmias, caused by disorders in the generation and transmission of cardiac impulses, is included among the heart disorders that cause inefficient blood circulation. The most commonly-used method for diagnosing this disorder is electrocardiography. In this study, we aimed to identify and diagnose different types of arrhythmia prevalent among the seemingly-healthy horses of Sanandaj City, with particular regard to breeds specific to this region. The researcher took electrocardiograms of 50 horses in Base-Apex, including Kurdish purebreds (n = 4), Arab purebreds (n = 20), and hybrid horses (n = 26; 35 male and 15 female overall). The results of the electrocardiograms showed arrhythmias in 16 (32%) out of all the horses in this study. Of these, 23% of the stallions, 10% of mares, 40% of the Kurdish purebreds, 8% of the Arab purebreds, and 26% of hybrid horses suffered from arrhythmias. Different types of arrhythmia diagnosed included sinus arrhythmia (10%), sinus tachycardia (8%), wandering pacemaker (8%), and first degree atrioventricular block (6%). The frequencies of arrhythmia in horses found in this study were similar to the results of other researchers. It is important to distinguish between physiological and pathological arrhythmias in horses after diagnosis, since arrhythmias can have a great impact on exercise performance.

Third‐Degree Atrioventricular Block in a Horse Secondary to Rattlesnake Envenomation

Third‐Degree Atrioventricular Block in a Horse Secondary to Rattlesnake Envenomation

Salinomycin toxicosis in horses

A 4-month-old American Paint filly was evaluated because of sudden onset of ataxia that progressed to recumbency. Five additional horses from the same and neighboring premises developed signs of poor performance, generalized weakness, ataxia, and recumbency; 2 of those horses were also evaluated. A new batch of a commercial feed supplement had been introduced to the horses' diet on each farm within the preceding 3 days. Other than recumbency, findings of physical and neurologic examinations of the foal were unremarkable. The other 2 horses had generalized weakness and mild ataxia, and 1 horse also had persistent tachycardia. The foal had mild leukocytosis with neutrophilia, hyperglycemia, and mildly high serum creatine kinase activity. Results of cervical radiography, CSF analysis, and assessments of heavy metals and selenium concentrations in blood and vitamin E concentration in serum were within reference limits. Feed analysis revealed high concentrations of the ionophore antimicrobial salinomycin. The 5 affected horses survived, but the foal was euthanized. At necropsy, a major histopathologic finding was severe vacuolation within neurons of the dorsal root ganglia, which was compatible with ionophore toxicosis. The surviving horses developed muscle atrophy, persistent weakness, and ataxia. In horses, ionophore toxicosis should be considered as a differential diagnosis for acute weakness, ataxia, recumbency, or sudden death. Furthermore, ionophore toxicosis should be considered as a cause of poor performance, weakness, muscle wasting, and cardiac arrhythmias in horses. Surviving horses may have impaired athletic performance.

Effect of drug formulation and feeding on the pharmacokinetics of orally administered quinidine in the horse

Quinidine is the drug of choice for the treatment of cardiac arrhythmias in horses. The plasma concentrations vs. time profiles following oral administration of two formulations of quinidine sulphate, an oral solution and an oral suspension paste, were evaluated in nine horses. They received multiple administrations of the oral solution under fed and non-fed conditions and of the paste under non-fed conditions. A loading dose of 20 mg.kg-1 and a maintenance dose of 10 mg.kg-1 quinidine with dosing interval of 6 h were used. The relative bioavailability of the oral solution under fed conditions in comparison to the solution under non-fed conditions was 75.0 +/- 10.2% for the loading dose and 97.18 +/- 31.66% after the fourth dose. For the paste formulation the relative bioavailability values are not reported, as steady-state levels were not reached. There was a large variation in plasma quinidine levels when the paste formulation was administered. Feeding conditions had a significant influence on the Cmax values after administration of the loading dose. The Tmax values were not affected by food intake. It was concluded that an oral solution has to be preferred because of the variable drug bioavailability from the paste formulation and the poor acceptability of the paste by the horse.

Effect of hypercapnia on the arrhythmogenic dose of epinephrine in horses anesthetized with guaifenesin, thiamylal sodium, and halothane

SUMMARY The effect of hypercapnia on the arrhythmo-genic dose of epinephrine (ADE) was investigated in 14 horses. Anesthesia was induced with guaifenesin and thiamylal sodium and was maintained at an end-tidal halothane concentration between 0.86 and 0.92%. Base-apex ECG, cardiac output, and facial artery blood pressure were measured and recorded. The ADE was determined at normocapnia (arterial partial pressure of carbon dioxide [Paco2 = 35 to 45 mm of Hg), at hypercapnia (Paco2 = 70 to 80 mm of Hg), and after return to normocapnia. Epinephrine was infused at arithmetically spaced increasing rates (initial rate = 0.25 μg/kg of body weight/min) for a maximum of 10 minutes. The ADE was defined as the lowest epinephrine infusion rate, to the nearest 0.25 μg/kg/min, at which 4 premature ventricular complexes occurred in a 15-second period. The ADE (mean ± SD) during hypercapnia (1.04 ± 0.23 μg/kg/min) was significantly (P &lt; 0.05) less than the ADE at normocapnia (1.35 ± 0.38 μg/kg/min), whereas the ADE after return to normocapnia (1.17 ± 0.22 μg/kg/min) was not significantly different from those during normocapnia or hypercapnia. Baseline systolic and diastolic arterial pressures and cardiac output decreased after return to normocapnia. Significant differences were not found in arterial partial pressure of O2 (PaO2) or in base excess during the experiment. Two horses developed ventricular fibrillation and died during normocapnic determinations of ADE. Hypercapnia was associated with an increased risk of developing ventricular arrhythmias in horses anesthetized with guaifenesin, thiamylal sodium, and halothane.

The influence of detomidine and epinephrine on heart rate, arterial blood pressure, and cardiac arrhythmia in horses.

Detomidine (10 micrograms/kg and 20 micrograms/kg) was administered to seven horses with and without epinephrine infusion (0.1 microgram/kg/min) from 5 minutes before to 5 minutes after detomidine injection. One or more single supraventricular premature heartbeats were observed in three horses after detomidine administration. Epinephrine infusion did not modify the incidence of cardiac arrhythmias in detomidine-treated horses at the doses tested. Relatively high momentary peak systolic pressures were registered in some horses after detomidine administration during epinephrine infusion. The highest systolic arterial blood pressure was 290 mm Hg, but this value was not higher than that reported in horses during maximum physical exercise. Epinephrine infusion did not alter blood gases, arterial pH, or base excess.