Background: Although atrial fibrillation (AF) can be successfully treated in horses, recurrence occurs frequently. In humans, atrial function after cardioversion can predict recurrence. Objectives: To examine the prognostic value of atrial mechanical function at 24 hours after cardioversion and other potential predictor variables for AF recurrence in horses. Animals: 117 horses treated for AF at 4 referral centers. Methods: Retrospective study. Inclusion criteria were successful cardioversion, echocardiography at 24 hours after cardioversion and ≥4 months follow-up. To determine factors associated with AF recurrence, a multivariable survival model was built. Results: 133 AF episodes in 117 horses were included. AF recurred in 36/100 horses with a first AF episode and in 57/133 AF episodes overall. Factors associated with recurrence in horses with a first episode were previous unsuccessful treatment attempt (hazard ratio HR 2.36, 95% confidence interval CI 1.11–4.99, P = .025) and mild or moderate mitral regurgitation (HR 2.70, 95% CI 1.23–5.91, P = .013). When the last AF episode of all horses was included, previous AF (HR 2.53, 1.33–4.82, P = .005) and active left atrial fractional area change ≤9.6% (HR 3.43, 1.22–9.67, P = .020) were significant predictors. Conclusions and Clinical Importance: The only echocardiographic variable of left atrial function with significant prognostic value for recurrence was low active left atrial fractional area change. Further research is necessary to evaluate whether echocardiography at a later timepoint could provide more prognostic information.

Background: Horses are extremely susceptible to ionophore intoxication. Although numerous reports are available regarding monensin, little is known about lasalocid toxicity. Objectives: To describe accidental lasalocid poisoning on a farm in Belgium. Animals: Eighty-one horses, of which 14 demonstrated clinical signs from day 0–21 after being fed a new concentrate batch. One horse died on day 20 and another on day 27. Methods: The most severe cases (n = 7), admitted to the clinic on day 29–46, underwent cardiac examination and blood biochemical analysis, including determination of plasma cardiac troponin I (cTnI) at admission and during follow-up. On day 57–70, cardiac examination, cTnI determination or both were undertaken on 72 remaining horses. Results: Short-term effects of lasalocid intoxication included inappetance, lethargy, sweating, and muscular weakness. All 7 horses admitted to the clinic demonstrated signs of myocardial degeneration such as increased cTnI, dysrhythmia and reduced myocardial contractility. Four horses developed ataxia on day 40–50. Five horses died or were euthanized on day 30–370, 2 horses recovered fully and returned to previous athletic use. None of the 72 remaining horses exhibited clinical signs between day 57–70, but 34 had dysrhythmia and 13 had increased cTnI concentrations. After a period of rest, all horses returned to their previous work. Lasalocid was detected in hepatic tissue of 2 necropsied horses. Conclusions and Clinical Importance: Lasalocid intoxication induced myocardial and neurological damage. Although uncommon, this should be included as differential diagnosis for unexplained inappetance, signs of depression, cardiomyopathy, and ataxia in horses.

Background: The quantification of equine left ventricular (LV) function is generally limited to short-axis M-mode measurements. However, LV deformation is 3-dimensional (3D) and consists of longitudinal shortening, circumferential shortening, and radial thickening. In human medicine, longitudinal motion is the best marker of subtle myocardial dysfunction. Objectives: To evaluate the feasibility and reliability of 2-dimensional speckle tracking (2DST) for quantifying equine LV longitudinal function. Animals: Ten healthy untrained trotter horses; 9.6 ± 4.4 years; 509 ± 58 kg. Methods: Prospective study. Repeated echocardiographic examinations were performed by 2 observers from a modified 4-chamber view. Global, segmental, and averaged peak values and timing of longitudinal strain (SL), strain rate (SrL), velocity (VL), and displacement (DL) were measured in 4 LV wall segments. The inter- and intraobserver within- and between-day variability was assessed by calculating the coefficients of variation for repeated measurements. Results: 2DST analysis was feasible in each exam. The variability of peak systolic values and peak timing was low to moderate, whereas peak diastolic values showed a higher variability. Significant segmental differences were demonstrated. DL and VL presented a prominent base-to-midwall gradient. SL and SrL values were similar in all segments except the basal septal segment, which showed a significantly lower peak SL occurring about 60 ms later compared with the other segments. Conclusions and Clinical Importance: 2DST is a reliable technique for measuring systolic LV longitudinal motion in healthy horses. This study provides preliminary reference values, which can be used when evaluating the technique in a clinical setting.

Background: Atrial tachycardia (AT) can be treated by medical or electrical cardioversion but the recurrence rate is high. Three-dimensional electro-anatomical mapping, recently described in horses, might be used to map AT to identify a focal source or reentry mechanism and to guide treatment by radiofrequency ablation. Objectives: To describe the feasibility of 3D electro-anatomical mapping and radiofrequency catheter ablation to characterize and treat sustained AT in horses. Animals: Nine horses with sustained AT. Methods: Records from horses with sustained AT referred for radiofrequency ablation at Ghent University were reviewed. Results: The AT was drug resistant in 4 out of 9 horses. In 8 out of 9 horses, AT originated from a localized macro-reentrant circuit (n = 5) or a focal source (n = 3) located at the transition between the right atrium and the caudal vena cava. In these 8 horses, local radiofrequency catheter ablation resulted in the termination of AT. At follow-up, 6 out of 8 horses remained free of recurrence. Conclusions and Clinical Importance: Differentiation between focal and macro-reentrant AT in horses is possible using 3D electro-anatomical mapping. In this study, the source of right atrial AT in horses was safely treated by radiofrequency catheter ablation.