Effect of sotalol on heart rate, QT interval, and atrial fibrillation cycle length in horses with atrial fibrillation.

BACKGROUND: Based on its pharmacokinetic profile and electrophysiological effects in healthy horses, sotalol potentially could be used as a long-term PO antiarrhythmic drug in horses. OBJECTIVES: To evaluate the effect of sotalol on heart rate (HR), QT interval, atrial fibrillatory rate, and success of cardioversion in horses with naturally occurring chronic atrial fibrillation (AF). ANIMALS: Twenty-eight horses referred for transvenous electrical cardioversion of AF were treated with 2 mg/kg sotalol PO q12h for 3 days before cardioversion, and 13 horses underwent the same protocol without sotalol administration. METHODS: Retrospective study. Before and after sotalol or no treatment, the HR was measured at rest and during an exercise test. The QT interval and atrial fibrillation cycle length (AFCL) were measured at rest using tissue Doppler velocity imaging. RESULTS: In the control group, no significant differences were found between the 2 examinations. In the sotalol group, the HR at rest and during exercise was significantly lower after sotalol treatment, whereas the QT interval and AFCL measured by tissue Doppler increased significantly. Cardioversion to sinus rhythm was achieved in 25/28 horses in the sotalol group and all horses in the control group, but the median number of shocks and energy at cardioversion were significantly lower in the sotalol group. CONCLUSIONS AND CLINICAL IMPORTANCE: In horses with AF, sotalol administration results in class III antiarrhythmic effects and ß-blocking activity, with moderate HR reduction during exercise.

Echocardiographic measurements of right heart size and function in healthy horses.

REASONS FOR PERFORMING STUDY: Right ventricular (RV) function is scarcely described in horses. OBJECTIVES: To establish reliable echocardiographic measurements of right heart size and function in horses. STUDY DESIGN: Descriptive study in healthy horses. METHODS: Ten healthy untrained adult trotter horses underwent repeated echocardiography performed by 2 sonographers from right and left parasternal standard and nonstandard views. Nonstandard views included a right parasternal view focused on the right atrium, left parasternal long-axis pulmonary artery view, left parasternal long-axis view focused on the right ventricle including anatomical M-mode of tricuspid annular motion and left parasternal pulsed wave Doppler recording of pulmonary flow. During off-line analysis, 2 observers performed two-dimensional, M-mode, pulsed wave Doppler, tissue Doppler imaging (TDI) and two-dimensional speckle tracking (2DST) measurements of RV size and function. Acquisition and measurement variability were assessed by calculating coefficients of variation (CV) from one-way repeated measures analyses of variance. The degree of variability was classified as low (CV<15%), moderate (CV 15-25%) or high (CV>25%). RESULTS: Most two-dimensional and M-mode measurements of RV, right atrial and pulmonary artery size showed low variability. The two-dimensional, M-mode and pulsed wave Doppler measurements of RV function showed a low to moderate variability. Right ventricular functional measurements by 2DST showed low variability, except for segmental strain rate. Right ventricular functional measurements by TDI showed a low to high variability, with a lower variability for timing than for peak measurements and a lower variability for velocity compared with deformation measurements. CONCLUSIONS: Right heart size and function can be assessed with low variability in horses.

Analytical validation of a high-sensitivity cardiac troponin T assay in horses.

Although cardiac troponin T (cTnT) assays have been used to detect myocardial damage in horses, a cTnT assay has not been analytically validated, to our knowledge. The aims of this study were to estimate the precision of a high-sensitivity cTnT assay in horses and determine the effect of hemolysis on the measured cTnT concentration. Serum samples from horses were mixed in 3 different pools. Pool 1 consisted of samples from 3 healthy horses, pool 2 from 6 horses with heart failure or atypical myopathy, and pool 3 from 10 horses with atypical myopathy. The within- and between-run coefficients of variation were determined for each pool. Pools 2 and 3 were diluted to estimate linearity. To study the influence of sample hemolysis, serum was collected from 4 horses with a high cTnT concentration, in which hemolysis was mechanically induced. In addition, ethylenediamine tetra-acetic acid blood tubes were collected from 3 other horses, from which hemolysate was prepared and added to plasma at different concentrations. The within- and between-run coefficients of variation of all pools were <10%, and a good linearity was found. Three out of 4 hemolyzed serum samples had a decreased serum cTnT concentration. Plasma samples with a high hemolysis index showed a negative interference, resulting in a lower cTnT concentration. Results of the high-sensitivity cTnT assay were highly reproducible. Because samples from horses with musculoskeletal damage were included, further studies should test the possible cross-reactivity between troponin T of musculoskeletal and cardiac origin before the assay can be used in equine clinical practice.