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Cardiac Arrhythmias in Performance Horses

The South West Regional meeting, was rescheduled at very short notice from its intended date, due to the howling blizzards sweeping the country in March. Despite this, over 40 people opted to escape from their demanding clients, foaling mares and twittering mobile phones to come to the bucolic setting of Sleepy Hollow in North Somerset, to auscultate the reshuffled team of experts who had shown great flexibility in re-arranging their stress, in order not to disappoint the enthusiastic audience.

After a brief introduction from Dr Samantha Franklin from The University of Bristol, Dr Lesley Young emerged from the pavilion to open the batting. Lesley is a world renowned specialist in equine cardiology, with her own referral practice, and furthermore, she perceived the chance to travel the breadth of the country to give a bunch of southern softies a good verbal trouncing as an opportunity not to be missed. Lesley launched into a clear and enlightening overview of the common equine arrythmias, with enhanced sound effects and accompanying ECG’s. After listening to her regular northern enunciation and recorded irregular “lubbs and dupps” the veterinary delegates appeared to be more confident about the relative significances of arrythmias in equine athletes. In addition Lesley alerted the audience of practitioners of variable experience,  to the possible complications and significance associated with ventricular premature contractions and atrial fibrillation, and cautioned against ignoring potential signs of increased risk, while also pouring scorn on the lily-livered folk who panic at the whisper of a barely audible flow murmur. Lesley reported data suggesting that detecting the horse which might be susceptible to spontaneous dysrhythmias remains challenging, and hence could limit the effectiveness of pre-event screening procedures. As ever Lesley delivered her presentation masterfully with a straight bat of Northern directness which was greatly appreciated by the practicing veterinarians and left some of the Bristol undergraduates in tachydysrhythmic awe.

After all of the excitement of unpredictable cardiac rhythms Mark Bowen, from the University of Nottingham had the job of restoring sinus rhythm in the room, which he undertook with jocular calm, and reviewed the treatment updates on the treatment of atrial fibrillation, including the traditional but occasionally fatal techniques using quinidine sulphate, and also the more technologically advanced, high input and as yet incompletely evaluated techniques of electrical defibrillation, which although routine on the screens of ER and Casulty, remains a very ambitious undertaking in horses. 

The meeting was temporarily suspended in atrioventricular block to enable the delegates to refuel their energy and electrolytes with a buffet supper, before Dr Samantha Franklin from the University of Bristol described a series of cases of horses which had exhibited paroxysmal atrial fibrillation. Fortunately for those delegates who had, by this stage, developed paroxysmal cerebral confusion at the array of different arrhythmias on display, the clear presentations with audible phonocardiograms , and the visually displayed ECG’s of each dysrhythmia, and also video loops of echocardiagrams, where appropriate, enabled the majority of people to leave much clearer on the identification and significance of the significant equine arythmias, which will undoubtedly assist those veterinarians involved with athletes and with pre-purchase examinations.   In timely fashion, as the evening drew on and concentration strayed off beat, the evening was concluded with each speaker describing case examples.  The willing participation of the audience in this reflected their enthusiasm for the subject and also the clarity with which the speakers had managed a subject which has historically depolarised many a veterinarian and student.

Thanks go the sponsors of the evening, Merial Animal health, to the speakers who gave very well received and enlightening talks and to Kate Allen, who not only organised the meeting, but was able to re-arrange the venue and speakers at short notice despite risking the wrath of the fearsome Langford dinner ladies.

Henry Tremaine