Effect of induced chronic atrial fibrillation on exercise performance in Standardbred trotters

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia affecting performance in horses. However, no previous studies have quantified the performance reduction in horses suffering from AF. OBJECTIVES: To quantify the effect of AF on maximum velocity (Vmax ), maximum heart rate (HRmax ), heart rate recovery (T100 ), hematologic parameters and development of abnormal QRS complexes. ANIMALS: Nine Standardbred trotters. METHODS: Two-arm controlled trial. Six horses had AF induced by means of a pacemaker and 3 served as sham-operated controls. All horses were subjected to an exercise test to fatigue before (SET1) and after (SET2) 2 months of AF or sham. The Vmax and HRmax were assessed using a linear mixed normal model. Abnormal QRS complexes were counted manually on surface ECGs. RESULTS: Atrial fibrillation resulted in a 1.56 m/sec decrease in Vmax (P < .0001). In the AF group, HRmax  ± SD increased from 226 ± 11 bpm at SET1 to 311 ± 27 bpm at SET 2. The AF group had higher HRmax at SET2 compared with controls (P < .0001), whereas no difference between the control and AF groups was observed at SET1 (P = .96). Several episodes of wide complex tachycardia were observed during exercise in 3 of the AF horses during SET2. CONCLUSIONS AND CLINICAL IMPORTANCE: Atrial fibrillation resulted in a significant reduction in performance, an increase in HR and development of abnormal QRS complexes during exercise, which may be a risk factor for collapse or sudden cardiac death.