Cardiac Therapeutics in Horses

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Key points

  • Quinidine remains the drug of choice for the pharmacologic cardioversion of atrial fibrillation. Medications such as amiodarone have established evidence available for their use in specific situations. The role of other agents, such as flecainide, sotalol, and the angiotensin-converting enzyme (ACE) inhibitors, are under increasing scrutiny for their usefulness in the management of atrial fibrillation.

  • Management of acute tachyarrhythmias is achieved through a variety of pharmacologic agents.

Antiarrhythmic agents

Classically the antiarrhythmic agents have been divided into 4 main classes based on their predominant actions on cardiac tissues using the Vaughan-Williams classification system.1 Although this classification system is useful for considering how these drugs impact on formation and propagation of the cardiac action potential (Fig. 1), the categorization of agents is not absolute, with many antiarrhythmic drugs having actions across more than one group. More relevant to the equine practitioner

Management of horses with congestive heart failure

Recognition and clinical signs of CHF are detailed in John D. Bonagura's article, “Overview of the Equine Heart in Health and Disease,” in this issue. There are no data to recommend any specific therapy for the management of horses with asymptomatic heart disease, or whether any such interventions would reduce the progression of disease or have added benefit. However, studies have demonstrated significant prolongation of life expectancy and quality of life in medicated dogs with myxomatous

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