Premature depolarisations in horses competing in United States Eventing Association and Federation Equestre Internationale-sanctioned 3-day events

BackgroundInjuries and sudden death during the cross-country (XC) phase of eventing have raised interest in the frequency and types of cardiac arrhythmias occurring in these equine athletes. ObjectivesTo characterise the frequency and types of rhythm disturbances and examine possible risk factors for premature depolarisations (PDs) occurring during the XC phase of United States Eventing Association (USEA) and Federation Equestre Internationale (FEI)-sanctioned events. Study designProspective, cross-sectional study. MethodsContinuous electrocardiographic (ECG) recordings were obtained from horses prior to, during and immediately following the XC competition. Physiological rhythms pre-XC were included in the arrhythmia group for analysis. The frequency of PDs was calculated for all horses, as well as by division. PDs were categorised by complexity (singles, couplets, triplets, complex) and variably grouped for statistical analysis. Multiple logistic regression was used to identify risk factors for the presence of specific cardiac arrhythmia groupings during XC. ResultsPDs were identified in 42/75 horses (56% [45, 67]) during XC. Horses competing in the upper divisions of eventing had higher odds for having any PD during XC compared to the lower divisions (OR = 17.5 [4.3, 72.01], p = 0.006). The amount of time the heart rate (HR) was greater than 199 beats per minute (BPM) was associated with more complex arrhythmias (triplets, salvos and tachyarrhythmias) (OR = 1.01 [1.0, 1.02], p = 0.005). An arrhythmia at rest (physiological or PD) was associated with arrhythmia in the early recovery period (OR = 3.5 [1.1, 10.8], p = 0.03). Main limitationsConvenience sampling and technical challenges of continuous ECG recordings under competition settings limited the number of enrollments. ConclusionsPDs were seen in a high percentage of horses during the XC competition. Upper levels and time the HR was greater than 199 BPM were related to PD presence and complexity.