Ventricular Arrhythmias during Race Recovery in Standardbred Racehorses and Associations with Autonomic Activity

Background A lack of information on normal heart rhythm at maximal effort hampers investigation of poor performance and sudden death in Standardbred racing. Hypothesis/Objective To characterize rhythm variations during scheduled racing in clinically normal Standardbred horses. Animals Two hundred and eighty-eight Standardbred horses competing in 40 scheduled races at a Southern Ontario racetrack. Methods Observational study, convenience sampling: Heart rhythm was monitored by ECG from harnessing to postrace recovery and assessed visually and by examining heart rate intervals. Rhythm variations were used as response variables in multivariate analysis of race records detailing signalment, race, and race outcome. Results Monitoring involved 345 individual horse or race events. Occasional, isolated premature cycles, only, occurred during the race. Postrace, sudden cardiac slowing (punctuated deceleration [PD]) appeared in 42 events (12.2%). Only premature ventricular complexes were exhibited in 40 events postrace (11.6%), whereas 55 (15.9%) exhibited complex ventricular arrhythmias (CVA) including torsades-like polymorphic ventricular tachycardia, 34.5% of these being closely associated with PD (odds ratio = 8). Predispositions to CVA were found for horses parked at the 1/2 mile (odds ratio = 3), and trotters breaking in the stretch (odds ratio = 38). Horses spontaneously reverted to sinus rhythm and no sudden death events were encountered. Conclusions and Clinical Importance Arrhythmias occur frequently in racing Standardbreds during cardiac deceleration, often associated with sudden, rapid increases in vagal tone. Circumstances imposing unusual demand and racing at the trot appear to predispose. Findings provide insight into possible mechanisms of sudden death.