THERAPEUTIC APPROACH AND CLINICAL MANAGEMENT OF ATRIAL FIBRILLATION IN HORSES

Abstract

Atrial fibrillation (AF) is the most relevant cardiac arrhythmia in equine medicine, being the main cause of decreased athletic performance. Characterized by disorganized atrial activation and loss of coordinated contraction, AF compromises cardiac output during intense activities. The condition is complex, multifactorial, and atrial remodeling establishes a self-sustaining cycle that favors chronicity. This study is characterized as a narrative literature review, aiming to synthesize the most recent evidence on the therapeutic approach and clinical management of AF in horses. The diagnosis is based on the electrocardiogram (absence of P waves and presence of f-waves), complemented by echocardiography to identify structural diseases. Conventional treatment for cardioversion includes quinidine sulfate (with 73% success in a retrospective review) and transvenous electrical cardioversion (TECV). However, the recurrence rate drives the exploration of new approaches focused on the underlying disease. Experimental studies indicate that metformin, a metabolic modulator, can mitigate atrial remodeling, protecting against chronicity of the arrhythmia. Ideal clinical management integrates accurate diagnosis, rapid intervention, and preventive strategies for a favorable prognosis and return to sport.