Antiarrhythmic drugs. Treatment of cardiac arrhythmias

This article focuses on drugs that have been specifically developed for the treatment of cardiac arrhythmias. A brief overview of the principal mechanisms responsible for the development of cardiac arrhythmias is also included, because it has been the goal of pharmacologists and clinical cardiologists to develop drugs and prescribe specific antiarrhythmic therapy based on a knowledge of these mechanisms with the assumption that specific antiarrhythmic therapy will be the most efficacious in restoring and maintaining normal sinus rhythm.     

Cardiac arrhythmias and serum cardiac troponins in Vipera palaestinae envenomation in dogs

BACKGROUND: Vipera palaestinae is responsible for most poisonous envenomations in people and animals in Israel. Cardiac arrhythmias were reported in a retrospective study of V. palaestinae envenomations in dogs. HYPOTHESIS: Cardiac arrhythmias in V. palaestinae-envenomed dogs are associated with myocardial injury reflected by increased serum concentrations of cardiac troponins (cTns). ANIMALS: Forty-eight client-owned dogs envenomed by V. palaestinae. METHODS: Blood sampling (serum biochemistry and cTns, CBC, and coagulation tests) and electrocardiography were performed periodically up to 72 hours postenvenomation. Cardiac rhythm strips were assessed blindly for the presence and type of arrhythmias. RESULTS: Serum cTn-T and cTn-I concentrations were increased in 25% (n = 12) and 65% (n = 31) of the dogs at least once during hospitalization, respectively. Arrhythmias were identified in 29% (n = 14) of the dogs. Dogs with increased cTn-T had a significantly higher occurrence of arrhythmias (58 versus 19%), and higher resting heart rate upon admission and within the following 24 hours. Dogs with increased serum cTn-T concentrations were hospitalized for a significantly (P= .001) longer period compared to those with normal serum cTn-T concentrations. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs envenomed by V. palaestinae appear to sustain some degree of myocardial injury, as reflected by increased serum cTn concentrations and by the occurrence of arrhythmias. The latter should alert clinicians to a potentially ongoing cardiac injury. An increase in cTn-T may be of clinical relevance and indicate a cardiac injury in V. palaestinae envenomations in dogs.     

The prevalence and nature of cardiac arrhythmias in horses following general anaesthesia and surgery

Background

The prevalence and nature of arrhythmias in horses following general anaesthesia and surgery is poorly documented. It has been proposed that horses undergoing emergency surgery for gastrointestinal disorders may be at particular risk of developing arrhythmias. Our primary objective was to determine the prevalence and nature of arrhythmias in horses following anaesthesia in a clinical setting and to establish if there was a difference in the prevalence of arrhythmias between horses with and without gastrointestinal disease undergoing surgery. Our secondary objective was to assess selected available risk factors for association with the development of arrhythmias following anaesthesia and surgery.

Methods

Horses with evidence of gastrointestinal disease undergoing an exploratory laparotomy and horses with no evidence of gastrointestinal disease undergoing orthopaedic surgery between September 2009 and January 2011 were recruited prospectively. A telemetric electrocardiogram (ECG) was fitted to each horse following recovery from anaesthesia and left in place for 24 hours. Selected electrolytes were measured before, during and after surgery and data was extracted from clinical records for analysis. Recorded ECGs were analysed and the arrhythmias characterised. Multivariable logistic regression was used to identify risk factors associated with the development of arrhythmias.

Results

Sixty-seven horses with gastrointestinal disease and 37 without gastrointestinal disease were recruited. Arrhythmias were very common during the post-operative period in both groups of horses. Supra-ventricular and bradyarrhythmias predominated in both groups. There were no significant differences in prevalence of any type of arrhythmias between the horses with or without gastrointestinal disease. Post-operative tachycardia and sodium derangements were associated with the development of any type of arrhythmia.

Conclusions

This is the first study to report the prevalence of arrhythmias in horses during the post-operative period in a clinical setting. This study shows that arrhythmias are very common in horses following surgery. It showed no differences between those horses with or without gastrointestinal disease. Arrhythmias occurring in horses during the post-anaesthetic period require further investigation.     

Cardiac troponin I and the occurrence of cardiac arrhythmias in horses with experimentally induced endotoxaemia

Branding is the traditional and well-established method used to mark horses, but recently microchip transponders for implantation have become available. In this study, behaviour, physiological stress variables and skin temperature in foals were determined in response to hot-iron branding (n=7) and microchip implantation (n=7). Salivary cortisol concentrations increased in response to branding (1.8 ± 0.2 ng/mL) and microchip implantation (1.4 ± 0.1ng/mL), but cortisol release over time did not differ. In response to both manipulations there was a transient increase in heart rate (P<0.001) and heart rate variability (P<0.01). Branding and microchip implantation induced a comparable aversive behaviour (branding, score 3.86 ± 0.85; microchip, score 4.00 ± 0.82). Both techniques thus caused similar physiological and behavioural changes indicative of stress. Acutely, implantation of a microchip was as stressful as branding in foals. Branding caused a necrotising skin burn lasting at least 7 days. Moreover branding, but not microchip implantation (P<0.001), was accompanied by a generalized increase in skin temperature which was comparable to low degree post-burn hypermetabolism in humans.     

Use of phenytoin to treat digitalis-induced cardiac arrhythmias in a miniature Shetland pony

Two miniature Shetland ponies showing clinical signs of Digitalis purpurea (foxglove) poisoning were examined. One animal died shortly afterwards, but the second was treated successfully with the anti-arrhythmic agent, phenytoin, and was discharged after 16 days.     

Exercising arrhythmias and sudden cardiac death in horses: Review of the literature and comparative aspects

Arrhythmias are common in equine athletes during and immediately after exercise. Many of these rhythm variations are not clinically relevant. In horses, a link between different exercising arrhythmias and poor performance or between exercising arrhythmias and sudden cardiac death (SCD) is strongly suspected but not fully understood or proven. SCD during races or competitions is rare, but has catastrophic consequences for the safety of the human partner and public perceptions of welfare during equestrian sports. This review summarises current knowledge of equine exercise arrhythmias and their implications in SCD and compares existing principles and recommendations for equine subjects with those for human athletes.     

猪场暴发附红细胞体病的诊疗

我市自 1 994年发现附红细胞体病以来 ,近几年的发生率逐年递增 ,发病的畜种也不断增加 ,先后诊断发生该病的畜种有 :牛、羊、猪、貂等。 2 0 0 0年 5月份以来在部分县、区、场频频发生该病 ,仅经我站诊断的就有牛附红细胞体病 5 0起 ,猪 5起 ,给畜牧业生产带来较大的损失 ,现将我市 7月初某猪场发生的猪附红细胞体病情况报告如下。1　发病情况　该猪场位于唐山市郊区 ,现存栏 670余头 ,其中种公猪 1 5头 ,种母猪 2 0 0多头。该猪场每年按常规免疫猪瘟、肺疫、仔猪副伤寒及细小病毒等疫苗 ,近几年来疫情稳定。 2 0 0 0年 7月 1日上午发现 1…     

梅花鹿巴氏杆菌病的诊治

2006年7月14日,临夏州某养殖场饲养的79只梅花鹿鹿群中个别发生一种以咳嗽、呼吸困难、流粘脓性鼻液为主要特征的疫病.发病8只,发病率为10.13%;死亡2只,死亡率为25%,不分年龄大小均发病,但以幼鹿和体弱者为主.     

犊牛脐疝的诊疗

疝是腹部内脏器官从自然孔道或病理性破裂孔脱至皮下或其他解剖腔的一种常见病，由疝轮、疝囊和疝内容物组成。当疝发生的解剖部位位于脐孔处时称为脐疝。奶牛的脐疝多见于犊牛，一般以先天性原因为主，属于遗传性疾病。犊牛的先天性脐疝多数在出生后数月逐渐消失，少数病例则越来越大。发生原因是脐孔没有闭锁，脐部化脓或腹壁发育缺陷等。