Intravenous administration of quinidine and metoprolol for treatment of atrial fibrillation in 2 neonatal foals

J Vet Intern Med. 2024 Sep-Oct;38(5):2783-2789. doi: 10.1111/jvim.17164. Epub 2024 Aug 30.

Abstract

Atrial fibrillation (AF) is a rarely reported arrhythmia in otherwise healthy newborn foals, with a single case of cardioversion using procainamide administration described in the literature. Two neonatal Thoroughbred colts were presented to an equine hospital because of an irregularly irregular tachyarrhythmia and poor latching when trying to nurse. History, physical examination, and initial diagnostic testing including ECG and echocardiography confirmed AF without structural heart disease. The 1st foal converted into normal sinus rhythm after treatment with IV metoprolol and quinidine. The 2nd foal converted to normal sinus rhythm after a single IV dose of metoprolol, intended for rate control. Demeanor and nursing behavior improved markedly after conversion. The 2 foals had normal heart rates and sinus rhythm that persisted for 6 weeks until euthanasia in the 1st foal and for 2 years in the 2nd foal. Rate control and cardioversion should be considered as a treatment for persistent lone AF in neonatal foals.

Keywords: arrhythmia; cardioversion; electrocardiography; equine.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous / veterinary
  • Animals
  • Animals, Newborn*
  • Anti-Arrhythmia Agents* / administration & dosage
  • Anti-Arrhythmia Agents* / therapeutic use
  • Atrial Fibrillation* / drug therapy
  • Atrial Fibrillation* / veterinary
  • Electrocardiography / veterinary
  • Female
  • Horse Diseases* / drug therapy
  • Horses
  • Male
  • Metoprolol* / administration & dosage
  • Metoprolol* / therapeutic use
  • Quinidine* / administration & dosage
  • Quinidine* / therapeutic use

Substances

  • Anti-Arrhythmia Agents
  • Quinidine
  • Metoprolol