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Atrial fibrillation in horses: factors associated with response to quinidine sulfate in 77 clinical cases.

Seventy-seven horses with atrial fibrillation (AF) were treated orally with quinidine sulfate (QS) at the University of Pennsylvania, School of Veterinary Medicine, Thirty-seven horses (48%) had adverse reactions to QS, the most common of which were nasal mucosal edema, anorexia, colic, and diarrhea. The mean highest daily QS dose was slightly greater in horses showing toxicity (P less than 0.1) and their conversion rate was less (P less than 0.05). A schedule of gradually increasing QS dose was time consuming, costly and not associated with fewer adverse reactions. Horses were compared by their response to QS: conversion for at least 12 months (Group I; 25 horses); reversion with 12 months (Group II; 8); nonconversion (Group III; 14). All horses with congestive heart failure (CHF) failed to convert. The mean age (P less than 0.05), total QS dose and highest daily QS dose (P less than 0.05) were significantly greater in Group III horses. The mean duration of signs before treatment and occurrence of adverse reactions to QS were greater in horses in Group II and III than Group I. (P less than 0.05). All horses in Groups I and II returned to performance, and many (81%) were successful. Most Group III horses (13/14) are known to have died. It was concluded that most horses with AF uncomplicated by CHF have a good prognosis when treated early with QS. Delayed QS therapy may reduce chances for conversion of AF or increase the probability of reversion.