Association of heart rate variability, exercise intensity and exercising arrhythmias with competition results in eventing horses.

Background
Exercising arrhythmias are common in horses participating in eventing competitions. Heart rate variability (HRV) and a specific measure of the degree of heart rate fluctuation (Detrended Fluctuation Analysis alpha1; DFA-α1) are proposed as exercise intensity and fatigue markers.Objectives
(1) To describe exercising arrhythmias and DFA-α1 values during 2-4* level eventing cross-country competitions in horses from two European countries; (2) to identify associations between exercising arrhythmias, DFA-α1 and competition results and (3) to evaluate whether markers of the intensity of exercise are associated with exercising arrhythmias, DFA-α1 or competition results.Methods
A convenience sample of exercising ECGs and competition results from horses during cross-country eventing competitions was examined. Statistical analysis was conducted using multivariable mixed-effects logistic, Poisson and linear regression models.Results
Arrhythmias were frequent during 69 cross-country competition ECGs from 43 horses. Detrended fluctuation analysis α1 was not associated with performance during cross-country, but a higher DFA-α1 during cross-country was associated with fewer showjumping phase penalties. More premature complexes, the presence of complex arrhythmias and arrhythmias during recovery were associated with fewer time penalties during cross-country. The presence of complex arrhythmias and arrhythmias during recovery of the cross-country phase was associated with more penalties during the showjumping phase. Higher blood lactate concentration, higher HRpeak and higher HRmean were associated with fewer time penalties during cross-country.Main Limitations
The arrhythmias observed do not allow conclusions to be drawn about the consequences of more severe arrhythmias. The associations described here were often of small magnitude or with large confidence intervals and must be interpreted cautiously.Conclusions
Arrhythmias during the cross-country test of eventing competitions were frequently associated with positive competition results during the cross-country phase and negative results during the showjumping phase. The specific arrhythmia types and circumstances that should raise concern about performance and safety remain relevant but unanswered questions for equine practitioners.