A five-year-old gelding suffered syncope at the end of a period of exercise. A 24-hour electrocardiogram recording revealed intermittent pauses in the sinus rhythm of up to 10 seconds, indicating sinus node disease; the pauses occurred repeatedly, particularly after exercise. A dual-chamber, rate-adaptive pacemaker was successfully implanted, which prevented excessive postexercise bradycardia and syncope, and allowed the horse to return to work.
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