Studies on the Development of a New Lead System for Equine Electrocardiography

An Exploratory Study on Vectorcardiographic Identification of the Site of Origin of Focally Induced Premature Depolarizations in Horses, Part I: The Atria

In human cardiology, the anatomical origin of atrial premature depolarizations (APDs) is derived from P wave characteristics on a 12-lead electrocardiogram (ECG) and from vectorcardiography (VCG). The objective of this study is to differentiate between anatomical locations of APDs and to differentiate APDs from sinus rhythm (SR) based upon VCG characteristics in seven horses without cardiovascular disease. A 12-lead ECG was recorded under general anaesthesia while endomyocardial atrial pacing was performed (800−1000 ms cycle length) at the left atrial free wall and septum, right atrial free wall, intervenous tubercle, as well as at the junction with the cranial and caudal vena cava. Catheter positioning was guided by 3D electro-anatomical mapping and transthoracic ultrasound. The VCG was calculated from the 12-lead ECG using custom-made algorithms and was used to determine the mean electrical axis of the first and second half of the P wave. An ANOVA for spherical data was used to test if the maximal directions between each paced location and the maximal directions between every paced location and SR were significantly (p < 0.05) different. Atrial pacing data were not available from the LA septum in three horses, the intervenous tubercle in two horses, and from the LA free wall in one horse. The directions of the maximal electrical axes showed significant differences between all paced locations and between the paced locations and SR. The current results suggest that VCG is useful for identifying the anatomical origin of an atrial ectopy.

A novel approach for obtaining 12-lead electrocardiograms in horses

BACKGROUND

In equine medicine, 12-lead electrocardiograms (ECGs) rarely are used, which may in part be a result of shortcomings in the existing guidelines for obtaining 12-lead ECGs in horses. The guidelines recommend placing the limb leads on the extremities, which is inappropriate because the ventricular mean electrical axis is then perpendicular to the limb leads, leading to large variations in ECG configuration even among healthy horses. From an electrophysiological point of view, the leads instead should be parallel to the electrical axis to minimize variability.

OBJECTIVE

Develop an improved method for obtaining 12-lead ECGs in horses based on electrophysiology and cardiac electrical vectors relevant to horses.

ANIMALS

Thirty-five healthy Standardbred horses.

METHODS

Two ECGs obtained at rest; 1 ECG with the electrodes placed according to the method developed in the present study, the Copenhagen method, and 1 ECG following existing guidelines.

RESULTS

In the Copenhagen method, we repositioned the limb electrodes to the thorax to better capture the electrical activity of the heart. Variation in the mean electrical axis decreased dramatically with the Copenhagen method (SD decreased from 24.6° to 1.6°, P < .001). Consequently, this new method provided stable ECGs with repeatable configurations.

CONCLUSIONS AND CLINICAL IMPORTANCE

With this novel method, the ECG is recorded with respect to the electric axis to fully realize the potential of 12-lead ECG in horses. The Copenhagen method delivered more consistent and reliable ECG recordings compared to existing guidelines. The Copenhagen method potentially allows for expanded use of 12-lead ECGs in equine medicine.

Normal electro- and vectorcardiographic data in the growing Friesian calf using a semi-orthogonal lead system

This study derives normal values for electro- and vectorcardiographic parameters, as generated by the Holmes semi-orthogonal lead system, in healthy growing calves. Sixty-four electrocardiograms were recorded from healthy Friesian calves aged from one week to one year. Waveform and duration were analysed and compared in the X-, Y- and Z-leads. The modal P, QRS and T tridimensional vectors were graphically constructed and their magnitude and orientation were calculated. The duration of waves and intervals were similar to data previously reported in the bovine species. Differences from data reported in other species were attributed to heart rate. The duration of waves and QT and ST intervals significantly lengthened with the decrease in heart rate which occurred during growth. PR interval significantly lengthened with physical maturation, and this change was independent of the decrease in heart rate. The magnitude and the orientation of the spatial modal vectors were approximately similar to the few data previously reported in cattle and in other ungulates and were not affected by somatic growth.

Bovine vectocardiography: a comparative study relative to the validity of four tridimensional lead systems

For spatial vectocardiography to become applicable for cardiac investigation in cattle, it was necessary to develop a reliable standardized electrocardiographic lead system in this species. In this study, four tridimensional lead systems, initially developed in horses, were compared when applied in calves. Fifty seven electrocardiograms were collected. The between-subject variability of the magnitude and angles of the tridimensional P, QRS and T modal vectors obtained by use of each lead system was compared. Reproducibility of vectrocardiographic measurements was analyzed by comparing results obtained in 10 calves within a one day interval. The Holmes semi-orthogonal lead system, giving the lowest between-subject variability and the highest between-day reproducibility, appeared to be the most reliable lead system in order to apply vectocardiography in the bovine species.

The ratio of cardiopulmonary blood volume to stroke volume as an index of cardiac function in horses

A method was developed for determining the ratio of cardiopulmonary blood volume to stroke volume, in horses. The radioisotope 99 Tc (technetium 99m pertechnetate) was injected into the jugular vein as a bolus, which was then detected in the right and left ventricles consecutively by a scanning device consisting of a Na I crystal, a collimator, an amplifier and a discriminator. The radiocardiogram (RCG) and the ECG were recorded simultaneously by a two-channel writing device. The ratio of cardiopulmonary blood volume to stroke volume (cardiopulmonary flow index = CPFI) was then determined from the RCG and ECG tracings. Five categories of horses were examined, viz. Thoroughbreds in training, showjumpers in training, horses not in training, horses with cardiovascular disease and horses with chronic lung disease. The mean CPFI of the above categories were respectively 7.0 +/- 0.39, 7.3 +/- 0.45, 6.7 +/- 0.61, 9.8 +/- 1.30 and 6.2 +/- 0.47. The mean CPFI of the subjects with heart disease was significantly greater than the mean values of the other four categories (P less than 0.001). It was concluded that the CPFI was a reproducible physiological parameter in horses and that the value was significantly increased in our series of subjects with heart disease.

Spatial vector changes during ventricular depolarisation using a semi-orthogonal lead system--a study of 190 cases

The paper describes the spatial vector changes during ventricular depolarisation in 190 horses using a semi-orthogonal ECG lead system. The replacement of planar vector loops by a plot of 3 parameters to depict the changing spatial vector, with a time base on the X axis, is described and illustrated. Some horses with diastolic murmurs and some with a history of respiratory problems formed 2 distinct groups. As a result of these findings a possible relationship between the vector changes and the anatomical siting of the ventricles is suggested and discussed. Attention is drawn to certain measurements which appear to have possible use in assessing the significance of cardiac electrical activity in relation to changes in the ventricular myocardium.