Agreement between Electrocardiogram and Heart Rate Meter Is Low for the Measurement of Heart Rate Variability during Exercise in Young Endurance Horses

Serum protein electrophoresis in European mink (Mustela lutreola): reference intervals and comparison of agarose gel electrophoresis and capillary zone electrophoresis

BACKGROUND

Knowledge of reference intervals for blood analytes, including serum protein fractions, is of great importance for the identification of infectious and inflammatory diseases and is often lacking in wild animal species.

MATERIAL AND METHODS

Serum samples were obtained from European minks enrolled in the breeding program (n = 55). Agarose gel electrophoresis (AGE) and capillary zone electrophoresis (CZE) were used to separate and identify protein fractions. Albumin, α1, α2, β, and γ-globulins fractions were identified in all mink sera by both electrophoresis methods. Reference intervals (90% CI) were determined following the 2008 guidelines of the Clinical Laboratory Standard Institute. The methods were compared using Passing-Bablok regression, Bland-Altman analysis, and Lin's concordance correlation.

RESULTS

A significant bias was found between methods for α1, α2, and γ-globulin. Lin's concordance correlation was considered unacceptable for α1, α2, and β-globulins. Differences for gender between methods were found for albumin and α2-globuins, which were higher for males than females. γ-globulins were higher for adults than young minks using both methods; however, α1 and α2-globulins were lower.

CONCLUSION

Both methods are adequate for identifying serum protein disorders, but the AGE and CZE methods are not equivalent. Therefore, reference intervals for each technique are required.

Behavioral observations, heart rate and cortisol monitoring in horses following multiple oral administrations of a cannabidiol containing paste (part 2/2)

As a remedy against stress and anxiety, cannabidiol (CBD) products are of increasing interest in veterinary medicine. Limited data is available describing the actual effectiveness of CBD in horses. The aim of this study (part 2 of 2) was to analyze stress parameters via behavioral observation, heart rate monitoring and assessment of blood and saliva cortisol levels in healthy horses treated repeatedly with a CBD containing paste. Twelve horses were randomly assigned to a treatment or a control group. Two pastes were orally administered in a double-blinded study design, one paste containing CBD and one paste without active ingredient. Both pastes were administered twice daily over 15 days (dose: 3 mg CBD/kg). Behavioral observations were conducted daily using a sedation score and a rating of facial expressions, based on the previously described facial sedation scale for horses (FaceSed) and the Horse Grimace Scale. Blood and saliva samples were obtained regularly to determine cortisol levels throughout the study. Cortisol levels were analyzed by means of liquid chromatography/tandem mass spectrometry (LC/MS/MS). Behavioral observations and cortisol levels were compared between groups. Prior to paste administration, a novel object test was performed and the horses' reaction to loading on a trailer was recorded. Both tests were repeated after 13 days of paste application. Movement patterns such as different gaits during the novel object test were evaluated and an ethogram was designed to assess exhibited behavioral traits. Cardiac beat-to-beat (R-R) intervals were recorded throughout and evaluated using heart rate (HR) and heart rate variability (HRV) parameters. Blood and saliva samples for cortisol analysis were taken before and after the tests. Daily behavioral observations and cortisol levels did not differ between the treatment and the control group. Similarly, analysis of movement patterns, HR, HRV and cortisol levels during the novel object test and trailer test did not identify significant differences between the groups. Regularly administered oral CBD (3 mg/kg BID over 15 days) had no statistically significant effect on behavioral observations, cortisol levels, HR and HRV in horses. Further research is required to establish adequate doses and indications for the use of CBD in horses.

Behavioral observations, heart rate and heart rate variability in horses following oral administration of a cannabidiol containing paste in three escalating doses (part 1/2)

Cannabidiol (CBD) products have been proposed to exert stress- and anxiety-relieving effects in animals. Despite the increasing popularity of CBD for veterinary use, the available research detailing the effects of CBD in horses is limited. The aim of this study (part 1 of 2) was to analyze stress parameters via behavioral observations and heart rate monitoring in healthy horses following single oral administration of a CBD containing paste in different doses. Study products were two pastes for oral administration, one containing CBD and one containing no active ingredient. Pastes were applied as single administrations in consecutive trials with escalating dosages (doses: 0.2, 1.0, 3.0 mg CBD/kg) to a treatment (trial 1: n = 3, trial 2: n = 3, trial 3: n = 5 horses) and a control group (trial 1: n = 3, trial 2: n = 3, trial 3: n = 6 horses) with minimum wash-out periods of seven days in between. Behavioral parameters were evaluated using video recordings to score the levels of sedation including the horses' reactions to acoustic and visual stimuli. Facial expression was assessed using photographs. Evaluation was based on the previously described facial sedation scale for horses (FaceSed) and the Horse Grimace Scale. For baseline values, identical observations were recorded on the day before each paste administration. Both paste administration and behavioral evaluation were performed double blinded. Cardiac beat-to-beat (R-R) intervals were continuously recorded throughout the trial and assessed using heart rate and heart rate variability parameters. Statistical analysis included comparison between treatment and control group over escalating doses and time points using linear mixed models. The CBD paste was well tolerated, and no side effects were observed. Analysis of sedation scores and facial expressions did not indicate significant differences between treatment and control group over the escalating doses. The heart rate was neither reduced, nor were significant changes in heart rate variability observed compared to the control group. Main limitation of this study is the small sample size. Further research is required to determine adequate doses and indications for the use of CBD products in horses.

Effect of Exercise in a Vector-Protected Arena for Preventing African Horse Sickness Transmission on Physiological, Biochemical, and Behavioral Variables of Horses

During an African horse sickness (AHS) outbreak, horses were able to exercise daily in a net-covered arena, yet the physiological responses to exercise in a netted arena was unknown. In a cross-over study design, eight horses performed a 39-minute aerobic exercise in conventional (CA) and vector-protected arenas (VPA). Horses were slower in some gaits and covered less distance in the VPA arena (P < .01). Cortisol release, hematology, and heart rate variability (HRV) were also examined. An interaction between the riding arena and time was observed in hematocrit (P = .0013), hemoglobin (P = .0012), and red blood cell count (P = .0027) and HRV variables, including mean beat-to-beat (RR) intervals (P < .0001), mean heart rate (P < .0001), sympathetic nervous system (SNS) index (P = .0038) and parasympathetic nervous system (PNS) index (P < .0001). Cortisol concentrations increased during exercise and 30 minutes postexercise in both arenas. Hematocrit, hemoglobin, and red blood cell count increased immediately postexercise in horses in VPA while remaining high from immediate post-exercise to 60 minutes postexercise in horses in CA. HRV decreased during exercise and was not different between horses in both arenas, but a higher RR interval and PNS index, corresponding to lower heart rate and SNS index, were detected during 30 to 60 minutes postexercise in horses in the VPA compared to the CA. Riding horses in different arenas impacted hematological and HRV variables. The greater RR intervals and PNS index, coinciding with the lower SNS index and heart rate, indicated parasympathetic dominance post-exercise in horses in VPA compared to CA.

Comparison of Asymmetry During Trot In-Hand With Evaluations of Discomfort and Pain in Horses While Exercised

Traditional visual lameness assessment is subjective. Ethograms have been developed for evaluating pain and objective sensors to detect lameness. Heart rate (HR) and heart rate variability (HRV) have been used to evaluate stress and pain. The aim of our study was to compare subjective and behavioral lameness scores, a sensor system measuring movement asymmetry, HR, and HRV. We hypothesized that these measures would show related trends. In 30 horses, an inertial sensor system was used to measure movement asymmetries during trot in-hand. A horse was categorized as sound if each asymmetry was less than 10 mm. We recorded riding to observe lameness and evaluate behavior. Heart rate and RR intervals were measured. Root mean squares of successive RR intervals (RMSSD) were calculated. Five horses were categorized as sound and 25 horses as lame by the inertial sensor system. No significant differences were detected between sound and lame horses in the ethogram, subjective lameness score, HR, and RMSSD. Overall asymmetry, ethogram, and lameness score had no significant correlation with each other, whereas overall asymmetry and ethogram correlated significantly with HR and RMSSD during certain phases of the ridden exercise. The main limitation of our study was the small number of sound horses detected by the inertial sensor system. The association between gait asymmetry and HRV suggests that the more gait asymmetry a horse shows during trot in-hand, the more pain or discomfort it probably experiences when ridden with a higher intensity. The threshold for lameness used by the inertial sensor system may require further evaluation.

Measuring heart rate variability using a heart rate monitor in horses (Equus caballus) during groundwork

Measuring physiological parameters of stress in horses during groundwork, for example when involved in equine-assisted interventions, is important to gain insight into the stress levels of the horses. Heart rate and heart rate variability can be used as physiological indicators of stress in horses. Heart rate monitors could be easily incorporated into practice, as they are not expensive and easy to use. However, it is questionable whether heart rate monitors present accurate heart rate variability results in exercising horses, similar to electrocardiograms. The aim of this study was to determine the accuracy of heart rate monitors for the assessment of heart rate variability in horses during groundwork exercise. Simultaneous telemetric electrocardiograms (Televet) and heart rate monitor (Polar H10 transmitter and M430 receiver, Hylofit electrodes) recordings were performed on 28 horses (15 mares and 13 geldings). Results indicate that the heart rate monitor accurately determined heart rate and time-domain heart rate variability parameters when compared to electrocardiograms during both baseline and groundwork conditions. As expected, heart rate significantly increased and the heart rate variability significantly decreased during groundwork compared to baseline conditions. This indicates that the heart rate monitor can be used to accurately determine heart rate variability during groundwork.

Can Sound Alone Act as a Virtual Barrier for Horses? A Preliminary Study

Virtual fencing is an innovative alternative to conventional fences. Different systems have been studied, including electric-impulse-free systems. We tested the potential of self-applied acoustic stimulus in deterring the horses from further movement. Thirty warmblood horses were individually introduced to a designated corridor leading toward a food reward (variant F) or a familiar horse (variant S). As the subject reached a distance of 30, 15 or 5 m from a finish line, an acute alarming sound was played. Generally, a sudden and unknown sound was perceived by horses as a threat causing an increase in vigilance and sympathetic activation. Horses' behaviour and barrier effectiveness (80% for F vs. 20% for S) depended on motivator (F/S), while the cardiac response indicating some level of stress was similar. The motivation for social interactions was too strong to stop the horses from crossing a designated boundary. Conversely, the sound exposure distance did not vary the barrier effectiveness, but it differentiated HRV responses, with the strongest sympathetic activation noted at a distance of 5 m. Thus, the moment of a sound playback has important welfare implications. Due to the limited potential of sound as a virtual barrier, auditory cues cannot be used as an alternative for conventional fencing.

Minimizing the Effects of Social Isolation of Horses by Contact with Animals of a Different Species: The Domestic Goat as an Example

This study aimed to perform a comparative analysis of the horses’ heart rate parameters and locomotor activity in a herd or isolation, with or without the company of goats. Twenty horses were tested in a paddock, accompanied (or not) by three goats. The experiment comprised four tests (a control test of a herd of horses without goats, a horse isolation test without goats, a test of a herd of horses with goats and a test of an isolated horse with goats). The horse’s locomotor behavior, and the HR, RR, rMSSD, LF, HF, and LF/HF were recorded. The data analysis included a 15-min rest, procedural and recovery HR/HRV periods, and a 5-min period at the beginning of the test. The duration of the horses standing in the company of goats increased significantly. The rMSSD parameter was the significantly lowest in the test of a herd of horses with goats. The company of goats in a paddock does not eliminate the emotional effects of the phenomenon. However, the locomotor behavior decreases. Goats in a paddock can provide a positive distraction for horses in a herd as a decrease in emotional excitability can be regarded as having a relaxing impact on a different animal species.

Dog–Owner Relationship, Owner Interpretations and Dog Personality Are Connected with the Emotional Reactivity of Dogs

Simple Summary

The relationship between owner and the dog affects the dog’s attachment behaviors and stress coping. In turn, the quality of the relationship may affect owner’s interpretations about their dog’s behavior. Here, we assessed dogs’ emotional responses from heart rate variability and behavioral changes during five different situations. Dog owners evaluated the emotion (valence and arousal) of their dog after each situation. We found that both negative and positive incidents provoked signs of emotional arousal in dogs. Owners detected the dog’s arousal especially during fear- and stress-evoking situations. The dog–owner relationship did not affect owners’ interpretation of dogs’ emotion. However, the dog–owner relationship was reflected in the dog’s emotional reactions. Close emotional bond with the owner appeared to decrease the arousal of the dogs. Dog owners’ frequent caregiving of their dog was associated with increased attachment behaviors and heightened arousal of dogs. Owners rated the disadvantages of the dog relationship higher for the dogs that were less owner-oriented and less arousable. Dog’s arousal may provoke dog’s need to seek human attention, which in turn may promote the development of emotional bond.

Abstract

We evaluated the effect of the dog–owner relationship on dogs’ emotional reactivity, quantified with heart rate variability (HRV), behavioral changes, physical activity and dog owner interpretations. Twenty nine adult dogs encountered five different emotional situations (i.e., stroking, a feeding toy, separation from the owner, reunion with the owner, a sudden appearance of a novel object). The results showed that both negative and positive situations provoked signs of heightened arousal in dogs. During negative situations, owners’ ratings about the heightened emotional arousal correlated with lower HRV, higher physical activity and more behaviors that typically index arousal and fear. The three factors of The Monash Dog–Owner Relationship Scale (MDORS) were reflected in the dogs’ heart rate variability and behaviors: the Emotional Closeness factor was related to increased HRV (p = 0.009), suggesting this aspect is associated with the secure base effect, and the Shared Activities factor showed a trend toward lower HRV (p = 0.067) along with more owner-directed behaviors reflecting attachment related arousal. In contrast, the Perceived Costs factor was related to higher HRV (p = 0.009) along with less fear and less owner-directed behaviors, which may reflect the dog’s more independent personality. In conclusion, dogs’ emotional reactivity and the dog–owner relationship modulate each other, depending on the aspect of the relationship and dogs’ individual responsivity.

Paroxysmal Atrial Fibrillation in Horses: Pathophysiology, Diagnostics and Clinical Aspects

Atrial fibrillation (AF) is the most common arrhythmia in horses causing poor performance. As in humans, the condition can be intermittent in nature, known as paroxysmal atrial fibrillation (pAF). This review covers the literature relating to pAF in horses and includes references to the human literature to compare pathophysiology, clinical presentation, diagnostic tools and treatment. The arrhythmia is diagnosed by auscultation and electrocardiography (ECG), and clinical signs can vary from sudden loss of racing performance to reduced fitness or no signs at all. If left untreated, pAF may promote electrical, functional and structural remodeling of the myocardium, thus creating a substrate that is able to maintain the arrhythmia, which over time may progress into permanent AF. Long-term ECG monitoring is essential for diagnosing the condition and fully understanding the duration and frequency of pAF episodes. The potential to adapt human cardiac monitoring systems and computational ECG analysis is therefore of interest and may benefit future diagnostic tools in equine medicine.

Selection of Image Texture Analysis and Color Model in the Advanced Image Processing of Thermal Images of Horses following Exercise

Simple Summary

Detecting horse state after exercise is critical for maximizing athletic performance. The horse’s response to fatigue includes exercise termination or exercise continuation at a lower intensity, which significantly limit the results achieved in races and equestrian competition. As conventional methods of detecting and quantifying exercise effort have shown some limitations, infrared thermography was proposed as a method of contactless detection of exercise effect. The promising correlation between body surface temperature and exercise-dependent blood biomarkers has been demonstrated. As the application of conventional thermography is limited by low specificity, advanced thermal image analysis was proposed here to visualize the link between blood biomarkers and texture of thermal images. Twelve horses underwent standardized exercise tests for six consecutive days, and both thermal images and blood samples were collected before and after each test. The images were analyzed using four color models (RGB, red-green-blue; YUV, brightness-UV-components; YIQ, brightness-IQ-components; HSB, hue-saturation-brightness) and eight texture-features approaches, including 88 features in total. In contrast to conventional temperature measures, as many as twelve texture features in two color models (RGB, YIQ) were linked with blood biomarker levels as part of the horse’s response to exercise.

Abstract

As the detection of horse state after exercise is constantly developing, a link between blood biomarkers and infrared thermography (IRT) was investigated using advanced image texture analysis. The aim of the study was to determine which combinations of RGB (red-green-blue), YUI (brightness-UV-components), YIQ (brightness-IQ-components), and HSB (hue-saturation-brightness) color models, components, and texture features are related to the blood biomarkers of exercise effect. Twelve Polish warmblood horses underwent standardized exercise tests for six consecutive days. Both thermal images and blood samples were collected before and after each test. All 144 obtained IRT images were analyzed independently for 12 color components in four color models using eight texture-feature approaches, including 88 features. The similarity between blood biomarker levels and texture features was determined using linear regression models. In the horses’ thoracolumbar region, 12 texture features (nine in RGB, one in YIQ, and two in HSB) were related to blood biomarkers. Variance, sum of squares, and sum of variance in the RGB were highly repeatable between image processing protocols. The combination of two approaches of image texture (histogram statistics and gray-level co-occurrence matrix) and two color models (RGB, YIQ), should be considered in the application of digital image processing of equine IRT.

Validation of an equine fitness tracker: ECG quality and arrhythmia detection

BACKGROUND

Cardiac arrhythmias in exercising horses are the focus of much interest, both in terms of what is considered normal and potential associations with poor performance and sudden cardiac death. One barrier to performing large-scale studies is the lack of an easily applicable device, to allow recording of large numbers of high-quality exercising electrocardiograms (ECGs). The EquimetreTM is a new wearable device which records a single lead ECG, amongst other parameters. Validation of such wearable devices is essential before further studies are undertaken.

OBJECTIVES

To evaluate the quality of ECG using the EquimetreTM and compare arrhythmia detection during exercise with the reference TelevetTM system.

STUDY DESIGN

Prospective blinded clinical study.

METHODS

Simultaneous ECGs were recorded with both systems in 49 healthy horses during exercise. High intensity exercise (>40km/h) was performed by 29 racehorses, and lower intensity exercise for the remainder of the racehorses and show jumpers. Tracings were excluded if >10% artefact was present (duration of artefact relative to duration of exercise). For included ECGs, the duration of artefact was recorded and compared. ECGs were evaluated using Kubios premium software. Arrhythmia detection (yes/no) and arrhythmia classification (sinus arrhythmia, narrow complex of similar morphology to the sinus complexes or wide complex with a different morphology) were compared using Cohen's Kappa coefficient.

RESULTS

Nine TelevetTM ECGs and 3 EquimetreTM ECGs were excluded due to artefact >10%. TelevetTM ECGs included significantly more artefact during exercise than EquimetreTM ECGs (5% vs. 0.25% p<0.001). Arrhythmia analysis was performed on 38 horses' paired ECGs. The Kappa coefficient was excellent for arrhythmia detection (K=0.97) and arrhythmia classification (K=0.93).

MAIN LIMITATIONS

Relatively low numbers of horses with arrhythmias (n=21) were included. The ECG recordings only provided one lead, making arrhythmia classification challenging in some cases.

CONCLUSIONS

The Equimetre device provides a reliable ECG for arrhythmia detection during exercise. This system may be useful clinically and for future large-scale investigations into the occurrence and significance of exercising arrhythmias.

Comparison of novel wearable cardiac monitors to yield accurate exercising ECG and heart rate data in horses

Exercise associated deaths (EADs) in horses are a problem for the equestrian industry. Sudden death (SD) is responsible for approximately 20% of EADs. The underlying cause of SD is suspected to be cardiovascular disease but often cannot be determined post-mortem. User-friendly cardiac monitors are needed for large scale investigations of arrhythmias associated with SD in horses. We hypothesised that novel wearable devices would provide exercising electrocardiograms (ECGs) of sufficient diagnostic quality for this purpose. Diagnostic quality of ECGs generated by two wearable devices (W2nd™ and Polar Equine™) were compared to simultaneous recordings with a telemetry unit (Televet™) in 5 Thoroughbreds completing 43 separate submaximal exercise tests on a high-speed treadmill. Maximal heart rate (HRmax) generated by mobile applications (HRmaxapp), HRmax after manual correction (HRmaxcorr), percentage of diagnostic ECGs (%diag) at the gallop, and overall quality assessed by visual analogue scale (VAS) were assessed by a blinded observer. HRmaxcorr did not differ significantly between groups. HRmaxapp was significantly lower for W2nd (166.8/min, 95% confidence interval (CI): 160.5-173.1/min) but did not differ significantly between Televet (178.8/min 95% CI: 165.8-191.1/min) and Polar (181.3/min, 95% CI: 174.5-188.1/min). HRmaxcorr was accurate and precise in all runs. HRmaxapp was within a priori limits of agreement in 16/23 W2nd and 18/19 Polar recordings. %diag was significantly lower (77.1%, 95% CI: 67.4-86.8) for W2nd than Polar (100%, 95% CI: 89.9-110.3). VAS was lower for W2nd (46.2, 95% CI: 35.5-57.0) than Polar (90.6, 25% CI: 79.4-101.9). In conclusion, wearable devices appear to be promising tools for investigation of equine exercising arrhythmias in large-scale studies.

Accuracy of a heart rate monitor for calculating heart rate variability parameters in exercising horses

Heart rate is evaluated in exercising horses to monitor the level of fitness to exercise, and it is usually acquired using heart rate monitors (HRM) or telemetric electrocardiograms (ECG). While HRM are commonly available and easy-to-use for horse's owners, ECG is a more expensive equipment requiring user's experience. Interest for heart rate variability (HRV) in horses is increasing for both research and clinical purposes. HRV is usually calculated from interbeat intervals (IBI) obtained by ECG. The aim of this study was to determine the accuracy of an HRM to detect IBI for the calculation of HRV in both resting and exercising horses. Simultaneous ECG and HRM recordings were performed on 13 horses and ponies under normal training conditions for at least 45 minutes. IBI from ECG were corrected using a dedicated software. IBI from HRM were exported without correction. Two HRV-parameters were calculated on both recordings for resting and exercising periods: the standard deviation of R-R intervals (SDRR) and the root mean square of successive differences (RMSSD). Agreement and concordance between the two systems were determined using Bland-Altman plot and Lin's correlation coefficient, respectively. Effects of variables were consequently assessed. For both HRV-parameters during resting and exercising periods, the means of the differences between the two systems were lower than 0.47 ms with a correlation coefficient higher than 0.999. Height, weight and body condition score had no effect on the results. The studied HRM could be of interest as easy-to-use device for obtaining HRV-parameters SDRR and RMSSD in resting and exercising horses.

Changes in saliva biomarkers during a standardized increasing intensity field exercise test in endurance horses

Salivary biomarkers could be useful to evaluate stress, fitness level, and skeletal muscle damage associated to exercise in horses in an easy and non-painful way. Therefore, this study aims to evaluate if cortisol in saliva (sCor), salivary alpha-amylase (sAMY) and butyrylcholinesterase (sBChE) and lactate (sLA) and creatine kinase (sCK) in saliva of horses can show changes during a standardized exercise test, and if they are related to heart rate variability (HRV) parameters related to sympathetic and parasympathetic tone, fitness level or skeletal muscle damage. For this purpose, ten endurance horses were submitted to a standardized exercise test in field conditions. Saliva and blood were obtained at basal time (TB), after the seven bouts of velocity (T + 01 to T + 07), and 5, 15, 30, and 45 min later (T + 5, T + 15, T + 30, and T + 45). Five endurance horses in resting condition (control group) were also enrolled. HRV and fitness level parameters, and plasma CK as a marker of muscle damage were also evaluated. Salivaryalpha-amylase increased at T + 30 (P = 0.03), sBChE at T + 5 (P = 008), and sCK at T + 07 (P = 0.009) after the exercise test, with significant differences between the exercise and control groups' results. The sCor did not show significant changes during the exercise test in the exercise group but higher concentration compared to the control horses (P < 0.001) were observed. sCor, sAMY, sBChE, and sCK showed a positive correlation (r values between 0.47 and 0.64) with the sympathetic tone and a negative correlation (r values between -0.37 and -0.56) with the parasympathetic tone. In conclusion, sAMY, sBChE, and sCK showed significant increases in ten endurance horses after an increasing intensity velocity exercise. Values of sCor, sAMY, sBChE, and sCK were associated with HRV, which is used to evaluate stress, and therefore, they could be potentially used to assess the exercise-related stress after a physical effort.

The use of electrical impedance tomography (EIT) to evaluate pulse rate in anaesthetised horses

Electrical impedance tomography (EIT) provides clinically useful lung images; however, it would be an advantage to extract additional cardiovascular information from the data. The aim of this study was to evaluate if cardiac-related changes measured by EIT can be used to measure pulse rate (PR) under physiological as well as high and low blood pressure states in anaesthetised horses. Electrical impedance tomography data and PR from seven horses anaesthetised in dorsal recumbency were recorded over 1 min during mechanical ventilation and 1 min of apnoea. Data were collected at four measurement time points; before and during intravenous administration of nitroprusside and phenylephrine, respectively. Nine pixels, estimated to represent the heart, were chosen from the EIT image. A novel algorithm detected peaks of impedance change for these pixels over 10 s intervals. Concurrent PR measured using an invasive blood pressure trace, was recorded every 10 s. EIT- and pulse-rate data were compared using Bland-Altman assessment for multiple measurements on each horse. Overall, 288 paired datasets from six of seven horses were available for analysis. There was excellent agreement for baseline measurements, as well as during hypertension and hypotension, with a bias of -0.26 and lower and upper limit of agreement at -2.22 (95% confidence intervals [CI], -2.89 to -1.86) and 1.69 (95% CI, 1.34-2.36) beats per min, respectively. EIT can be used to evaluate PR using cardiac-related impedance changes. More work is required to determine bias that might occur in anaesthetised horses in other recumbencies or clinical situations.

Validation of an equine fitness tracker: heart rate and heart rate variability

The adoption of fitness tracker devices to monitor training in the equine market is in full expansion. However, the validity of most of these devices has not been assessed. The aim of this study was to examine the validity of heart rate (HR) and heart rate variability (HRV) measurements during high-intensity exercise by an integrated equine fitness tracker with an electrocardiogram (ECG) (Equimetre) in comparison to an ECG device (Televet). Twenty Thoroughbred racehorses were equipped with the two devices and completed a training session at the track. Data from 18 horses was readable to be analysed. Equimetre HR was compared to Televet HR derived from the corrected Televet ECG. HRV parameters were computed in a dedicated software (Kubios) on uncorrected and manually corrected ECG from both devices, and compared to the Televet corrected data. The HR was recorded on the entire training session and HRV parameters were calculated during the exercise and recovery periods. A strong correlation between the Equimetre HR and Televet HR on corrected data was found (Pearson correlation: r=0.992, P<0.001; root mean square error = 4.06 bpm). For HRV, the correlation was good for all parameters when comparing corrected Equimetre to corrected Televet data (Lin’s coefficient = 0.998). When comparing data obtained from uncorrected Equimetre data to the corrected Televet data, the correlation for HR was still good (Lin’s coefficient = 0.995) but the correlation for all HRV parameters was poor, except for the triangular index (Lin’s coefficient = 0.995). However, correlation between the uncorrected Televet HRV data and the corrected Televet data was equally poor (Lin’s coefficient <0.9). In conclusion, the integrated equine fitness tracker Equimetre satisfies validity criteria for HR monitoring in horses during high intensity exercise. When using corrected ECG data, it provides accurate HRV parameters as well.

Heart rate variability analysis in horses for the diagnosis of arrhythmias

Heart rate variability (HRV) analysis has been performed on ECG-derived data sets for more than 170 years but is currently undergoing a rapid evolution, thanks to the expansion of the human and veterinary medical technology sector. Traditional HRV analysis was initially performed to identify changes in vago-sympathetic balance, while the most recent focus has expanded to include the use of complex computer algorithms, neural networks and machine learning technology to identify cardiac arrhythmias, particularly atrial fibrillation (AF). Some of these techniques have recently been translated for use in the field of equine cardiology, with particular focus on improving the diagnosis of arrhythmias both at rest and during exercise. This review focuses on understanding the basic HRV variables and important factors to consider when collecting data for use in HRV analysis. In addition, the use of HRV analysis for the diagnosis of arrhythmias is discussed from human, small animal and equine perspectives. Finally, the future of HRV analysis is briefly introduced, including an overview of future developments in this rapidly expanding and exciting field.

Evaluation of Stress Response under a Standard Euthanasia Protocol in Horses Using Analysis of Heart Rate Variability

Simple Summary

In our study, we examined different stress factors during euthanasia in horses. Therefore, we measured the heart rate variability (HRV), which is a method to determine stress in various species. The HRV was determined in 40 horses undergoing euthanasia due to various reasons, at different times and locations throughout the clinic, and with/without owner presence. Significant differences in HRV parameters were found between the times of euthanasia. The location of euthanasia, presence of owner, or type of primary diseases had no influence on stress parameters. Horse with colic however presented with less smooth euthanasia. In conclusion, HRV is a sensitive, noninvasive parameter to assess the stress response during euthanasia. Further, euthanasia in horses with colic was the most challenging and modification of the protocols for colic horses should be considered.

Abstract

The effects of a standard protocol for euthanasia on heart rate variability (HRV) as a consequence of stress response were analyzed in this prospective clinical study. The HRV was determined in 40 horses undergoing euthanasia due to various reasons, at different locations, and with/without owner presence. For euthanasia, horses were sedated with xylazine or a combination of xylazine and butorphanol. General anesthesia was induced using diazepam and ketamine. Afterwards, horses were euthanized with pentobarbital. The ECG data were taken by a Telemetric ECG at three time points (sedation, anesthesia, anesthesia until death). The HRV was analyzed including the low (LF) and high frequency (HF) components of HRV and the sympathovagal balance (LF/HF ratio). Significant differences in the LF, HF and LF/HF ratio were found between the three time points of euthanasia (p < 0.001). The HRV analysis showed dominating sympathetic activity in the preparation phase of euthanasia and during the injection of pentobarbital. The location of euthanasia, presence of owner and type of primary diseases had no influence on stress parameters. Horses showing excitations or groaning during euthanasia did not differ in HRV. Horse with colic were however more likely to show reoccurrence of breathing during euthanasia. In conclusion, HRV is a sensitive, noninvasive parameter to obtain sympathovagal stimulations during euthanasia and adapted protocols for euthanasia in horse with colic should be studied.

Continuous ECG Monitoring Trial for Outpatient - Patient Receptiveness and Signal Accuracy

We have conducted a clinical trial to investigate the receptiveness and signal accuracy of our in-house light-weight single lead wearable wireless ECG device with 20 outpatients, who were suspected of cardiac rhythm issues. The receptiveness was measured via a survey score sheet while the signal accuracy was evaluated by comparing the Holter's hourly heart rate report (the gold-standard) against the ones from our device. In terms of receptiveness, a score of 8.6 indicates good patient compliance. In terms of accuracy, the mean absolute error is 1.4 bpm (beats per minute) with precision of ±1.6 bpm. In addition, measurements from both devices were found to be linearly related with coefficient of determination, r², of 0.97. Furthermore, the limits of agreement were calculated to be +3.54 and -4.71 based on the Altman and Bland technique, which indicated good agreement for most of our measurements against the Holter device. In addition, this paper also discusses the unexpected challenges of conducting a trial on actual outpatients which can be used as a reference for similar subsequent studies.

Equine Electrocardiography

Analyzing electrocardiographic (ECG) recordings, making a diagnosis and assessment of any arrhythmias present, is an important part of the workup of many equine cases. Accurate analysis requires a good-quality recording, free of as many artifacts as possible, with clear P-QRS-T complex morphology. For sustained arrhythmias, short-term recordings are sufficient to make the appropriate diagnosis before instigating treatment. Longer-term recordings are essential for arrhythmias that are paroxysmal, intermittent, or occurring infrequently, while exercising ECGs are required for arrhythmias associated with physical activity. A stepwise, logical approach to ECG analysis will help the observer to recognize and correctly diagnose any arrhythmias present.

Recording Heart Rate Variability of Dairy Cows to the Cloud-Why Smartphones Provide Smart Solutions

In the last decades, there has been an increasing interest in animal protection and welfare issues. Heart rate variability (HRV) measurement with portable heart rate monitors on cows has established itself as a suitable method for assessing physiological states. However, more forward-looking technologies, already successfully applied to evaluate HRV data, are pushing the market. This study examines the validity and usability of collecting HRV data by exchanging the Polar watch V800 as a receiving unit of the data compared to a custom smartphone application on cows. Therefore, both receivers tap one signal sent by the Polar H7 transmitter simultaneously. Furthermore, there is a lack of suitable methods for the preparation and calculation of HRV parameters, especially for livestock. A method is presented for calculating more robust time domain HRV parameters via median formation. The comparisons of the respective simultaneous recordings were conducted after artifact correction for time domain HRV parameters. High correlations (r = 0.82⁻0.98) for cows as well as for control data set in human being (r = 0.98⁻0.99) were found. The utilization of smart devices and the robust method to determine time domain HRV parameters may be suitable to generate valid HRV data on cows in field-based settings.