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Animals : an open access journal from MDPI2022; 12(5); 549; doi: 10.3390/ani12050549

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

Abstract: 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.
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Publication Date: 2022-02-23 PubMed ID: 35268117PubMed Central: PMC8908827DOI: 10.3390/ani12050549Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The researchers performed a study to determine whether vectorcardiography (VCG), an established method used in human cardiology to identify the anatomical origin of atrial premature depolarizations (APDs), can be successfully used in the same capacity in horses. The study was conducted in seven horses without pre-existing cardiovascular disease. VCG was used to identify differences between APDs and normal sinus rhythm based on anatomical locations.

Methodology

  • The horses were put under general anaesthesia during the study procedure.
  • A 12-lead electrocardiogram (ECG) was recorded while performing endomyocardial atrial pacing, a procedure that involves posting tiny electrical impulses to the atria to regularize the heart rate.
  • The pacing was done at numerous locations namely, the left atrial free wall and septum, right atrial free wall, intervenous tubercle, and the junction with the cranial and caudal vena cava.
  • Transthoracic ultrasound and 3D electro-anatomical mapping were used to ensure accurate catheter positioning.
  • A VCG was then calculated from the ECG readings using custom algorithms.
  • These algorithms were designed to determine the mean electrical axis of the first and second half of the P wave. The P wave is a part of the ECG recording that signifies the depolarization of the atria – generally the first visible part of the recording.
  • The researchers aimed to determine if the directions of these electrical axes showed significant delineation between the various paced locations, as well as differences between the paced locations and sinus rhythm (SR).

Results

  • A wide variation in the availability of atrial pacing data was observed due to the different positions not being accessible in all horses. For instance, data was not available from the left atrial (LA) septum in three horses, the intervenous tubercle in two horses, and from the LA free wall in one horse.
  • Despite these limitations, the researchers found that the directions of the maximal electrical axes showed significant differences between all paced locations and between the paced locations and SR.
  • These differences were tested using ANOVA for spherical data, a statistical method for analysing complex data structures, and results were considered significant if there was less than a 5% chance that they were due to random variation.

Conclusions

  • These findings suggest that vectorcardiography could be a valuable tool in equine cardiology for identifying the anatomical origin of atrial ectopy, a condition marked by irregular heart rhythms due to rapid and/or erratic electrical impulses in the atria.
  • Further research would be useful to validate these findings and explore their applicability, especially considering the limitations encountered during this study.

Cite This Article

APA
Van Steenkiste G, Delhaas T, Hermans B, Vera L, Decloedt A, van Loon G. (2022). An Exploratory Study on Vectorcardiographic Identification of the Site of Origin of Focally Induced Premature Depolarizations in Horses, Part I: The Atria. Animals (Basel), 12(5), 549. https://doi.org/10.3390/ani12050549

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 12
Issue: 5
PII: 549

Researcher Affiliations

Van Steenkiste, Glenn
  • Equine Cardioteam, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
Delhaas, Tammo
  • Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, 6200 MD Maastricht, The Netherlands.
Hermans, Ben
  • Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, 6200 MD Maastricht, The Netherlands.
Vera, Lisse
  • Equine Cardioteam, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
Decloedt, Annelies
  • Equine Cardioteam, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
van Loon, Gunther
  • Equine Cardioteam, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.

Grant Funding

  • 1134917N / Research Foundation - Flanders
  • 1S56217N / Research Foundation - Flanders

Conflict of Interest Statement

The authors declare no conflict of interest.

References

This article includes 39 references
  1. Van Steenkiste G, Duytschaever M, De Clercq D, Tavernier R, Michielsen A, Decloedt A, Schauvliege S, van Loon G. First successful radiofrequency ablation of atrial tachycardia in a horse guided by a high density 3D electro-anatomical mapping system (Rhythmia). J. Vet. Intern. Med. 2019;33:1547.
    doi: 10.1111/jvim.15447google scholar: lookup
  2. van Loon G, Van Steenkiste G, Vera L, Decloedt A. Catheter-based electrical interventions to study, diagnose and treat arrhythmias in horses: From refractory period to electro-anatomical mapping.. Vet J 2020 Sep;263:105519.
    doi: 10.1016/j.tvjl.2020.105519pubmed: 32928488google scholar: lookup
  3. Lee JM, Fynn SP. P wave morphology in guiding the ablation strategy of focal atrial tachycardias and atrial flutter.. Curr Cardiol Rev 2015;11(2):103-10.
    doi: 10.2174/1573403X10666141013121252pmc: PMC4356716pubmed: 25308814google scholar: lookup
  4. Santilli RA, Perego M, Crosara S, Gardini F, Bellino C, Moretti P, Spadacini G. Utility of 12-lead electrocardiogram for differentiating paroxysmal supraventricular tachycardias in dogs.. J Vet Intern Med 2008 Jul-Aug;22(4):915-23.
    doi: 10.1111/j.1939-1676.2008.0127.xpubmed: 18564226google scholar: lookup
  5. Muylle E, Oyaert W. Equine electrocardiography. The genesis of the different configurations of the "QRS" complex.. Zentralbl Veterinarmed A 1977 Nov;24(9):762-71.
    doi: 10.1111/j.1439-0442.1977.tb01754.xpubmed: 413289google scholar: lookup
  6. Holmes JR, Alps BJ. Studies Into Equine Electrocardiography and Vectorcardiography: II. Cardiac Vector Distributions in Apparently Healthy Horses.. Can J Comp Med Vet Sci 1967 Jun;31(6):150-5.
    pmc: PMC1494694pubmed: 17649589
  7. Pfister R, Seifert-Alioth C, Beglinger R. [Determination of the focus of ventricular extrasystole in the horse].. Schweiz Arch Tierheilkd 1984 Apr;126(4):165-72.
    doi: 10.5169/seals-588065pubmed: 6203170google scholar: lookup
  8. HAMLIN RL, SMETZER DL, SMITH CR. ANALYSIS OF QRS COMPLEX RECORDED THROUGH A SEMIORTHOGONAL LEAD SYSTEM IN THE HORSE.. Am J Physiol 1964 Aug;207:325-33.
    doi: 10.1152/ajplegacy.1964.207.2.325pubmed: 14205342google scholar: lookup
  9. Van Zijl WJ. The electrocardiogram of the normal horse using the techniques of Einthoven and Wilson. Tijdschrift Diergeneeskunde 1951;76:85–96.
  10. Muylle E, Oyaert W. Atrial activation pathways and the P wave in the horse.. Zentralbl Veterinarmed A 1975 Aug;22(6):474-84.
    doi: 10.1111/j.1439-0442.1975.tb01454.xpubmed: 811016google scholar: lookup
  11. Holmes JR, Darke PGGG. Studies on the development of a new lead system for equine electrocardiography. Equine Vet. J. 1970;2:12–21.
    doi: 10.1111/j.2042-3306.1970.tb04146.xgoogle scholar: lookup
  12. Holmes JR, Else RW. Further studies on a new lead for equine electrocardiography.. Equine Vet J 1972 Apr 5;4(2):81-7.
    doi: 10.1111/j.2042-3306.1972.tb03884.xpubmed: 4677298google scholar: lookup
  13. Muylle E, Oyaert W. Clinical evaluation of cardiac vectors in the horse.. Equine Vet J 1971 Oct;3(4):129-36.
    doi: 10.1111/j.2042-3306.1971.tb04455.xpubmed: 5161365google scholar: lookup
  14. Hesselkilde EM, Isaksen JL, Petersen BV, Carstensen H, Jespersen T, Pehrson S, Kanters JK, Buhl R. A novel approach for obtaining 12-lead electrocardiograms in horses.. J Vet Intern Med 2021 Jan;35(1):521-531.
    doi: 10.1111/jvim.15980pmc: PMC7848388pubmed: 33274799google scholar: lookup
  15. Man S, Maan AC, Schalij MJ, Swenne CA. Vectorcardiographic diagnostic & prognostic information derived from the 12-lead electrocardiogram: Historical review and clinical perspective.. J Electrocardiol 2015 Jul-Aug;48(4):463-75.
    doi: 10.1016/j.jelectrocard.2015.05.002pubmed: 26027545google scholar: lookup
  16. Augustyniak P. On the equivalence of the 12-lead ECG and the VCG representations of the cardiac electrical activity. Proceedings of the 10th International Conference on System-Modelling-Control Zakopane, Poland. 21–25 May 2001; pp. 21–25.
  17. SANO T, HELLERSTEIN HK, VAYDA E. P vector loop in health and disease as studied by the technique of electrical dissection of the vectorcardiogram (differential vectorcardiography).. Am Heart J 1957 Jun;53(6):854-79.
    doi: 10.1016/0002-8703(57)90322-8pubmed: 13424466google scholar: lookup
  18. Rangel MO, O'Neal WT, Soliman EZ. Usefulness of the Electrocardiographic P-Wave Axis as a Predictor of Atrial Fibrillation.. Am J Cardiol 2016 Jan 1;117(1):100-4.
    doi: 10.1016/j.amjcard.2015.10.013pubmed: 26552511google scholar: lookup
  19. Van Steenkiste G, L V, Decloedt A, Schauvliege S, Boussy T, van Loon G. Endocardial electro-anatomic mapping in healthy horses: Normal sinus impulse propagation in the left and right atrium and the ventricles.. Vet J 2020 Apr;258:105452.
    doi: 10.1016/j.tvjl.2020.105452pubmed: 32564870google scholar: lookup
  20. Van Steenkiste G, De Clercq D, Boussy T, Vera L, Schauvliege S, Decloedt A, van Loon G. Three dimensional ultra-high-density electro-anatomical cardiac mapping in horses: methodology.. Equine Vet J 2020 Sep;52(5):765-772.
    doi: 10.1111/evj.13229pubmed: 31954064google scholar: lookup
  21. Magnani JW, Mazzini MJ, Sullivan LM, Williamson M, Ellinor PT, Benjamin EJ. P-wave indices, distribution and quality control assessment (from the Framingham Heart Study).. Ann Noninvasive Electrocardiol 2010 Jan;15(1):77-84.
    doi: 10.1111/j.1542-474X.2009.00343.xpmc: PMC2901840pubmed: 20146786google scholar: lookup
  22. Cremers J, Klugkist I. One Direction? A Tutorial for Circular Data Analysis Using R With Examples in Cognitive Psychology.. Front Psychol 2018;9:2040.
    doi: 10.3389/fpsyg.2018.02040pmc: PMC6218623pubmed: 30425670google scholar: lookup
  23. Paine PJ, Preston SP, Tsagris M, Wood ATA. An elliptically symmetric angular gaussian distribution. Stat. Comput. 2018;28:689–697.
    doi: 10.1007/s11222-017-9756-4google scholar: lookup
  24. Sra S. A short note on parameter approximation for von Mises-Fisher distributions: And a fast implementation of I s(x). Comput. Stat. 2012;27:177–190.
    doi: 10.1007/s00180-011-0232-xgoogle scholar: lookup
  25. Mardia KV, Jupp PE. Statistics of Directional Data. 2nd ed. John Wiley & Sons, Ltd.; Hoboken, NJ, USA: 1972.
  26. Hamlin RL, Himes JA, Guttridge H, Kirkham W. P wave in the electrocardiogram of the horse.. Am J Vet Res 1970 Jun;31(6):1027-31.
    pubmed: 5430694
  27. Platonov PG. P-wave morphology: underlying mechanisms and clinical implications.. Ann Noninvasive Electrocardiol 2012 Jul;17(3):161-9.
    doi: 10.1111/j.1542-474X.2012.00534.xpmc: PMC6932587pubmed: 22816534google scholar: lookup
  28. Boineau JP, Canavan TE, Schuessler RB, Cain ME, Corr PB, Cox JL. Demonstration of a widely distributed atrial pacemaker complex in the human heart.. Circulation 1988 Jun;77(6):1221-37.
    doi: 10.1161/01.CIR.77.6.1221pubmed: 3370764google scholar: lookup
  29. Stiles MK, Brooks AG, Roberts-Thomson KC, Kuklik P, John B, Young GD, Kalman JM, Sanders P. High-density mapping of the sinus node in humans: role of preferential pathways and the effect of remodeling.. J Cardiovasc Electrophysiol 2010 May;21(5):532-9.
    doi: 10.1111/j.1540-8167.2009.01644.xpubmed: 19912447google scholar: lookup
  30. Fedorov VV, Schuessler RB, Hemphill M, Ambrosi CM, Chang R, Voloshina AS, Brown K, Hucker WJ, Efimov IR. Structural and functional evidence for discrete exit pathways that connect the canine sinoatrial node and atria.. Circ Res 2009 Apr 10;104(7):915-23.
    doi: 10.1161/CIRCRESAHA.108.193193pmc: PMC2740656pubmed: 19246679google scholar: lookup
  31. Konings KT, Kirchhof CJ, Smeets JR, Wellens HJ, Penn OC, Allessie MA. High-density mapping of electrically induced atrial fibrillation in humans.. Circulation 1994 Apr;89(4):1665-80.
    doi: 10.1161/01.CIR.89.4.1665pubmed: 8149534google scholar: lookup
  32. Hamlin RL, Smetzer DL, Senta T, Smith CR. Atrial activation paths and P waves in horses.. Am J Physiol 1970 Aug;219(2):306-13.
    doi: 10.1152/ajplegacy.1970.219.2.306pubmed: 5448058google scholar: lookup
  33. De PR, Ho SY, Salerno-Uriarte JA, Tritto M, Spadacini G. Electroanatomic analysis of sinus impulse propagation in normal human atria.. J Cardiovasc Electrophysiol 2002 Jan;13(1):1-10.
    doi: 10.1046/j.1540-8167.2002.00001.xpubmed: 11843475google scholar: lookup
  34. Holmqvist F, Husser D, Tapanainen JM, Carlson J, Jurkko R, Xia Y, Havmöller R, Kongstad O, Toivonen L, Olsson SB, Platonov PG. Interatrial conduction can be accurately determined using standard 12-lead electrocardiography: validation of P-wave morphology using electroanatomic mapping in man.. Heart Rhythm 2008 Mar;5(3):413-8.
    doi: 10.1016/j.hrthm.2007.12.017pubmed: 18313600google scholar: lookup
  35. Dong J, Zrenner B, Schreieck J, Deisenhofer I, Karch M, Schneider M, Von Bary C, Weyerbrock S, Yin Y, Schmitt C. Catheter ablation of left atrial focal tachycardia guided by electroanatomic mapping and new insights into interatrial electrical conduction.. Heart Rhythm 2005 Jun;2(6):578-91.
    doi: 10.1016/j.hrthm.2005.03.014pubmed: 15922263google scholar: lookup
  36. Qian ZY, Hou XF, Xu DJ, Yang B, Chen ML, Chen C, Zhang FX, Shan QJ, Cao KJ, Zou JG. An algorithm to predict the site of origin of focal atrial tachycardia.. Pacing Clin Electrophysiol 2011 Apr;34(4):414-21.
    doi: 10.1111/j.1540-8159.2010.02980.xpubmed: 21091746google scholar: lookup
  37. Tang CW, Scheinman MM, Van Hare GF, Epstein LM, Fitzpatrick AP, Lee RJ, Lesh MD. Use of P wave configuration during atrial tachycardia to predict site of origin.. J Am Coll Cardiol 1995 Nov 1;26(5):1315-24.
    doi: 10.1016/0735-1097(95)00307-Xpubmed: 7594049google scholar: lookup
  38. Tada H, Nogami A, Naito S, Suguta M, Nakatsugawa M, Horie Y, Tomita T, Hoshizaki H, Oshima S, Taniguchi K. Simple electrocardiographic criteria for identifying the site of origin of focal right atrial tachycardia.. Pacing Clin Electrophysiol 1998 Nov;21(11 Pt 2):2431-9.
    doi: 10.1111/j.1540-8159.1998.tb01196.xpubmed: 9825362google scholar: lookup
  39. Kistler PM, Roberts-Thomson KC, Haqqani HM, Fynn SP, Singarayar S, Vohra JK, Morton JB, Sparks PB, Kalman JM. P-wave morphology in focal atrial tachycardia: development of an algorithm to predict the anatomic site of origin.. J Am Coll Cardiol 2006 Sep 5;48(5):1010-7.
    doi: 10.1016/j.jacc.2006.03.058pubmed: 16949495google scholar: lookup

Citations

This article has been cited 7 times.
  1. Buschmann E, Van Steenkiste G, Boussy T, Vernemmen I, Schauvliege S, Decloedt A, van Loon G. Three-dimensional electro-anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: A case report. J Vet Intern Med 2023 Mar;37(2):728-734.
    doi: 10.1111/jvim.16668pubmed: 36866668google scholar: lookup
  2. Weis R, Carstensen H, Sattler SM, Buhl R, Hesselkilde EM. Electrocardiographic Changes in a Horse with Induced Myocardial Infarction. Animals (Basel) 2022 May 16;12(10).
    doi: 10.3390/ani12101272pubmed: 35625118google scholar: lookup
  3. Buschmann E, Van Steenkiste G, Vernemmen I, Demeyere M, Schauvliege S, Decloedt A, van Loon G. Multiple Catheter Recording in Horses to Investigate Atrial Depolarization Pattern During Sinus Rhythm and Induced Premature Atrial Complexes. J Vet Intern Med 2025 Sep-Oct;39(5):e70218.
    doi: 10.1111/jvim.70218pubmed: 40966305google scholar: lookup
  4. Buschmann E, Easton-Jones C, Van Steenkiste G, De Wilde H, Roberts V, Durando M, Decloedt A, Marr C, van Loon G. Orthodromic Atrioventricular Reentry Bradycardia and Tachycardia Caused by an Accessory Pathway in Horses. J Vet Intern Med 2025 Jul-Aug;39(4):e70175.
    doi: 10.1111/jvim.70175pubmed: 40671630google scholar: lookup
  5. Buschmann E, Van Steenkiste G, Vernemmen I, Demeyere M, Schauvliege S, Decloedt A, van Loon G. Caudal vena cava isolation using ablation index-guided radiofrequency catheter ablation (CARTO™ 3) to treat sustained atrial tachycardia in horses. J Vet Intern Med 2025 Jan-Feb;39(1):e17251.
    doi: 10.1111/jvim.17251pubmed: 39614765google scholar: lookup
  6. Paulussen E, Van Steenkiste G, Hermans BJM, Decloedt A, van Loon G, Delhaas T. Einthoven's triangle adapted for horses: Proposal for the Delta configuration. J Vet Intern Med 2024 Sep-Oct;38(5):2698-2706.
    doi: 10.1111/jvim.17179pubmed: 39193868google scholar: lookup
  7. Vernemmen I, Buschmann E, Demeyere M, Verhaeghe LM, Van Steenkiste G, Decloedt A, van Loon G. Feasibility of transthoracic echocardiographic guidance for multicatheter electrophysiological mapping studies in horses. J Vet Intern Med 2024 Sep-Oct;38(5):2686-2697.
    doi: 10.1111/jvim.17156pubmed: 39096119google scholar: lookup
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