Detection of atrial fibrillation with implantable loop recorders in horses.
Abstract: Cardiac arrhythmias in horses are diagnosed by auscultation or electrocardiogram (ECG), which results in a low sensitivity for detecting arrhythmias that occur sporadically. Implantable loop recorders (ILRs) are small ECG devices placed subcutaneously, to automatically detect arrhythmias in human patients. Objective: To test ILRs ability to detect atrial fibrillation (AF) in horses. Furthermore, we hypothesised that anatomical location of the implant site might influence signal quality. Signal quality was evaluated both during exercise and over time. Methods: Experimental study. Methods: In five Standardbred mares, eleven ILRs were implanted subcutaneously in up to three different positions (Front: pectoral region, Left-6: sixth left intercostal space and Ventral: xiphoid region) and AF induced. The R- and T-wave amplitudes were measured in all positions over time during AF. AF burden automatically registered by the ILRs over a 2-month period was compared with selected Holter ECG recordings. Results: All three positions had stable R- and T-wave amplitudes during the study period and were of sufficient quality to allow AF detection at rest. The position Left-6 showed significantly higher R- and T-wave amplitudes compared with the other positions. During submaximal exercise only the Left-6 position was able to record ECG signals of diagnostic quality. No position yielded diagnostic signals at maximum exercise due to artefacts. Conclusions: Few horses and ILRs included and no spontaneous AF episodes were studied. Conclusions: This preliminary study indicates that ILRs can be used for AF detection in horses, but the anatomical location is important for optimal ECG quality. Despite insufficient quality during exercise, ILRs were suitable for AF detection at rest. Therefore, the ILR may be a valuable diagnostic tool for detecting paroxysmal AF in horses.
© 2020 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Publication Date: 2020-06-28 PubMed ID: 32506470PubMed Central: PMC7891449DOI: 10.1111/evj.13301Google Scholar: Lookup
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- Journal Article
- Cardiac Arrhythmias
- Clinical Findings
- Clinical Pathology
- Clinical Study
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Disease Management
- Disease Treatment
- Electrocardiography
- Equine Diseases
- Equine Health
- Equine Science
- Experimental Methods
- Horses
- In Vivo
- Standardbred Horses
- Veterinary Medicine
- Veterinary Practice
- Veterinary Procedure
- Veterinary Research
Summary
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This research investigates the potential use of implantable loop recorders (ILRs) to detect atrial fibrillation (AF), a type of heart arrhythmia, in horses. The researchers conducted an experimental study on five standardbred mares to understand if ILRs can provide a higher sensitivity for detecting sporadic arrhythmias than the currently used methods of auscultation or electrocardiogram and to test whether or not the anatomical location of the implant site might affect the signal quality.
Research Methodology
- The experimental study involved implanting 11 implantable loop recorders (ILRs) subcutaneously on up to three different positions on five Standardbred mares (the front: pectoral region, Left-6: sixth left intercostal space, and Ventral: xiphoid region).
- Atrial fibrillation was then induced in the horses, and the R- and T-wave amplitudes from the ILRs implanted in all positions were measured over time.
- The researchers also compared the AF burden registered automatically by the ILRs over a two-month period with selected Holter ECG recordings.
Results of the Research Study
- All three implant positions provided stable R-wave and T-wave amplitudes during the study period and were capable of detecting AF at rest.
- There was a notable difference in the anatomical locations with the Left-6 position showing significantly higher R-wave and T-wave amplitudes compared to the other positions.
- During submaximal exercise, however, only the Left-6 position was able to provide ECG signals of diagnostic quality.
- Maximum exercise led to interruptions or artifacts in the signal that prevented diagnosis from any of the implantation positions.
Conclusion
- The researchers concluded that implantable loop recorders could be useful for detecting atrial fibrillation in horses at rest but stressed the importance of the anatomical location of the ILR for optimal ECG signal quality.
- Even though the signal quality was insufficient during exercise, the researchers suggested that ILRs could serve as a valuable diagnostic tool for detecting paroxysmal atrial fibrillation in horses, given their performance at rest.
- It’s important to note, however, that these conclusions are based on a limited sample of horses and ILRs, and no spontaneous AF episodes were studied, which implies a need for further research.
Cite This Article
APA
Buhl R, Hesselkilde EM, Carstensen H, Fenner MF, Jespersen T, Tfelt-Hansen J, Michael Sattler S.
(2020).
Detection of atrial fibrillation with implantable loop recorders in horses.
Equine Vet J, 53(2), 397-403.
https://doi.org/10.1111/evj.13301 Publication
Researcher Affiliations
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
- Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
MeSH Terms
- Animals
- Atrial Fibrillation / diagnosis
- Atrial Fibrillation / veterinary
- Electrocardiography / veterinary
- Electrocardiography, Ambulatory / veterinary
- Female
- Horse Diseases / diagnosis
- Horses
- Humans
- Prostheses and Implants / veterinary
Grant Funding
- Augustinus Fonden
- Novo Nordisk Fonden
- Brdr Hartmann Foundation
- 675351 / European Union Horizon 2020 research and innovation programme
Conflict of Interest Statement
No competing interests have been declared.
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