FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Journal of veterinary internal medicine2024; doi: 10.1111/jvim.17179

Einthoven’s triangle adapted for horses: Proposal for the Delta configuration.

Abstract: Reliable ECGs are crucial for diagnosing arrhythmias, yet a lack of standardization impedes arrhythmia diagnosis and treatment in horses. Objective: To objectively determine an optimal position of Einthoven's triangle for ECG recordings in horses at rest, which can form the basis for standardized ECG recording and improve diagnosis and treatment of arrhythmias. Methods: The study involved 72 healthy, warmblood horses aged between 3 and 20 years. Methods: In view of future 12-lead studies and vectorcardiography, requiring an orthogonal system, Einthoven's triangle was positioned around the heart, in the transverse plane. Therefore, 11 electrodes were placed encircling the thorax behind the olecranon, to construct triangles with a horizontal base. Electrocardiogram recordings from different triangles were analyzed. Signal processing involved filtering, R peak detection, and median complex generation. Principal component analysis (PCA) and Euclidean distance measures were employed for data analysis. Results: The left mid-thoracic and ventral regions had high PCA scores, indicating high information content. Base-down triangles exhibited higher summed Euclidean distances, contributing to enhanced diagnostic capabilities. A base-down triangle, called "Delta (Δ) configuration" emerged as most informative, while meeting all criteria. Conclusions: The base-down "Delta configuration" is the optimal Einthoven's triangle adapted for horses, providing large amplitudes and potential to provide basic insights into the mechanisms and origins of cardiac arrhythmias. Because the Delta configuration is positioned in the transverse plane, it forms the ideal basis for 12-lead ECG recordings that provide vectorcardiograms in an orthogonal coordinate system. Standardizing electrode positioning could improve ECG data comparability in equine cardiology.
© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Get Full Text
Publication Date: 2024-08-28 PubMed ID: 39193868DOI: 10.1111/jvim.17179Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

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 study proposes an optimal position for Einthoven’s Triangle (a method used in ECG recordings) in horses, called the “Delta configuration”. This configuration aids in diagnosing and treating arrhythmias in horses by standardizing ECG recording, providing larger amplitudes and insights into the origins of cardiac arrhythmias.

Objective and Methodology

  • The aim of the study was to establish an ideal positioning for Einthoven’s Triangle in Electrocardiogram (ECG) recordings for horses. This optimization was sought in order to improve the potential for diagnosing and treating arrhythmias, or irregular heartbeats, in horses.
  • Participants in the study comprised 72 healthy, warmblood horses, aged between 3 and 20 years old.
  • Einthoven’s Triangle, a theoretical triangle used in ECG for humans, was adapted and positioned around the heart of the horses in the transverse plane.
  • Eleven electrodes were placed encircling the thorax behind a horse’s elbow (olecranon) to create triangles with a horizontal base.
  • ECGs from these different triangles were recorded and analyzed. Various methodologies such as filtering, R peak detection, median complex generation, Principal Component Analysis (PCA), and Euclidean distance measures were used in the analysis.

Results

  • The study findings indicated that the left mid-thoracic and ventral regions showed high PCA scores. High PCA scores reflect high information content, implying valuable input for the ECGs.
  • Base-down triangles (those pointing downward) displayed larger summed Euclidean distances, suggesting these configurations could potentially improve diagnostic capabilities.
  • The optimal configuration, referred to as “Delta configuration”, was a base-down triangle. This configuration meets all evaluation criteria and offers the most amount of information.

Conclusions and Implications

  • The “Delta configuration” is the suggested optimal Einthoven’s Triangle positioning for ECG recordings in horses. It provides large amplitudes and vital insights about the mechanisms and origins of cardiac arrhythmias.
  • As the Delta configuration is positioned in a transverse plane around the heart, it is ideal for 12-lead ECG recordings, which provide vectorcardiograms in an orthogonal coordinate system. A vectorcardiogram is a method of recording the magnitude and direction of electrical forces in the heart by means of continuous changes in the position of a single variable vector.
  • The results of the research suggest that standardizing the positioning of ECG-recordings in horses can improve the comparability of data in the field of equine cardiology.

Cite This Article

APA
Paulussen E, Van Steenkiste G, Hermans BJM, Decloedt A, van Loon G, Delhaas T. (2024). Einthoven’s triangle adapted for horses: Proposal for the Delta configuration. J Vet Intern Med. https://doi.org/10.1111/jvim.17179

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English

Researcher Affiliations

Paulussen, Ellen
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Van Steenkiste, Glenn
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Hermans, Ben J M
  • Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
Decloedt, Annelies
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
van Loon, Gunther
  • Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Delhaas, Tammo
  • Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.

References

This article includes 23 references
  1. Wilson FN, Johnston FD, Macleod AG, Barker PS. Electrocardiograms that represent the potential variations of a single electrode.. Am Heart J 1934;9:447‐458.
  2. Hamlin RL, Smith CR. Anatomical and physiologic basis for interpretation of the electrocardiogram.. Am J Vet Res 1960;21:701‐708.
  3. Verheyen T, Decloedt A, De Clercq D. Electrocardiography in horses—part 1: how to make a good recording.. VDT 2010;79:331‐336.
  4. Hamlin RL, Smith CR. Categorization of common domestic mammals based upon their ventricular activation process.. Ann N Y Acad Sci 1965;127:195‐203.
  5. Andries E, Stroobandt R, De Pooter J. ECG‐registratie en nomenclatuur.. In: Andries E, Roland Stroobandt R, De Pooter J, Verdonck F, Sinnaeve F, eds. ECG uit het hoofd. 6th ed. Antwerpen: Garant Uitgevers; 2016:107‐126.
  6. Muylle E, Oyaert W. Equine electrocardiography: the genesis of the different configurations of the “QRS” complex.. Zentralbl Veterinärmed A 1977;24:762‐771.
  7. Holmes JR, Alps BJ. Studies into equine electrocardiography and vectorcardiography IV. Vector distributions in some arrhythmias.. Can J Comp Med Vet Sci 1967;31:150‐155.
  8. Van Steenkiste G, Delhaas T, Hermans B. An exploratory study on electrocardiographic and vectorcardiographic differentiation of the site of origin of focally induced premature depolarizations in horses, part I: the atria.. Animals 2022;12:549.
  9. Einthoven W. Die galvanometrische Registrirung des menschlichen Elektrokardiogramms, zugleich eine Beurtheilung der Anwendung des Capillar‐Elektrometers in der Physiologie.. Arch Für Die Gesamte Physiol Des Menschen Und Der Tiere 1903;99:472‐480.
  10. Einthoven W. Weiteres über das Elektrokardiogramm.. Arch Für Die Gesamte Physiol Des Menschen Und Der Tiere 1908;122:517‐584.
  11. Hesselkilde E, Isaksen J, Petersen B. A novel approach for obtaining 12‐lead electrocardiograms in horses.. J Vet Intern Med 2021;35:521‐531.
  12. Neuckermans Z, vanSteenkiste G, Decloedt A. Diagnosis of left ventricular hypertrophy diagnosis by vectorcardiography: first confirmed cases.. Abstracts European conference. Voorjaarsdagen 2020.
  13. Vernemmen I, Vera L, Van Steenkiste G. Reference values for 2‐dimensional and M‐mode echocardiography in Friesian and warmblood horses.. J Vet Intern Med 2020;34:2701‐2709.
  14. Ven S, Decloedt A, Van Der Vekens N. Assessing aortic regurgitation severity from 2D, M‐mode and pulsed wave Doppler echocardiographic measurements in horses.. Vet J 2016;210:34‐38.
  15. Hiraga A, Sugano S. History of research in Japan on electrocardiography in the racehorse.. J Eq Science 2015;26(1):1‐13.
  16. Dubois M. Du choix des dérivations et d'une normalisation de l'électrocardiogramme chez quelques ongulés domestiques.. Rec Méd Vét 1961;133:425‐448.
  17. Zeemering S, Lankveld TAR, Bonizzi P. Principal component analysis of body surface potential mapping in atrial fibrillation patients suggests additional ECG lead locations.. Conference paper: Computing in Cardiology 2014 at Cambridge, USA Vol. 41.
  18. Holmes JR, Darke PGGG. Studies on the development of a new lead system for equine electrocardiography.. Equine Vet J 1970;1:84‐92.
  19. Van Steenkiste G, Boussy G, Duytschaever M. Detection of the origin of atrial tachycardia by 3D electro‐anatomical mapping and treatment by radiofrequency catheter ablation in horses.. J Vet Intern Med 2022;36:1481‐1490.
  20. Buschmann E, Van Steenkiste G, Boussy T. 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;37(2):728‐734.
  21. Da Costa CF, Samesima N, Pastore CA. Cardiac mean electrical axis in thoroughbreds—standardization by the Dubois lead positioning system.. PLoS One 2017;12:e0169619.
  22. Frank E. An accurate, clinically practical system for spatial vectorcardiography.. Circulation 1956;13:737‐749.
  23. Van Steenkiste G, Delhaas T, Hermans B. An exploratory study on vectorcardiographic identification of the site of origin of focally induced premature depolarizations in horses, part II: the ventricles.. Animals 2022;12:550.

Citations

This article has been cited 2 times.
  1. Dufourni A, Demeyere M, Vernemmen I, Van Steenkiste G, Verhaeghe LM, van Loon G, Decloedt A. Effect of N-Butylscopolammonium Bromide and Metamizol Sodium on Heart Rate, Blood Pressure, and Echocardiographic Measurements in Warmblood Horses With Aortic and Mitral Valve Regurgitation. J Vet Intern Med 2025 Nov-Dec;39(6):e70254.
    doi: 10.1111/jvim.70254pubmed: 41070729google scholar: lookup
  2. 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
Subscribe to our newsletter
Join 100,129 horse owners like you who receive our email updates on horse health and nutrition.