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Home / Equine Research Bank / J Vet Intern Med / Einthoven’s triangle adapted for horses: Proposal for ...
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.
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Publication Date: 2024-08-28 PubMed ID: 39193868DOI: 10.1111/jvim.17179Google Scholar: Lookup
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Summary

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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.

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