Observer agreement for detection of cardiac arrhythmias on telemetric ECG recordings obtained at rest, during and after exercise in 10 Warmblood horses.
Abstract: Frequent supraventricular or ventricular arrhythmias during and after exercise are considered pathological in horses. Prevalence of arrhythmias seen in apparently healthy horses is still a matter of debate and may depend on breed, athletic condition and exercise intensity. Objective: To determine intra- and interobserver agreement for detection of arrhythmias at rest, during and after exercise using a telemetric electrocardiography device. Methods: The electrocardiogram (ECG) recordings of 10 healthy Warmblood horses (5 of which had an intracardiac catheter in place) undergoing a standardised treadmill exercise test were analysed at rest (R), during warm-up (W), during exercise (E), as well as during 0-5 min (PE(0-5)) and 6-45 min (PE(6-45)) recovery after exercise. The number and time of occurrence of physiological and pathological 'rhythm events' were recorded. Events were classified according to origin and mode of conduction. The agreement of 3 independent, blinded observers with different experience in ECG reading was estimated considering time of occurrence and classification of events. Results: For correct timing and classification, intraobserver agreement for observer 1 was 97% (R), 100% (W), 20% (E), 82% (PE(0-5)) and 100% (PE(6-45)). Interobserver agreement between observer 1 vs. observer 2 and between observer 1 vs. 3, respectively, was 96 and 92.6% (R), 83 and 31% (W), 0 and 13% (E), 23 and 18% (PE(0-5)), and 67 and 55% (PE(6-45)). When including the events with correct timing but disagreement for classification, the intraobserver agreement increased to 94% during PE(0-5) and the interobserver agreement reached 83 and 50% (W), 20 and 50% (E), 41 and 47% (PE(0-5)), and 83.5 and 65% (PE(6-45)). The interobserver agreement increased with observer experience. Conclusions: Intra- and interobserver agreement for recognition and classification of events was good at R, but poor during E and poor-moderate during recovery periods. These results highlight the limitations of stress ECG in horses and the need for high-quality recordings and adequate observer training.
© 2010 EVJ Ltd.
Publication Date: 2011-05-27 PubMed ID: 21059008DOI: 10.1111/j.2042-3306.2010.00172.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
- Athletic Horses
- Cardiac Arrhythmias
- Cardiovascular Health
- Clinical Study
- Diagnostic Technique
- Electrocardiography
- Equine Diseases
- Equine Health
- Equine Studies
- Exercise
- Exercise Physiology
- Heart Rate
- Horses
- Observational Study
- Physiology
- Treadmill Exercise
- Veterinary Care
- Veterinary Medicine
- Veterinary Research
- Warmblood Horses
Summary
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The research investigated the reliability and consistency of detecting heart arrhythmias in horses using telemetry-based ECG recordings at various stages including rest, during exercises, and recovery periods. The study revealed significant variations in observer agreement based on the phase of the activity and level of experience.
Objective and Methodology
- The primary objective was to determine the level of agreement among observers in identifying cardiac arrhythmias in horses at different times — at rest, during exercise, and post-exercise — by employing telemetric electrocardiography.
- To achieve this, ECG readings of 10 healthy warmblood horses were analyzed at different stages including rest, warm-up, exercise, immediate recovery (0-5 min), and extended recovery (6-45 min).
- Pathological and physiological ‘rhythm events’ were examined and categorized based on their origin and conduction mode, by three independent, blinded observers of varying levels of ECG reading experience.
Results
- The intraobserver agreement, specifically for observer 1, varied significantly depending on the stage of the activity. It was high at rest (97%) and during warm-up (100%), but drastically dropped during exercise (20%), subsequently rising during immediate recovery (82%) and maintaining a high agreement during extended recovery (100%).
- Similarly, interobserver agreement oscillated based on the activity stage, with the highest agreement seen at rest (96 and 92.6%) and the lowest during exercise (0 and 13%). The agreement moderately improved during the recovery stages.
- The inclusion of events with accurate timing but divergent classification led to an increased intraobserver agreement during immediate recovery (94%), and a varied interobserver agreement depending on the activity phase.
- Interestingly, observer experience positively influenced the level of interobserver agreement.
Conclusion
- Observer agreement for the detection and classification of arrhythmic events was particularly high when the horses were at rest, considerably low during exercise, and moderate to poor during recovery.
- The findings underscore the limitations of utilizing stress ECG in horses and emphasize the critical need for superior quality ECG recordings and improved observer training for more consistent and reliable diagnosis.
Cite This Article
APA
Trachsel DS, Bitschnau C, Waldern N, Weishaupt MA, Schwarzwald CC.
(2011).
Observer agreement for detection of cardiac arrhythmias on telemetric ECG recordings obtained at rest, during and after exercise in 10 Warmblood horses.
Equine Vet J Suppl(38), 208-215.
https://doi.org/10.1111/j.2042-3306.2010.00172.x Publication
Researcher Affiliations
- Equine Department, Vetsuisse Faculty, University of Zurich, Switzerland. dtrachsel@vetclinics.uzh.ch
MeSH Terms
- Animals
- Arrhythmias, Cardiac / veterinary
- Electrocardiography / instrumentation
- Electrocardiography / veterinary
- Horse Diseases / diagnosis
- Horses
- Observer Variation
- Physical Conditioning, Animal / adverse effects
- Telemetry / statistics & numerical data
- Telemetry / veterinary
Citations
This article has been cited 4 times.- McCrae P, Spong H, Rutherford AA, Osborne V, Mahnam A, Pearson W. A Smart Textile Band Achieves High-Quality Electrocardiograms in Unrestrained Horses.. Animals (Basel) 2022 Nov 23;12(23).
- Ter Woort F, Dubois G, Tansley G, Didier M, Verdegaal L, Franklin S, Van Erck-Westergren E. Validation of an equine fitness tracker: ECG quality and arrhythmia detection.. Equine Vet J 2022 Feb 9;55(2):336-43.
- da Costa CF, Samesima N, Pastore CA. Cardiac Mean Electrical Axis in Thoroughbreds-Standardization by the Dubois Lead Positioning System.. PLoS One 2017;12(1):e0169619.
- Lanata A, Guidi A, Baragli P, Valenza G, Scilingo EP. A Novel Algorithm for Movement Artifact Removal in ECG Signals Acquired from Wearable Systems Applied to Horses.. PLoS One 2015;10(10):e0140783.
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