Marc S Kraus1, Mark Rishniw2, Thomas J Divers2, Virginia B Reef3, Anna R Gelzer4. 1. Department of Clinical Sciences and Advanced Medicine-Philadelphia, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America. 2. Department of Clinical Sciences, Cornell University, College of Veterinary Medicine, Ithaca, NY 14853, United States of America. 3. Dept of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA 19348, United States of America. 4. Department of Clinical Sciences and Advanced Medicine-Philadelphia, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America. Electronic address: agelzer@upenn.edu.
Abstract
OBJECTIVE: Evaluate accuracy and utility of a smartphone-based ECG device compared to a standard base-apex lead ECG in horses. METHODS: ECGs were acquired prospectively from 28 client-owned horses at 2 equine referral hospitals. Twenty-five pairs of 30-s ECG recordings were acquired simultaneously from 23 horses with a smartphone ECG device (a bi-polar single lead recorder coupled to a smartphone with an ECG application) and with a standard base-apex lead ECG; 2 horses provided two pairs of simultaneously acquired ECGs. In one horse, the ECGs pairs were recorded immediately sequentially. An additional 7 smartphone ECGs were recorded from 5 horses without contemporaneous reference ECGs. Three observers independently evaluated all ECGs without knowledge of ECG pairing. Inter- and intra-observer agreement between the 2 ECG modalities was evaluated for rhythm diagnosis and QRS polarity. Heart rate agreement was also evaluated. RESULTS: Intra-observer agreement for rhythm assessment was very high; one observer diagnosed the same cardiac rhythm on both recordings in 24/26 instances and two observers agreed in 25/26 instances. The polarity of the QRS complex was similar on ECGs acquired simultaneously by both systems. Heart rates calculated from ECG pairs were within 1 beat of each other. CONCLUSIONS: The smartphone-acquired ECG accurately identified cardiac rhythm and heart rate in most horses. In one case, small size of the complexes precluded identification of P waves on smartphone-acquired ECGs, resulting in a misdiagnosis. The smartphone-acquired ECG device might allow veterinarians to evaluate and monitor cardiac arrhythmias relatively inexpensively in field or hospital settings.
OBJECTIVE: Evaluate accuracy and utility of a smartphone-based ECG device compared to a standard base-apex lead ECG in horses. METHODS: ECGs were acquired prospectively from 28 client-owned horses at 2 equine referral hospitals. Twenty-five pairs of 30-s ECG recordings were acquired simultaneously from 23 horses with a smartphone ECG device (a bi-polar single lead recorder coupled to a smartphone with an ECG application) and with a standard base-apex lead ECG; 2 horses provided two pairs of simultaneously acquired ECGs. In one horse, the ECGs pairs were recorded immediately sequentially. An additional 7 smartphone ECGs were recorded from 5 horses without contemporaneous reference ECGs. Three observers independently evaluated all ECGs without knowledge of ECG pairing. Inter- and intra-observer agreement between the 2 ECG modalities was evaluated for rhythm diagnosis and QRS polarity. Heart rate agreement was also evaluated. RESULTS: Intra-observer agreement for rhythm assessment was very high; one observer diagnosed the same cardiac rhythm on both recordings in 24/26 instances and two observers agreed in 25/26 instances. The polarity of the QRS complex was similar on ECGs acquired simultaneously by both systems. Heart rates calculated from ECG pairs were within 1 beat of each other. CONCLUSIONS: The smartphone-acquired ECG accurately identified cardiac rhythm and heart rate in most horses. In one case, small size of the complexes precluded identification of P waves on smartphone-acquired ECGs, resulting in a misdiagnosis. The smartphone-acquired ECG device might allow veterinarians to evaluate and monitor cardiac arrhythmias relatively inexpensively in field or hospital settings.
Authors: Elena Alberti; Luca Stucchi; Valeria Pesce; Giovanni Stancari; Elisabetta Ferro; Francesco Ferrucci; Enrica Zucca Journal: Vet Rec Open Date: 2020-12-21