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ECG Horse

This document provides an overview of electrocardiography (ECG) in horses. It describes the clinical significance of ECG and different types of ECG machines that can be used including telemetry, compact ECG, computer systems, and holter monitoring. It explains how to analyze an ECG including determining heart rate and examining the P, Q, R, S, and T waves. Common arrhythmias are classified and examples of sinus tachycardia, sinus arrhythmia, sinus block, premature atrial complexes, premature ventricular complexes, AV block grades 1-3, ventricular tachycardia, and ventricular fibrillation are shown and described.

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56 views33 pages

ECG Horse

This document provides an overview of electrocardiography (ECG) in horses. It describes the clinical significance of ECG and different types of ECG machines that can be used including telemetry, compact ECG, computer systems, and holter monitoring. It explains how to analyze an ECG including determining heart rate and examining the P, Q, R, S, and T waves. Common arrhythmias are classified and examples of sinus tachycardia, sinus arrhythmia, sinus block, premature atrial complexes, premature ventricular complexes, AV block grades 1-3, ventricular tachycardia, and ventricular fibrillation are shown and described.

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UNICORN TIME
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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ELECTROCARDIOGRAPHY

IN HORSES

Trakia University
FACULTY OF VETERINARY Assoc. Prof. S. SABEV,
Clinical significance of ECG

⮞ Cardiac arrhythmias are a common


auscultation finding in horses at rest and after
exercise.
⮞ Physiological arrhythmias are caused by the
dominance of n. vagus over sympathetic in rested
horses.
⮞ Only an ECG examination during physical
activity can distinguish physiological from
pathological dysrhythmias and determine the type
of arrhythmia.
Types of electrocardiography

Telemetry

🖛 in real time

🖛 gives the horse


freedom of
behavior
(movement)

🖛 functional
Compact ECG with transmitter
Computer system
Monitor

digital recording in
different leads
 HOLTER

🖛 Long (24 hours) recording of cardiac activity.


🖛 Freedom of behavior on the horse.
🖛 Possibility for functional testing of CVS.
• Ambulatory ECG

🖛 in real time
🖛 instant frequency
🖛 instant rhythm
🖛 fixed motionless
patients
🖛 inability to perform
functional testing
NB: The ECG in horses does
not provide information on the
volume of heart cavities and
myocardial thickness !!!

Why?
Purkinium network (PN) in herbivore ends in the
myocardium of the ventricles and the impulses in them
spread instantly in all directions. There are no deviations
in the amplitudes of the R waves!

PN in carnivorous (humans) ends below the endocardium


of the ventricles and the impulses propagate to the
pericardium. Velocity depends on the thickness of the
myocardium, which leads to changes in the amplitudes of
the R waves!
ECG leads
1. Peripheral (limbs) - not applied in practice.
2. Precordial (chest):

🖝 Y-lead:
positive (+) electrode - proc. xiphoideus
negative (-) electrode - manubrium sterni
neutr. electrode - on the neck
🖝 Apex-Base lead:
positive (+) electrode - heart apex (olecranone)
negative (-) electrode - cardiac base (scapula)
neutr. electrode - sulcus jugularis
Apex-Base lead:
Y-
lead:
Analysis of ECG
1. Determination of heart rate:
HR (min-1) =
𝟏𝟓𝟎𝟎 𝟑𝟎𝟎𝟎 speed 25 (50) мм/s
𝐑𝐑 (𝐦𝐦)
2.Presence and sequence of all ECG elements in
the specified order -P, Q, R, S, T.

3.Investigation of the configuration of cardiac


complexes.

4.Determination of length and amplitude of


cardiac complexes.
ECG Elements

ECG Analysis – channel 1, apex / base lead


R
P

S
Q T
ECG standards *

P1-P2 QRS
пик. инт.
инт.

Р QT
вълна интервал
PR 25 mm/s 1
интервал кв./0.04 s
Classification of arrhythmias
By origin:
🖛 From the Sinus node:
1. Sinus bradycardia (HR < 24 min-1).
2. Sinus tachycardia (HR > 50 min-1).
3. Sine block - pause ═ 2 PP intervals.
4. Sinus arrest – pause > 2 PP interval.
5. Sinus arrhythmia.

🖛 From the atrial myocardium:


6. Premature atrial contractions.
7. Atrial fibrillation (p waves up to 500 min-1).
8. Atrial flutter (p waves 300-440 min-1).
🖛 From the atrioventricular node:

1. Atrio-ventricular block I degree.


2. Atrio-ventricular block II degree.
3. Atrio-ventricular block III degree.

🖛 From ventricular myocardium:


4. Premature ventricular contractions.
5. Ventricular tachycardia (PVCs ≥ 4).

6. Ventricular fibrillation !!!!!


ECG (Apex-Base)
Sinus tachycardia (HR 55 min-1)
speed 25 mm/s
Sinus tachycardia
1. HR (calm and rested horses !!!) > 50 min-1.

2. Some P waves merge with the preceding


T waves.

3. Equal length R-R intervals.

4. Auscultation - rhythmic heart activity.


Sinus arrhythmia

All complexes are of the same morphology


(sinus origin).
All elements (P, Q, R, S, T) are available.
Different lengths of R-R intervals:
4.32 s, 3.08 s, 1.96 s !!!
Sinus block

ECG cardiac activity is absent for a period of


duration at < or = to the two R-R interval (4.6 s).
The R-R intervals between I-II, III-IV and IV-V
ventricular complex is 2.4 s. The arrow indicates the
location of unrealized cardiac complex. All
complexes are of sinus origin.
With sinus arrest, the pause is more
than twice as long.
Premature atrial complexes

Premature atrial contractions (arrows),


anticipating the complexes of sinus origin and
having a P wave with a different morphology
(biphasic).
Etiology - ectopic foci in the atria.
Premature ventricular complexes
T P T
P

Two premature ventricular complexes (oval) not


preceded by P wave and originating from different
ectopic foci.
The third extrasystole (thick arrow) is
immediately after the sinus contraction.
Premature ventricular complexes

Premature ventricular complex, differing in


shape and duration from the rest. The T wave
of the next sinus complex is bifid (arrow). The
rest of the T waves are one- sided and
negative.
AV block - grade II: type Mobitz 1
(Wenckebach)

P R P

0.28 s 0.32 s 0.36 s

Gradual extension of the P-R intervals (0.28 s,


0.32 s, 0.36 s). The fourth P wave (arrow) is not
followed by a chamber complex. Its expected location
is indicated by a thick arrow.
HR = 50 min-1.
AV block - grade II: type Mobitz 1
P

T
The red arrow indicates the location
of the not conducting
P ventricular
AV block II degree in condition of
tachycardia – HR 82 min-1

Holter ECG: multiple single AV blocks II grade


(arrows).
AB block - III degree

Sinus atrial rhythm- 150 min-1.


Idioventricular rhythm- 38 min-1.
Complete dissociation in the atria and ventricular
contractions.
🖑 Clinical findings:
reduced physical tolerance, recurrent episodes of collapse,
positive venous pulse!
Ventricular tachycardia

N o r m a
V T

High heart rate (over 100 / min-1).


Abnormal morphology of QRS
complexes
(minimum 4), merging with large T waves.
Most P waves covered by ventricular
complexes and are not visible on the ECG
recording.
Ventricular fibrillation

Lack of visible atrial and ventricular complexes.


Presence of gross fluctuations of isoelectric line.

🖑 Clinical significance:
DEATH COMES SOON !!!
What is your diagnosis?

AV blocks (3) + PVC

SA arrest + AV block II grade

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