Wireless body sensor for electrocardiographic monitoring in dogs and cats.

OBJECTIVES: To evaluate the diagnostic utility of electrocardiogram data obtained by a wireless sensor from 36 dogs and four cats with suspected arrhythmias caused by cardiac or systemic diseases. MATERIALS AND METHODS: Wireless electrocardiographic recordings were obtained via two precordial electrodes attached to an electrocardiogram sensor connected to a smart device via low-power Bluetooth technology. Cardiac rate, rhythm and duration of P-QRS-T waves were evaluated with VisECG® software. Fifteen- to 30-minute wireless recordings were compared to standard electrocardiograms. Furthermore, the wireless sensor was used in 10 dogs and four cats for 24-hour continuous electrocardiogram monitoring at home. RESULTS: When compared to standard electrocardiogram, equivalent results were obtained for heart rate and duration of different waves. Due to the longer recording time, more arrhythmias were diagnosed with the wireless device in 50% (15 of 30) of animals with arrhythmias. Satisfactory recordings were obtained when the dogs were resting, standing or walking but interpretation of the wireless electrocardiogram signal was not possible during strenuous physical activity. CLINICAL SIGNIFICANCE: Wireless electrocardiographic monitoring is a reliable and accurate method for identification of heart rate, arrhythmia and duration of electrocardiogram waves. A higher diagnostic yield of arrhythmias was documented with the wireless sensor due to prolonged monitoring. The device offers a good option for the long-term monitoring of canine and feline cardiac rhythm.

Beat-to-beat repolarisation variability in body surface electrocardiograms.

The repolarisation variability in body surface electrocardiograms has been evaluated by beat-to-beat QT interval variability. Interpolated R-peak time and template T-wave matching algorithms were used to determine the characteristic time points of the R-wave and T-wave, respectively. The T-wave time can be determined accurately and robustly by searching for the best match between a template T-wave and measured T-waves. The authors studied 5 min multichannel ECG recordings (35 channels) measured in 20 healthy subjects. A QT variability of 2.24 +/- 0.79 ms was obtained (1.15 +/- 0.30 ms, if linear detrend was used), which is significantly lower than that reported in several other studies. To explore this discrepancy, the sensitivity of the template matching algorithm to periodic and random noise on the ECG was estimated by a simulation study. The results showed that the repolarisation variability depended on selection of the appropriate lead, the signal-to-noise ratio and the effectiveness of baseline correction. Lead II of a standard 12-lead ECG is a reasonable choice for QT variability analysis; however, precordial leads V3-V6 could be better with regard to the amplitude of the T-wave. Poor signal-to-noise ratios can lead to unrealistic values for repolarisation variability.

Beat-to-beat QT interval variability before and after cardiac surgery.

Non-uniform recovery of excitability may be essential in triggering malignant ventricular tachycardia after cardiac surgery. Thirty-five channels ECG was recorded for 6 min in 27 patients before and after heart surgery and in 20 control subjects. Off-line analysis was performed. RR interval duration, RR SD, QT SD and power spectra of RR variability were computed from 256 s stable RR and QT interval series. When compared to controls, patients had decreased RR SD and increased QT SD before surgery (p<0.002 and p<0.0005, respectively); RR SD further decreased and QT SD increased after the surgery (p<0.0001 and p<0.0002, respectively). Increase of QT variability and decrease of RR variability after cardiac surgery may reflect disrupted electrophysiological stability of the myocardium and thus electrophysiological substrate for triggering malignant arrhythmia.

Imaging of power spectral heart rate variability regarding subject position.

Heart rate variability (HRV) and its assessment using power spectral analysis revealed a possibility to quantify the characteristics of autonomic nervous system, related cardiovascular status and sympathovagal interaction. This study was designed to assess vagal tone in supine and right recumbent position in normal healthy subjects as many maneuvers that potentially increase vagal tone have been sought both in normal subjects and in patients with heart disease. Seven subjects, four male and three female, aged 20-27 years were enrolled in the study. To evaluate the time-dependent stability of short term ECG recordings, every subject participated in six ECG recording sessions (three successive morning and three successive afternoon measurements). Heart rate power spectra were obtained by off-line Fast Fourier Transform analysis. The frequency domain measures, namely very low frequency power (VLF), low frequency power (LF), high frequency power (HF) and total power were determined, and their normalized correlates used in the comparison between supine and right recumbent position. Normalized high frequency (nHF) indicated cardiac vagal activity, normalized low frequency power indexed sympathetic modulated activity, low frequency power/high frequency power ratio (LF/HF) represented sympathovagal balance. The results showed remarkable variation among successive day measurements as well as among study subjects. However, several types of response to adopting right recumbent position could be identified. In the first, in right recumbent position the values of nHF, indicator of vagal activity did not differ appreciably from the values measured in supine position. Secondly, there was a tendency towards higher nHF values and lower LF/HF power ratio in supine position. We were not able to notice any appreciable difference among morning and afternoon short-term measurements. Finally, our results do not suggest higher vagal modulation when lying in right recumbent position.

Spatial resolution of epicardial pace mapping using body surface potentials.

Body surface potential maps (BSPMs) recorded during pace mapping provide an important non-invasive means for identifying local cardiac events; recent clinical studies demonstrated that endocardial pacing sites can be resolved within less than 10 mm. We sought to determine whether similar spatial resolution could be achieved during epicardial pacing. Four patients who were undergoing either heart valve replacement (one), aortocoronary bypass graft (one), or both (two) were studied. In each patient, a pair of epicardial electrodes was placed intraoperatively at the middle aspect of the right ventricular free wall. The distance between the neighbouring electrodes was 10 mm. Five days after the surgery, ECGs were acquired from 35 leads during pacing from each epicardial electrode. We determined the distributions of QRS integrals (the net area under the ECG signal) and compared integrals corresponding to pacing from each of the adjacent electrodes using statistical indices. Student's t-test was applied to these indices and in all the patients revealed that differences in distributions of QRS integral maps were statistically significant (p < 0.01). Results of our study indicate that the non-invasive acquisition of body surface ECGs could resolve epicardial breakthrough sites within 10 mm, which may be useful in facilitating therapeutic ablations in patients with ventricular tachycardias.

Metal implant localizers: frontiers and diagnostic feasibility.

The paper describes and analyses a method for locating metal implants based on the interaction of a conductive object with a weak alternating magnetic field. Theoretical values for the boundary of detectability and the boundary of localability are introduced to show some technical characteristics, the diagnostic feasibility and limitations of the method. Clinical experiences are described in order to compare the theoretical expectations with practical results. Several advantages of the proposed diagnostic method in terms of inexpensive instrumentation, ease of operation and sensitivity are discussed.