Gelzer A R, Kraus M S, Rishniw M
Department of Cardiology, Small Animal Teaching Hospital, School of Veterinary Science, University of Liverpool, Leahurst, Neston, CH64 7TE.
Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
J Small Anim Pract. 2015 Jul;56(7):456-62. doi: 10.1111/jsap.12363. Epub 2015 Apr 23.
To determine if the in-clinic ECG-derived heart rate could predict the at-home Holter-derived 24-hour average heart rate (Holter24h ), and whether it is useful to identify slow versus fast atrial fibrillation in dogs.
82 pairs of 1-minute ECGs and 24-hour Holter recordings were acquired in 34 dogs with atrial fibrillation. The initial 24-hour Holter was used to test if the ECG heart rate can identify dogs with "slow" versus "fast" atrial fibrillation based on a Holter24h threshold value of 140 bpm.
ECG heart rate overestimated Holter24h by 26 bpm (95% CI: 3 bpm, 48 bpm; P < 0 · 015) with a 95% limit of agreement of -21 to 83 bpm. The in-clinic ECG-derived heart rate Ä155 bpm had a sensitivity of 73% and a specificity of 100% for identifying a Holter24h HR Ä140 bpm; an in-clinic ECG-derived HR <160 bpm had a sensitivity and specificity of 91% each.
In-clinic ECG assessment of heart rate in dogs with atrial fibrillation does not reliably predict the heart rate in their home environment. However, an in-clinic heart rate greater than 155 bpm is useful in identifying "fast" atrial fibrillation, allowing clinicians to stratify which case may benefit from antiarrhythmic therapy.
确定门诊心电图得出的心率是否能够预测家庭动态心电图得出的24小时平均心率（Holter24h），以及其对于鉴别犬类的缓慢型与快速型心房颤动是否有用。
对34只患心房颤动的犬获取了82对1分钟心电图和24小时动态心电图记录。最初的24小时动态心电图用于检验基于140次/分钟的Holter24h阈值，心电图心率能否鉴别出患有“缓慢型”与“快速型”心房颤动的犬。
心电图心率比Holter24h高估了26次/分钟（95%可信区间：3次/分钟，48次/分钟；P < 0.015），一致性界限的95%为-21至83次/分钟。门诊心电图得出的心率≥155次/分钟对于鉴别Holter24h心率≥140次/分钟的敏感性为73%，特异性为100%；门诊心电图得出的心率<160次/分钟的敏感性和特异性均为91%。
对患心房颤动的犬进行门诊心电图心率评估并不能可靠地预测其在家中的心率。然而，门诊心率大于155次/分钟对于鉴别“快速型”心房颤动是有用的，可让临床医生对哪些病例可能从抗心律失常治疗中获益进行分层。
