Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
J Vet Intern Med. 2024 Sep-Oct;38(5):2698-2706. doi: 10.1111/jvim.17179. Epub 2024 Aug 28.
Reliable ECGs are crucial for diagnosing arrhythmias, yet a lack of standardization impedes arrhythmia diagnosis and treatment in horses.
To objectively determine an optimal position of Einthoven's triangle for ECG recordings in horses at rest, which can form the basis for standardized ECG recording and improve diagnosis and treatment of arrhythmias.
The study involved 72 healthy, warmblood horses aged between 3 and 20 years.
In view of future 12-lead studies and vectorcardiography, requiring an orthogonal system, Einthoven's triangle was positioned around the heart, in the transverse plane. Therefore, 11 electrodes were placed encircling the thorax behind the olecranon, to construct triangles with a horizontal base. Electrocardiogram recordings from different triangles were analyzed. Signal processing involved filtering, R peak detection, and median complex generation. Principal component analysis (PCA) and Euclidean distance measures were employed for data analysis.
The left mid-thoracic and ventral regions had high PCA scores, indicating high information content. Base-down triangles exhibited higher summed Euclidean distances, contributing to enhanced diagnostic capabilities. A base-down triangle, called "Delta (Δ) configuration" emerged as most informative, while meeting all criteria.
The base-down "Delta configuration" is the optimal Einthoven's triangle adapted for horses, providing large amplitudes and potential to provide basic insights into the mechanisms and origins of cardiac arrhythmias. Because the Delta configuration is positioned in the transverse plane, it forms the ideal basis for 12-lead ECG recordings that provide vectorcardiograms in an orthogonal coordinate system. Standardizing electrode positioning could improve ECG data comparability in equine cardiology.
可靠的心电图对于心律失常的诊断至关重要，但由于缺乏标准化，阻碍了马中心律失常的诊断和治疗。
客观确定休息时马的心电图记录的艾因托芬三角形的最佳位置，这可以为标准化心电图记录奠定基础，并改善心律失常的诊断和治疗。
本研究涉及 72 匹 3 至 20 岁的健康温血马。
鉴于未来的 12 导联研究和向量心电图需要正交系统，艾因托芬三角形在心脏周围的横平面上定位。因此，在肘突后面环绕胸部放置 11 个电极，构建具有水平基底的三角形。分析来自不同三角形的心电图记录。信号处理包括滤波、R 波检测和中值复合生成。采用主成分分析（PCA）和欧几里得距离测量进行数据分析。
左中胸和腹侧区域具有较高的 PCA 评分，表明信息量较高。基底向下的三角形表现出较高的总和欧几里得距离，有助于提高诊断能力。一个基底向下的三角形，称为“Delta（Δ）配置”，表现出最高的信息性，同时满足所有标准。
基底向下的“Delta 配置”是最适合马的艾因托芬三角形，提供大的振幅，并有可能提供对心脏心律失常机制和起源的基本了解。由于 Delta 配置位于横平面上，它为在正交坐标系中提供向量心电图的 12 导联心电图记录提供了理想的基础。标准化电极定位可以提高马心脏病学中心电图数据的可比性。
