Effect of body position on the 6-lead ECG of dogs

ECGs recorded from dogs show characteristic morphology and changes in morphology with various disease states. These changes are determined by comparing individual recordings to reference ranges established from recordings obtained from normal dogs in right lateral (RL) recumbency. Using these reference ranges for ECGs recorded from dogs in other positions may not be valid. We compared ECG complexes from 39 normal dogs obtained in RL, left lateral (LL), and standing (ST) body positions. ECGs from dogs in ST position showed increased Q-wave and R-wave amplitudes in leads I and II, increased R-wave and S-wave amplitudes in leads aVR and aVL, and decreased R-wave and S-wave amplitudes in lead III when compared with recordings obtained in RL position. ECGs from dogs in LL position showed increased R-wave amplitude in leads II, III, and aVF and S-wave amplitude in lead aVL but decreased R-wave amplitude in lead aVR when compared with recordings obtained in RL position. The mean electrical axis (MEA) shifted to the left in ST position but remained within the normal range in LL position. We determined that both a change in the relative position of the recording electrodes with respect to the heart as well as a change in intrathoracic cardiac position contributed to these changes. P-wave amplitude, P-R and S-T intervals, and QRS complex durations remained unaltered by changes in body position. Our findings indicate that ECGs of dogs recorded in RL, LL, and ST positions yield dramatically different results, and investigators should use position-specific reference ranges to minimize potential misinterpretation of ECG results.     

Evaluation of six-lead electrocardiograms obtained from dogs in a sitting position or sternal recumbency

OBJECTIVE: To compare 6-lead ECG traces in clinically normal conscious dogs in a sitting position and sternal recumbency to that of right lateral recumbency. ANIMALS: 31 healthy dogs with no history of cardiac disease. PROCEDURE: Six-lead ECGs were recorded for dogs in right lateral recumbency, a sitting position, and sternal recumbency. Q-, R-, and S-wave amplitudes as well as QRS-complex duration were measured in all leads. Additionally, P-wave amplitude and duration, PR interval, ST-segment elevation or depression, and OT interval were measured in lead II. RESULTS: Compared with measurements in right lateral recumbency, the sitting position resulted in increased Q-wave amplitude (lead III), increased R-wave amplitude (leads I and aVL), decreased R-wave amplitude (leads III and aVF), increased S-wave amplitude (lead aVR), decreased S-wave amplitude (lead aVL), increased P-wave amplitude (lead II), and a leftward shift in the mean electrical axis. Compared with measurements in right lateral recumbency, sternal recumbency resulted in decreased Q-wave amplitude (leads I, II, and aVF), increased R-wave amplitude (leads 11, III, and aVF), decreased R-wave amplitude (lead aVR), increased S-wave amplitude (lead aVR), increased P-wave amplitude (lead II), and decreased ST-segment depression (lead II). Compared with right lateral recumbency, the sitting position or sternal recumbency did not result in significant differences in PR interval, QT interval, or QRS-complex duration. CONCLUSIONS AND CLINICAL RELEVANCE: Significant changes are found in ECG measurements in the sitting position and sternal recumbency, compared with right lateral recumbency. In dogs, many ECG reference range values for right lateral recumbency are not valid for ECGs obtained in the sitting position or sternal recumbency.     

The normal electrocardiogram of the unanaesthetized competition "Spanish Pouler" pigeon (Columba livia gutturosa)

This investigation was carried out on 64 healthy adult competition pigeons (Spanish Poulers) to determine reference values of electrocardiographic parameters in standard lead II; a comparative study between males and females was also performed to find changes in the electrocardiographic patterns related to sex. P wave was positive and monophasic; PR segment depression was present in 64% of records; the QRS pattern obtained was in most cases of the rS type, followed by the QS configuration. ST slurring (absence of ST) was observed in 47% of records and the mean electrical axis was in all cases negative. Statistically significant differences related to sex were found for P-wave, R-wave and T-wave amplitudes, showing the males have greater amplitudes than females, associated with the increase of cardiac tissue mass. No sex-related differences were found in heart rate and mean electrical axis.     

Assessment of electrocardiographic parameters in healthy dogs undergoing dobutamine stress testing

The electrocardiographic effects of dobutamine stress testing (10 to 40 microg/kg/minute) were investigated in five conscious healthy dogs. We studied the changes in the duration and amplitude of P wave, PR interval, duration of QRS complex, R wave amplitude, QT interval, and heart rate. Development of arrhythmias and ST segment abnormalities were also recorded. It was observed that dobutamine significantly affects atrioventricular-nodal conduction and total electrical systole time at higher infusion rates. Only a single episode of sustained ventricular tachycardia was observed, which was promptly restored to sinus rhythm shortly after dobutamine infusion was discontinued. No ST segment abnormalities were detected. Dobutamine stress testing was concluded to play a role in some ECG parameters at higher infusion rates.     

Congenital cardiac disease in dogs

Aortic stenosis is a heritable cardiac anomaly most common in German Shepherds, Boxers and Newfoundlands, and less common in Pugs, English Bulldogs, Boston Terriers, Fox Terriers, Schnauzers and Bassets. Clinical signs are associated with secondary left-sided heart failure and include coughing, moist rales, exercise intolerance, arrhythmias and a weak femoral pulse. It causes an ejection-type crescendo-decrescendo, systolic murmur best heard on the left side near the elbow. The ECG may be normal or may show signs of left ventricular hypertrophy, including an axis of less than 40 degrees, a QRS complex of greater than 60 seconds in duration, R waves greater than 3 mv in amplitude, ST segment slurring or depression, or T waves of an amplitude greater than 25% of that of R waves. A LAT radiograph usually reveals an enlarged cardiac silhouette, loss of the cranial cardiac waist, and normal pulmonary vasculature, while DV projections show an elongated cardiac silhouette, rounding of the left ventricular border, and a normal descending aorta. Nonselective angiocardiography reveals poststenotic dilatation of the aorta. Treatment of severely affected dogs involves surgical correction.     

High-magnesium exposure to bullfrog heart causes ST segment elevation

Hypermagnesemia occurs in elderly people or patients with renal insufficiency after excessive ingestion of magnesium-containing laxatives. In addition to typical electrocardiogram (ECG) findings caused by conduction defects, changes in the ST segments and T waves are also observed in patients with severe hypermagnesemia. This suggested the involvement of similar pathophysiology to acute myocardial infarction, as we previously demonstrated using burn-induced subepicardial injury model in frog hearts. In the present study, by exposing the bullfrog heart to high-magnesium solution, we reproduced prominent ST segment changes in ECG as actually observed in patients with severe hypermagnesemia. In addition to the great increase in the T waves, the ECG showed a marked elevation of the ST segments and the cardiac action potential demonstrated a marked shift of the resting membrane potential to the depolarized side. High-magnesium exposure did not affect the abundance of Na⁺/K⁺-ATPase proteins. However, the pharmacological stimulation of Na⁺/K⁺-ATPase activity by insulin quickly retrieved the elevated ST segments in ECG. From these results, the functional blockade of Na⁺/K⁺-ATPase activity by magnesium ions was thought to be responsible for generating the potassium concentration gradient and the subsequent ST segment changes.     

The effects of intravenous ciprofloxacin on the electrocardiogram of healthy dogs

The purpose of this study was to evaluate the electrocardiographic effects of single intravenous dose of ciprofloxacin in dogs. Ten adult cross-breed dogs of both sexes were selected as the sample population. Baseline electrocardiographic values were recorded just before drug administration. Then the dogs received intravenous infusion of ciprofloxacin (10 mg/kg) over the fifteen minutes. The ECGs recorded at 15, 30, 60 and 120 minutes after ciprofloxacin administration. The ECG measurements of heart rate, PR interval, QRS interval, ST segment, T-wave amplitude and QT interval were taken from lead II. There was a small but significant increase in the longest QT intervals over baseline at T₆₀ (P = 0.041). The mean PR intervals, QTc intervals, JT intervals, ST segment, T-wave amplitude did not differ significantly before and after ciprofloxacin except for JT intervals at T₆₀ (P = 0.041). At this measurement point_, there was an increased QT interval value of 0.02 second or 9.51 % in comparison to the baseline. In Conclusions, Only minor QT intervals changes were observed after ciprofloxacin injection. Despite the occurrence of ECG changes following intravenous ciprofloxacin administration neither dangerous rhythm disturbances nor serious ECG changes were seen in this study.     

Electrocardiographic changes in the growing Mastín Español

Serial electrocardiograms were recorded from 70 Mastín Español dogs in right lateral recumbency, aged between one day and three years, in order to observe the changes in the waveform and intervals, QRS morphology, cardiac rhythm and heart rate caused by their growth. Age and bodyweight caused a gradual increase in the duration and amplitude of the P wave, duration of the PR, QT and RR intervals, amplitude of the R wave and duration of the QRS complex and ST segment. Q wave was observed in nearly all the recordings with different amplitudes. The S wave was only significant in one-day-old animals and QRS morphology showed significant important changes from qrS and rS to qR and qRs morphologies during the first two weeks of life. The T wave increased its amplitude until the age of two months and changed its polarity (from negative to positive) from five months of age onwards. The heart rate decreased until the age of seven months, reaching stabilised values of 110 ± 7-3 beats per minute. Sinus tachycardia was commonplace in animals under one month old and respiratory sinus arrhythmia was found from six months of age. Sex only influenced the duration and amplitude of the T wave. Males had higher mean values than females.     

Electrocardiography in the horse. (A report of findings in 138 horses)

Over a period of approx. 3 years, electrocardiograms (ECG) were recorded from 138 horses referred as patients to the Medical Clinic. Of these, 22 horses (approx. 16 per cent) has ECG alterations. The 22 ECG's revealed a total of 29 ECG abnormalities. The most frequent ECG alteration was incomplete AV block, that was seen in 9 horses (31 per cent of the ECG abnormalities). Abnormal (i.e. broad, tent-like and, sometimes, inverted) T waves and deviations of the ST segment were seen each in 5 ECG's from 7 horses, 3 of which had both abnormalities which were associated with severe underlying disease (colic, enteritis, pneumonia, strangles a.o.). Premature ventricular beats were seen in 3 horses, two of which had serious cardiovascular dysfunction whereas the third showed no signs of cardiac disease. Atrial fibrillation was observed in two horses. Both were treated with chinidine sulphate but a conversion to sinus rhythm was not achieved in either case. Other ECG abnormalities observed in the study were, parasystole (1 horse), sinus arrhythmia (2 horses), sinoatrial block (1 horse) and wandering pacemaker (1 horse). Each abnormality is discussed with regard to its clinical significance and diagnosis. Cardiac murmurs were detected on auscultation of 26 horses (approx. 19 per cent). The murmurs in 15 horses were short and faint sounds most of which were diastolic. They were considered of no importance. Eleven horses, on the other hand, had distinct, loud (grade 4 or 5), holosystolic or holodiastolic murmurs that were considered pathological. Eight of these horses had actual signs of cardiac disease. Cardiac vector distribution in patients with ECG abnormalities or murmurs showed no systematic differences from vectors in horses showing no cardiac abnormality.     

Electrocardiography of Grevy's zebras (Equus grevyi)

Electrocardiograms (ECGs) are a good baseline test for assessing cardiac rhythm. ECGs have not been reported in any zebra species and in very few Perissodactyla species. Standard limb, six-lead ECGs were recorded in 23 anesthetized Grevy's zebras (Equus grevyi). Heart rate, RR interval, P-wave duration, RR maximum/minimum, PR interval, QRS duration, QT interval, ST segment deviation, P-wave amplitude, QRS amplitude, and T-wave amplitude were measured and calculated from lead II ECGs from these Grevy's zebras. Several variables were tested, including gender, age (0-24, 24-48, 48-180, and >180 mo), weight (<350 kg or >350 kg), pregnancy status, and anesthetic differences (standard dose or supplemented dose), to see if they affected ECG values in these animals. There were no significant differences in any of the ECG parameters between genders. RR and QT intervals were longer in older zebras; heart rates were faster in younger zebras. The RR and PR intervals, as well as the QRS duration, were greater in heavier zebras; heart rates were faster in lighter zebras. The RR interval was significantly longer in pregnant zebras. There were no significant differences in any of the ECG parameters for zebras anesthetized with a standardized dose of the drug combination etorphine-detomidine-acepromazine compared to those receiving additional supplements of these drugs and/or ketamine. All other parameters were not significantly different among groups, except where noted previously. The results of this research indicate that differences in ECG parameters in zebras may occur between animals of different ages, weights, and pregnancy status and that these factors should be considered when interpreting the respective ECGs of these zebras.     

Effects of endurance training on standard and signal-averaged electrocardiograms of sled dogs

OBJECTIVE: To determine the effect of endurance training on QRS duration, QRS-wave amplitude, and QT interval. ANIMALS: 100 sled dogs in Alaska. PROCEDURE: Dogs were examined in early September (before training) and late March (after training). During the interim, dogs trained by pulling a sled with a musher (mean, 20 km/d). Standard and signal-averaged ECG were obtained before and after training. RESULTS: Endurance training significantly increased mean QRS duration by 4.4 milliseconds for standard ECG (mean +/- SEM; 62.3 +/- 0.7 to 66.7 +/- 0.6 milliseconds) and 4.3 milliseconds for signal-averaged ECG (51.5 +/- 0.7 to 55.8 +/- 0.6 milliseconds) without changing body weight. Increase in QRS duration corresponded to a calculated increase in heart weight (standard ECG, 23%; signal-averaged ECG, 27%). Signal-averaged QRS duration was correlated with echocardiographically determined left ventricular diastolic diameter for the X orthogonal lead (r = +0.41), Y orthogonal lead (r = +0.33), and vector (r = +0.35). Training also increased QT interval (234 +/- 2 to 249 +/- 2 milliseconds) and R-wave amplitude in leads II and rV2, increased peak-to-peak voltage and S-wave amplitude in the Y orthogonal lead, and decreased Q-wave amplitude in the Y orthogonal lead. CONCLUSIONS AND CLINICAL RELEVANCE: Electrocardiographic changes reflected physiologic cardiac hypertrophy in these canine athletes in response to repetitive endurance exercise. The QRS duration increases in response to endurance exercise training and, therefore, may be of use in predicting performance in endurance activities.     

Burn-induced subepicardial injury in frog heart: a simple model mimicking ST segment changes in ischemic heart disease

To mimic ischemic heart disease in humans, several animal models have been created, mainly in rodents by surgically ligating their coronary arteries. In the present study, by simply inducing burn injuries on the bullfrog heart, we reproduced abnormal ST segment changes in the electrocardiogram (ECG), mimicking those observed in ischemic heart disease, such as acute myocardial infarction and angina pectoris. The “currents of injury” created by a voltage gradient between the intact and damaged areas of the myocardium, negatively deflected the ECG vector during the diastolic phase, making the ST segment appear elevated during the systolic phase. This frog model of heart injury would be suitable to explain the mechanisms of ST segment changes observed in ischemic heart disease.     

The relationship of resting S-T segment depression to the severity of subvalvular aortic stenosis and the presence of ventricular premature complexes in the dog

Electrocardiograms (ECG) from 35 dogs with subvalvular aortic stenosis (SAS) with a left ventricular outflow tract pressure gradient (PG) of > or =50 mm Hg were retrospectively evaluated for S-T segment depression (STD, > or =0.2 mV in lead II). Pressure gradient, age, heart rate (HR), and number of ventricular premature complexes (VPCs) on a 24-hour ambulatory ECG for dogs with STD were not significantly different from those for dogs without STD. The S-T segment deviation did not correlate significantly with PG, age, HR, or VPCs. The significance of STD in the dog with SAS remains uncertain. Long-term prospective studies are needed to fully understand this observation.     

Pulsus Alternans During Halothane Anesthesia in a Dog

An adult dog with pyloric obstruction was anesthetized with thiamylal and halothane for surgical revision. When an ECG was attached, the QRS-complex rate was noted to differ dramatically from the peripheral pulse rate. A dorsal pedal arterial catheter was introduced, and direct arterial pressure measurements revealed a blood pressure waveform that alternated in amplitude. Blood pressure and ECG traces were recorded, and the condition was diagnosed as pulsus alternans. The inhalation anesthetic was changed to isoflurane, and the condition was resolved.     

Electrocardiographic changes and cardiac pathology in canine babesiosis

The main purpose of this study was to describe electrocardiographic (ECG) changes in canine babesiosis, and to relate these to clinical severity, outcome and cardiac pathology.Four groups of dogs with babesiosis were studied: mild to moderate anemia, severe anemia, concurrent autoagglutination and concurrent complications. Lead II ECG was recorded at admission for 1 minute in all dogs (121). A six lead ECG was recorded in 88 dogs. Full necropsy was performed on 16 dogs (5 died on arrival, 11 had ECG recording).The following ECG changes were recorded in relatively high prevalence: sinoatrial blocks or sinus arrest (7%), ventricular premature complexes (7%), low R-amplitude (23%), prominent Q (13%), axis deviations (40%), prolonged QRS (32%), ST depression and coving (28%), large T (42%), and notched R (28%). Differences between groups were minor. There was a significantly higher prevalence of sinus bradycardia and irregular rhythm in the non-survivors. Gross pathological changes were pericardial effusion and hemorrhages. Histological changes were hemorrhages, necrosis, inflammation and fibrin microthrombi. The only correlation between pathology and ECG was low R-amplitude and pericardial effusion.The ECG changes were similar to the pattern described for myocarditis and myocardial ischemia, and together with the histopathological findings indicated that the heart suffers from the same pathological processes described in other organs in canine babesiosis, namely inflammation and hypoxia. As the clinical application of the ECG changes found in this study was limited, cardiovascular assessment should be based on functional monitoring rather than ECG.     

Electrocardiographic parameters of free-ranging roe deer (Capreolus capreolus).

Electrocardiographic parameters were measured in 28 free-ranging roe deer (Capreolus capreolus). The electrocardiograms (ECGs) were recorded in base-apex lead, standard bipolar limb leads (I, II, III), and augmented unipolar limb leads (aVR, aVL, aVF). Morphology and amplitude of P waves, QRS complexes, and T waves were analyzed in all seven leads. Cardiac rhythm, heart rate, and durations of P, QRS, and T waves, PR interval, QTc interval, and ST segment were calculated in the base-apex lead. The mean electrical axis for each individual was determined from the net amplitude of the QRS complex in leads I and II. All of the animals had a sinus rhythm. Heart rates ranged from 60-180 beats per minute, with a mean +/- SD of 104.8 +/- 44.1. The electrical axis was 100 degrees-220 degrees, with a mean +/- SD of 169.5 degrees +/- 40.8 degrees. The base-apex lead provided the most uniform ECG patterns and higher mean amplitudes than did standard leads.     

EVALUATION OF IOHEXOL AS A GASTROINTESTINAL CONTRAST MEDIUM IN NORMAL CATS

The non-ionic, iodinated contrast medium, iohexol (240 mg I/ml) was evaluated as a gastrointestinal (GI) contrast medium in cats. Iohexol, both undiluted and diluted with tap water, was administered via a percutaneous endoscopically-placed gastrotomy (PEG) tube to 4 mature clinically normal cats. The dilution of contrast medium administered was 1:1, 1:2, and 1:3, and doses were 10 ml/kg and 5 ml/kg body weight. All combinations of dilution and dose of iohexol provided adequate visualization of the contrast medium column within the GI tract, and results were not significantly different than those observed using 30% w/v barium sulfate. Dehydration and diarrhea were not observed after contrast medium administration, but vomiting occurred within 15–30 minutes after administration of undiluted iohexol in all experimental cats. Renal opacification did not occur on exposures made through a 2 hour period, and dilution in transit was not apparent.     

IOHEXOL MYELOGRAPHY IN THE DOG

Myelography with iohexol (180 mg iodine/ml, 0.25 ml/kg), a new nonionic radiologic contrast medium, was performed in 100 dogs of 33 different breeds. In 96 of the dogs the iohexol mixed evenly with the cerebrospinal fluid, providing an homogeneous, continuous column of contrast medium within the subarachnoid space, and a radiologic diagnosis of a normal myelogram or disease involving the spinal cord was made. Pooling of iohexol in the dorsal part of the subarachnoid space occurred in four dogs; whether this was related to poor mixing of contrast medium with cerebrospinal fluid or disease of the spinal cord and meninges requires further study. Postmyelographic signs of central nervous system irritation (fasciculations of the temporal muscles and three episodes of seizure activity) were observed in only one dog and were controlled with diazepam. The presenting neurologic signs were aggravated after myelography in four other dogs, two of which were eventually killed. This study provided further evidence of the increased safety of iohexol compared with metrizamide, the first of the nonionic media, as a contrast medium for myelography in the dog.     

Electrocardiographic parameters of normal alpacas (Lama pacos)

The electrocardiographic parameters of 40 healthy alpacas (Lama pacos) were recorded with a base-apex lead system to establish the normal resting electrocardiographic parameters in this species. The following parameters were measured: heart rate and rhythm, QRS and T morphology, ST segment position, P amplitude and duration, QRS duration and PQ and QT intervals. The heart rate varied between 50 and 110 bpm, with a mean (sd) of 80 (17.8) bpm, and no significant differences were observed between males and females or between alpacas of different ages. Sinus arrhythmia was observed in 35 of the animals, and a regular sinus rhythm was recorded in the other five. The QRS morphology was variable, with an 'rS' pattern observed in 29 animals, 'RS' in six, 'Rs' in three and 'QS' in the other two. A variable morphology was also observed for the T wave, which was positive in 27 animals, negative in seven and biphasic in the other six. All the electrocardiographic parameters were normally distributed and no significant differences were observed between the sexes, except that the amplitude of the P wave was higher in males. The PQ interval was significantly shorter in animals less than six months old.     

A PROSPECTIVE CLINICAL TRIAL COMPARING METRIZAMIDE AND IOHEXOL FOR EQUINE MYELOGRAPHY

A prospective clinical trial comparing adverse postmyelographic effects and myelographic quality of metrizamide and iohexol was conducted. Using a predetermined, randomized assignment, 24 horses exhibiting neurologic signs were administered either metrizamide (180 mgl/ml) or iohexol (180 mgl/ml) via cerebellomedullary puncture. Each horse was evaluated postmyelographically for adverse effects. Myelographic quality was assessed by a numerical scoring method. Adverse effects were observed more frequently with metrizamide (21) compared with iohexol (6) myelography (p < 0.05). Seizures, intensification of preexisting neurologic signs and prolonged anesthetic recovery were the most common complications after myelography. There was no difference in myelographic quality (p > 0.05). We conclude that iohexol is safer than metrizamide for equine myelography and that quality myelograms can be obtained with either contrast medium.