Continuous Electrocardiography in Dogs and Cats

Comparison of in‐hospital continuous electrocardiography versus recordable Holter monitoring in dogs with ventricular arrhythmias

“…To date, several studies have reported on the limitations of shortterm ECG. [1][2][3][4][5][6][7] The present study is the first to make a direct comparison of arrhythmia detection and quantification of an hourly 1-min ECG reported by an ICU technician from a continuous ECG to recordable Holter monitoring in hospitalized patients. Recordable telemetry may also be used to document the occurrence of arrhythmias that may otherwise go unnoticed in hospitalized patients and allow timely and appropriate interventions.…”

“…It bears mentioning that the Holter hour grade was reported as the worst rhythm over that hour, and it is therefore not possible to overestimate the minute grade. It was found that more severe arrhythmia grades (3)(4)(5) reported for an hourly 1-min ECG had the lowest agreement with the corresponding 1-h Holter arrhythmia grade (Figure 3). This suggests that 1-min hourly ECG assessments have poor sensitivity in the detection of the most severe arrhythmias (grades 3-5).…”

“…Holter monitors overcome the limitations of intermittent ECG by storing collected information and permitting review of data for detection of occasional or intermittent arrhythmias that may be difficult to identify in a shorter time period using nonrecordable continuous ECG or telemetry. 3 Studies have demonstrated that Holter monitoring is superior to standard ECG in detecting arrhythmias in dogs with preclinical or clinical myxomatous mitral valve disease, post-splenectomy, and screening for dilated cardiomyopathy in Doberman Pinschers and ventricular premature complexes (VPCs) in Boxers. 2,[4][5][6] Despite the many benefits of Holter monitoring, results of the recorded data are not available in real time and therefore cannot be practically applied to a critical ICU patient.…”