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Evaluation of in‐hospital electrocardiography versus 24‐hour Holter for rate control in dogs with atrial fibrillation
Author(s) -
Gelzer A. R.,
Kraus M. S.,
Rishniw M.
Publication year - 2015
Publication title -
journal of small animal practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 67
eISSN - 1748-5827
pISSN - 0022-4510
DOI - 10.1111/jsap.12363
Subject(s) - medicine , atrial fibrillation , cardiology , heart rate , holter monitor , electrocardiography , anesthesia , blood pressure
Objectives To determine if the in‐clinic ECG ‐derived heart rate could predict the at‐home Holter‐derived 24‐hour average heart rate (Holter 24h ), and whether it is useful to identify slow versus fast atrial fibrillation in dogs. Materials and Methods 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 Holter 24h threshold value of 140 bpm. Results ECG heart rate overestimated Holter 24h 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 Ä 155 bpm had a sensitivity of 73% and a specificity of 100% for identifying a Holter 24h HR Ä 140 bpm; an in‐clinic ECG ‐derived HR <160 bpm had a sensitivity and specificity of 91% each. Clinical Significance 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.