Comparison of the diagnostic value of a small, single channel, electrocardiogram monitoring patch with a standard 3-lead Holter system over 24 hours in dogs.

Abstract

INTRODUCTION/OBJECTIVES: The aim of this study was to compare a novel small event recorder device, the Carnation Ambulatory Monitor (CAM), with a standard Holter. ANIMALS: Nineteen adult dogs. MATERIAL AND METHODS: Comparative and explorative study. The two devices were simultaneously applied for approximately 24&#xa0;h. RESULTS: Analysis time (P=0.013) and percentage of artefacts (P<0.001) were greater for the CAM (110&#xa0;min [40-264]; and 9% [0-34], respectively) compared to a standard Holter (30&#xa0;min [18-270]; and 0.3% [0-9], respectively). The total number of beats (P=0.017) and maximum (P=0.02) and mean (P=0.037) heart rates were lower for the CAM (113,806&#xa0;&#xb1;&#xa0;23,619 beats; 227&#xa0;&#xb1;&#xa0;35 bpm; and 88&#xa0;&#xb1;&#xa0;22 bpm, respectively) compared to the standard Holter (131,640&#xa0;&#xb1;&#xa0;40,037 beats; 260&#xa0;&#xb1;&#xa0;64 bpm; and 92&#xa0;&#xb1;&#xa0;26 bpm, respectively). The minimal heart rate (P=0.725), number of pauses (P=0.078), duration of the longest pause (P=0.087), number of ventricular ectopic complexes (P=0.55), ventricular couplets (P=0.186), ventricular triplets (P=0.203), ventricular tachycardia (P=0.05), Lown grade (P=0.233), presence or absence of ventricular bigeminy, trigeminy, supraventricular tachycardia, and atrial fibrillation (P=0.98) did not differ. The CAM missed some relevant events, like complex ventricular arrhythmias, and the Lown grade did not match in 5/19 dogs when comparing the devices. CONCLUSIONS: Cardiac Ambulatory Monitor can be used to record ECG traces in dogs over a prolonged period, allowing to detect arrhythmias. Due to some clinically relevant limitations, including a higher percentage of artefacts, a longer reading time (which precludes quantitative counts of >300ventricular premature complexes), and underestimation of complex ventricular arrhythmias, the CAM appears not suitable for quantitative arrhythmia analysis in dogs.