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Ambulatory Electrocardiography Holter

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Maria Helena Matiko Akao Larsson – One of the best experts on this subject based on the ideXlab platform.

  • Holter monitoring 24 h Electrocardiography of holstein calves
    Acta Scientiae Veterinariae, 2018
    Co-Authors: Rebecca Bastos Pessoa, Camila Freitas Batista, Kamila Reis Santos, Jessyca Beraldi Bellinazzi, Alice Maria Melville Paiva Della Libera, Maria Helena Matiko Akao Larsson


    Background: Twenty-four h electrocardiographic monitoring is a noninvasive method of assessing cardiac rhythm. Holter monitoring in farm animals can help assessing heart rate variability and its relationship with stress and production. Several authors have reviewed the normal cardiac rhythm of bovines, but there is little information on heart rhythm in calves. The goal of this research is to elucidate which cardiac rhythms may be considered physiological in Holstein calves, from 3 to 6 months old. Materials, Methods & Results: Twenty-four h Ambulatory Electrocardiography (Holter monitoring) was performed in 10 male Holstein calves, with ages ranging from 3 to 6 months old. The animals came from private farms in Sao Paulo state and were housed in a semi-open stall during the study. The animals had their hair clipped from the third to the fifth intercostal spaces on both sides of the chest, from the sternal region to the glenohumeral joint, and seven electrodes were positioned in a diagonal configuration. Decoding of the recordings was performed using specialized software and in order to minimize digital mistakes, all of the beats marked as ectopic by the software were manually revised by the authors. Mean heart rate was 83.2 ± 11.06 beats per min (bpm), maximum heart rate was 147.1 ± 11.05 bpm, and minimum heart rate was 53.7 ± 7.45 bpm. In 90% of the calves, normal sinus rhythm was predominant, whereas in 10%, sinus arrhythmia (SA) was prevalent. Second degree atrioventricular blocks (AV blocks) were observed in 30% of the animals and supraventricular premature beats (SPB) were detected in 50%. Holter monitoring was repeated after three months in three of the animals; two showed no arrhythmias at the second exam, and in the other, the frequency of AV blocks was decreased by 88.64%. Discussion: In the present study, the authors observed a relatively high incidence of arrhythmias in Holstein calves, although there is little information available in the literature for comparison. The use of Holter monitoring is much more sensitive in the assessment of arrhythmias than a standard electrocardiogram, since it records the cardiac rhythm for 24 to 48 h, as opposed to only 2 to 3 min. Therefore, it is possible that the arrhythmias found in the calves in the current study were physiological events otherwise unidentified by conventional electrocardiogram. The AV blocks observed in the animals of the present study were intermittent and apparently non-related to any particular event or situation, so it was not possible to demonstrate whether they disappeared after exercise. As for the supraventricular ectopic beats, they are frequent in older bovines, mainly in dairy cows, and are usually related to increased vagal tone, stress, hormonal changes, ectopic atrial focus, and peak lactation volume overload. The animals used in the present study were otherwise healthy, and did not demonstrate any clinical signs of gastrointestinal dysfunction or other disease that might have justified an increase in their vagal tone. In addition, the decrease in the number of rhythm abnormalities in the older calves that were submitted to a second Holter exam supports the hypothesis that supraventricular ectopic beats and second degree AV blocks of Mobitz type II may be normal in calves up to six months old.

  • twenty four hour Ambulatory Electrocardiography Holter monitoring in normal unsedated cats
    Acta Scientiae Veterinariae, 2014
    Co-Authors: Fernanda Lie Yamaki, E C Soares, Guilherme G Pereira, Ronaldo Jun Yamato, Luciana Bastos Gallatti, Fabio Sandoli De Brito, Moacir Leomil Neto, Maria Helena Matiko Akao Larsson


    Background: Standard electrocardiogram (ECG) performed during a clinical examination has a limited ability to detect many arrhythmias. Holter or 24-h Ambulatory Electrocardiography (AECG) is the most sensitive non-invasive test for demonstrating transient arrhythmias, that allows continuous recording of cardiac electrical activity while the patient is engaged in normal daily activities. This study was undertaken to defi ne 24-h AECG parameters, including variations in heart rate, and the types and incidence of arrhythmias in clinically normal adult cats to provide a baseline for comparison for cats suspected of having cardiac diseases. Materials, Methods & Results: Twenty clinically normal adult cats, with an equal number of males and females, weighting from 2.8 to 7.6 kg (mean 4.10 ± 1.22), were used. All animals had no historical or clinical evidence of systemic diseases, with unremarkable physical examination, and with no alterations on either thoracic radiography, electrocardiographic, and echocardiographic evaluations, as well as on clinical pathology or blood pressure measurement. Ambulatory electrocardiographic recording was performed for 24-h, with a 3-lead, modifi ed bipolar, transthoracic system. The owner was requested to keep a diary to record the time of exercising, feeding, and other behaviours. The records were analysed using a microprocessor. In the current study, regular sinus rhythm was predominant, there was no evidence of atrioventricular conduction block, or ST segment alterations and the minimum heart rate was 102 ± 23 bpm, while the maximum heart rate was 242 ± 17 bpm and the mean heart rate was 151 ± 26 bpm. Discussion: The main disadvantage of routine clinical ECG is that it records only a short period of heart rhythm. Continuous 24-h AECG monitoring is an obvious way of circumventing this problem. The normal heart rhythm in felines is usually regular, varying from sinus rhythm to sinus tachycardia. Sinus arrhythmia is considered uncommon or abnormal, and when present, it is usually associated with respiratory disorders. Nonetheless, sinus arrhythmia occasionally occurs in cats when they are relatively relaxed. Consistently, it was noted that 95% (19/20) of the cats presented an apparent respiratory sinus arrhythmia with alternating periods of heart rate increase and decrease. Sinus arrhythmia has been previously observed in normal cats when they were calm and quiet in their home environment with either telemetry or Holter monitoring. In cats, sinus arrhythmia is commonly associated with bradycardia (sinus bradyarrhythmia). This fi nding may be an indication that the vagal tone is an important factor in the genesis of this rhythm. The heart rate variability parameters obtained through telemetry suggest that parasympathetic tone was higher (and sympathetic tone lower) when the cats were in their home environment. In the current study, the minimum heart rate was lower than that of hospitalized normal cats (102 ± 23 bpm versus 117 ± 15 bpm), while the maximum heart rate was higher (241 ± 17 bpm versus 241 ± 21 bmp) and the mean heart rate was lower (151 ± 26 bpm versus 151 ± 16 bpm), but without statistical signifi cance. There were no gender differences in the mean values for minimum, mean and maximum heart rate, a fi nding that is in contrast to a previous study in which females presented with higher mean values for minimum and mean heart rates than males did. This study suggests that occasional ventricular (and supraventricular) ectopic activity may occur in healthy young cats. However, it is still unclear how many premature beats can be considered “normal” in cats.

Martín Tomé F. – One of the best experts on this subject based on the ideXlab platform.

  • El Laboratorio de Electrofisiología. Recursos humanos y materiales
    Asociación Española de Enfermería en Cardiología, 2007
    Co-Authors: Martín Tomé F.


    The Electrophysiology Laboratory is the physical area where the electrophysiological studies and ablation procedures are performed along with the implantation of pacemakers, automatic defibrillators and subcutaneous Holters. The increasing in number of patients amenable to be treated in the laboratory, the use of noninvasive diagnostic techniques as the Ambulatory Electrocardiography Holter monitoring, tilt table testing, or the periodic check ups of the implantable devices emphasizes that the electrophysiology laboratory must not be conceived as something isolated, but rather form part of an Arrhythmia Unit. On the other hand, the progressive complexity of the activity in the laboratory needs an increasingly specialized and qualified personnel with a full time dedication.El Laboratorio de Electrofisiología es el área física donde se realizan los estudios electrofisiológicos, los procedimientos de ablación, los implantes de marcapasos, desfibriladores automáticos y Holter subcutáneo, entre otros. El incremento en el número de pacientes susceptibles de ser tratados en el laboratorio, la utilización de técnicas de diagnóstico no invasivas como la monitorización electrocardiográfica ambulatoria de Holter, el test de basculación, o los mismos controles periódicos de los dispositivos implantables, hacen que no deba concebirse el laboratorio de electrofisiología como algo aislado, sino que forme parte de lo que denominamos una Unidad de Arritmias. Por otro lado, la progresiva complejidad de la actividad del laboratorio reclama la necesidad de un personal cada vez más especializado y cualificado con una dedicación laboral plena

J Ikhidero – One of the best experts on this subject based on the ideXlab platform.

  • audit of 24 h Ambulatory Electrocardiography Holter of 281 nigerian patients in benin city metropolis
    Nigerian Journal of Cardiology, 2019
    Co-Authors: Veronica Adaku Josephs, Wilson E Sadoh, J Ikhidero


    Background: Recent advances in cardiovascular management have been the result of the implementation of technological advances in the form of facilities in patient care. Continuous Ambulatory Electrocardiography (ECG) is used for the diagnosis of symptomatic and asymptomatic arrhythmias of the cardiac patient which are not immediately apparent to the clinician, but otherwise amenable to treatment. Objective: The aim of this study is to examine the relevance of 24-h Ambulatory ECG in the management of arrhythmias in the Nigerian patient. The study was carried out from Winsephs’ family clinic, a private cardiology clinic in Benin City. Methods: A retrospective study of 281 adult patients referred for 24 h Ambulatory ECG (Holter) between January 2006 and June 2015. Results: The indications for Holter-ECG were as follows: unexplained recurrent palpitations (174) (61.9%); effort intolerance (67) (23.8%); probable ischemic heart disease (53) (18.9%); chest pain (53) (18.9%); and an assessment of arrhythmia in congestive cardiac failure (48) (17.1%). Others were syncopal attacks (23) (8.9%) and extreme weakness (15) (5.3%). The most common rhythm abnormalities and the number of individuals affected were as follows: premature atrial contractions (PAC) (188) (66.1%), sinus tachycardia (ST) (165) (58.7%), ventricular extrasystoles (148) (52.7%), paroxysmal supraventricular tachycardia (127) (45.2%), ventricular tachycardia (55) (19.6%), bradycardia (57) (20.3%), and pause (51) (18.2%). Other significant rhythm abnormalities were atrial fibrillation (17) (6.1%) and atrial flutter (10) (3.6%). Myocardial ischemia indicated by ST depressive episodes was observed in (32) (11.4%) patients, and the majority of those affected were >55 years of age. There were five normal reports. Conclusion: Holter-ECG is becoming an indispensable tool in diagnosis, management, and follow up of the cardiac patient.