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CUT-OUT AND KEEP GUIDE

Electrocardiography in dogs
Michael Johnson, MRCVS, MVB, DVC,
Veterinary Cardiorespiratory Centre, Kenilworth, UK
Michael Johnson graduated from UCD Dublin. He spent the next 10 years in mixed, mainly large animal practice in Ireland, Wales, Australia and Canada. This was followed by 6 years in small animal practice in Manchester, UK. He obtained the certificate examinations in small animal medicine and veterinary cardiology during this time. For the past 7 years Mike Johnson has specialised in cardiorespiratory medicine at a referral practice in the UK, Martin Referrals, during which time he was awarded his Diploma in veterinary cardiology.

n ECG recording is most commonly of 2 types. A standard recording records a rhythm over several minutes. A Holter recording, requiring a strap on device, can provide a recording over 1-7 days. Single or multi-channel recordings may be used. The latter typically record 3 or 6 leads simultaneously. The most useful paper speed settings are 25 or 50 mm/second. Most useful sensitivity settings are 1 cm/ mV (standard setting (Figure 110)) with 1/2 cm/ mV for large complexes and 2 cm/ mV for very small complexes (often seen in cats).

provide information if an abnormality is clearly present on auscultation. More useful in such cases would be a prolonged ECG such as a Holter recording over one or more days.

Indications to performing an ECG

If there is marked bradycardia or tachycardia present on auscultation, an ECG can determine the etiology. Chaotic rhythms usually represent atrial fibrillation but all such rhythms should be documented with an ECG. Premature or missed beats may also be characterized on ECG. If the arrhythmia is quite infrequent, it is unlikely to be detected on a standard recording and a prolonged or Holter recording may be necessary.

Contra-indications to performing an ECG

In general ECGs are probably performed more frequently than necessary. They are not of benefit for example in the diagnosis of the cause of a murmur in small animals. They are also unlikely to be of benefit where the rate and rhythm appear normal on auscultation. The ECG is not usually an accurate guide to heart size. If cardiomegaly is suspected, other tests particularly radiology should be considered. In cases of collapse where a cardiac origin is suspected, a standard ECG is only likely to

Positioning for ECG recording

The conventional recording is obtained in right lateral recumbency. Recording in other positions is quite acceptable. The standing position may be preferred in nervous or large dogs for example. Varying the position will lead to some alteration in the morphology of the complexes recorded. This is not clinically important however and the rhythm, which is the most important aspect of the recording, will remain unaffected.

Vol 18 No 3 / / 2008 / / Veterinary Focus / / 47

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ELECTROCARDIOGRAPHY IN DOGS

Figure 1. This ECG shows normal sinus rhythm at 140 beats per minute.

Figure 2. A West Highland White Terrier with marked depression and anorexia had a marked bradycardia on auscultation. Heart rate averages 35/minute. No P waves are visible. This represents atrial standstill. This occurred secondary to hyperkalemia caused by hypoadrenocorticism.

Figure 3. St Bernard with atrial fibrillation due to DCM. Note the rapid rate at 180/minute, chaotic rhythm and absence of P waves.

Figure 4. Sometimes altered morphology of complexes provides useful information. Note that the QRS complexes alternate markedly in amplitude. This dog had a pericardial effusion, which often leads to electrical alternans as noted here.

Figure 5. A 7-year-old Shetland Sheepdog presented for lethargy. The overall heart rate is low at 45/minute. P waves are unrelated to QRS complexes, representing third degree AV block.

Figure 6. Figure 7. Persistent sinus tachycardia at 180/minute in a dog with heart failure. A single supraventricular premature beat in a dog with atrial enlargement. Such complexes resemble the normal QRS complexes but occur early.

Figure 8. Dog with DCM showing initially 2 ventricular premature beats, VPCs, followed later by a run of rapid ventricular tachycardia. Note that VPCs appear quite different from the normal sinus complexes.

Figure 9. Normal dog showing wandering pacemaker. The P wave varies in amplitude and conformation from beat to beat. This is not an abnormality however.

Figure 10. West Highland White Terrier presented with occasional collapse. Note the sinus arrest/ pauses which occur, in this case due to sick sinus syndrome. This is well recognized in older Westies.

48 / / Veterinary Focus / / Vol 18 No 3 / / 2008