Stall-side screening potential of a smartphone electrocardiogram recorded over both sides of the thorax in horses

Abstract

Background: Comparisons between smartphone ECG (SpECG) recordings obtained from the right and left sides of the thorax have not been reported in animals. Objectives: To evaluate the screening potential of a SpECG obtained from both sides of the thorax and to compare the degree of agreement between the SpECG and a reference ECG (rECG) for measurement of the duration of baseline electrical deflections recorded over both sides of the thorax. Animals: Fifty horses admitted to the equine hospital, university-owned horses, and horses from an endurance riding facility. Methods: Prospective observational study. Simultaneous rECG and SpECG tracings were recorded on both sides of the thorax and evaluated by 2 experienced observers for interpretability, presence and classification of arrhythmias, and duration of deflections of the electrical baseline. Results: Fifteen (15/50) horses had spontaneous arrhythmias. Excellent agreement was found between the 2 devices (κ = 0.91; P < .001; 95% confidence interval [CI] 0.79-1.03) for the detection of arrhythmias. Significantly more P waves were of diagnostic quality from the right side (20 versus 5, P = .001) and significantly more QRS and QT intervals were of diagnostic quality from the left side (66 versus 38 and 62 versus 34, respectively, P < .001). Substantial agreement for the duration of deflections between devices only was observed for the QRS interval (SpECG left). Conclusions and Clinical Importance: It is important to obtain SpECG tracings from both sides of the thorax in horses. The SpECG is a useful stall-sidearrhythmiascreening tool for some common arrhythmias in horses.