Variability Inter-observer between Three Methods of Electrocardiographic (Conventional, Computerized and Computerized Printed) on Healthy Cats

Authors

  • Mariana Yukari Hayasaki Porsani Programa de Pós-graduação em Ciências Veterinárias, Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil.
  • Luiz Eduardo Duarte de Oliveira Programa de Pós-graduação em Ciências Veterinárias, Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil.
  • Ruthnea Aparecida Lázaro Muzzi Programa de Pós-graduação em Ciências Veterinárias, Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil.
  • Claudine Botelho de Abreu Programa de Pós-graduação em Ciências Veterinárias, Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil.
  • Camila Santos Pereira Programa de Pós-graduação em Ciências Veterinárias, Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil.
  • Vânia Chaves de Figueiredo Programa de Pós-graduação em Ciências Veterinárias, Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil.
  • Mariana de Resende Coelho Programa de Pós-graduação em Ciências Veterinárias, Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil.
  • Antonio Carlos Lacreta Junior Programa de Pós-graduação em Ciências Veterinárias, Universidade Federal de Lavras (UFLA), Lavras, MG, Brazil.

DOI:

https://doi.org/10.22456/1679-9216.97775

Abstract

Background: Electrocardiography is an exam widely used in feline medicine. It consists of recording the electrical activity of the heart in waves representing myocardial depolarization and repolarization. Two electrocardiographic evaluation methods are employed in dogs and cats: computerized and conventional. However, possible differences in ECG results performed by the different methods have been reported. This paper aims to evaluate the observer's interference in the interpretation of the electrocardiographic exams and possible differences between the methods: conventional single channel, computerized screen and computerized printed of healthy cats.

Materials, Methods & Results: Electrocardiographic tracings were obtained from 58 healthy cats, aged between 1 and 10 years-old, of both sexes, of the Persian and mixed breed and therefore interpreted by four observers with similar degree of experience. The examinations were performed in a sequential manner, the computerized method first, and then the conventional method. The animals were gently contained in the right lateral decubitus position. The tracings obtained by the conventional method were printed on thermally sensitive graph paper. The computerized method was performed in computer by means of specific software (TEB® ECGPC version 6.2), being the waves delimited by the observer. The tracings were also printed by means of a jet printer, and also interpreted. The morphology of P waves, QRS complexes and T waves were analyzed in the derivations: I, II, III, aVR, aVL and aVF. Heart rate, amplitude and duration of the P, QRS and T waves, PR, QT and heart rate (HR) intervals were calculated in derivation II. Mean electric axis was determined in leads I and III. Comparing the methods, there was a difference observed in the values of P and R waves, QRS complex, QT and PR intervals and T wave polarity. The interpretation of the evaluators presented statistical differences in the duration of the P wave, QRS, QT and HR. The three methods used presented differences during the mean of the interpretation of the evaluators.

Discussion: Some factors such as the positioning of the animal and the use of chemical containment may influence the electrocardiographic tracings, as well as variations between electrocardiographic devices. In our study, the non-use of sedation and the use of the same equipment in all animals reduced the variability of the results. The interpretation of the computerized method printed and on the screen presented different results which can be explained by the reduced human visual capacity when compared to the computers. It is known that the interpretation of different tracings by the observers might influence the results of the examination. The evaluators of the present study evaluated the same tracings, but there was a difference in the interpretation of the observers. Regarding the methods, there was a difference between the three methods evaluated in relation to the ST segment. The computerized on-screen method demonstrated in its totality isoelectric ST segments that represent normal pattern for the species. The conventional and computerized printed methods presented results of elevation in ST segments that represent alterations in the diagnosis. There was a difference between the measurements performed by different observers, however this fact did not influence the results of the tests, since the parameters remained within the normality standards for species. It can be concluded that the variation between observers and among the three methods evaluated suggests that the ST segment interpretation is subtle and less influenced when performed in the computerized method.

Downloads

Download data is not yet available.

References

Acheson R.M. 1960. Observer error and variation in the interpretation of electrocardiograms in an epidemiological study of coronary heart disease. British Journal of Preventive & Social Medicine. 14(3): 99-122.

Atmaca N., Simsek O., Arikan S. & Kabakci R. 2014. Evaluation of Some Electrocardiographic Parameters of Kitten and Adult Angora Cats. Research Journal for Veterinary Practitioners. 2(6): 113-116.

Camacho A.A., Paulino-Junior D., Pascon J.P.E. & Teixeira A.A. 2010. Comparison between conventional and computerized electrocardiography in cats. Arquivo Brasileiro de Medicina Veterinária e Zootecnia. 62(3): 765-769.

Chetboul V., Athanassiadis N., Concordet D., Nicolle A., Tessier D., Castagnet M., Pouchelon J.L. & Lefebvre H.P. 2004. Observer-dependent variability of quantitative clinical endpoints: the example of canine echocardiography. Journal of Veterinary Pharmacology and Therapeutics. 27(1): 49-56.

Chetboul V., Concordet D., Pouchelon J.L., Athanassiadis N., Muller C., Benigni L., Munari A.C. & Lefebvre H.P. 2003. Effects of Inter- and Intra-Observer Variability on Echocardiographic Measurements in Awake Cats. Journal of Veterinary Medicine Series A. 50(6): 326-331.

Dun L.F. & Rahm R.E. 1950. Electrocardiography: Modem trends in instrumentation and visual and direct recording electrocardiography. Annals of Internal Medicine. 32(4): 611-626.

Gava F.N., Paulino-Junior D., Pereira Neto G.B., Pascon J.P.E., Sousa M.G., Chanpion T. & Camacho A.A. 2011. Computerised electrocardiograph in Beagle dogs. Arquivo Brasileiro de Medicina Veterinária e Zootecnia. 63(2): 317-321.

Geer L., Oscarsson A. & Engvall J. 2015. Variability in echocardiographic measurements of left ventricular function in septic shock patients. Cardiovascular Ultrasound. 13:19.

Hanas S., Tidholm A., Egenvall A. & Holst B.S. 2009. Twenty-four hour Holter monitoring of unsedated healthy cats in the home environment. Journal of Veterinary Cardiology. 11(1): 17-22.

Hansson K., Haggstro J., Kvart C. & Lord P. 2005. Interobserver variability of vertebral heart size measurements in dogs with normal and enlarged hearts. Veterinary Radiology & Ultrasound. 46(2): 122-130.

Harvey A.M., Faena M., Darke P.G.G. & Ferasin L. 2005. Effect of Body Position on Feline Electrocardiographic Recordings. Journal of Veterinary Internal Medicine. 19(4): 533-536.

Martin M. 2007. Small Animal ECGs an Introductory Guide. 2nd edn. Oxford: Blackwell Publishing, 121p.

Pelter M.M., Adams M. & Drew B. 1997. Computer versus Manual Measurement of ST-Segment Deviation. Journal of Electrocardiology. 30(1): 151-156.

Tilley L.P. & Burtnick N.L. 2004. ECG Eletrocardiografia para o Clínico de Pequenos Animais. São Paulo: Roca, 112p.

Tilley L.P. & Smith J.R. 2011. Arrhythmias. In: Norsworthy G.D. (Ed). The Feline Patient. 4th edn. Ames: Wiley-Blackwell, pp.26-27.

Tilley L.P. 1992. Essentials of Canine and Feline Electrocardiography. 3rd edn. Philadelphia: Lea and Febiger, 252p.

Wolf R., Camacho A.A. & Souza R.C.A. 2000. Eletrocardiografia computadorizada em cães. Arquivo Brasileiro de Medicina Veterinária e Zootecnia. 52(6): 610-615.

Published

2020-01-01

How to Cite

Hayasaki Porsani, M. Y., Duarte de Oliveira, L. E., Lázaro Muzzi, R. A., de Abreu, C. B., Pereira, C. S., de Figueiredo, V. C., Coelho, M. de R., & Lacreta Junior, A. C. (2020). Variability Inter-observer between Three Methods of Electrocardiographic (Conventional, Computerized and Computerized Printed) on Healthy Cats. Acta Scientiae Veterinariae, 48. https://doi.org/10.22456/1679-9216.97775

Issue

Section

Articles

Most read articles by the same author(s)