A novel approach for obtaining 12‐lead electrocardiograms in horses

Abstract Background In equine medicine, 12‐lead electrocardiograms (ECGs) rarely are used, which may in part be a result of shortcomings in the existing guidelines for obtaining 12‐lead ECGs in horses. The guidelines recommend placing the limb leads on the extremities, which is inappropriate because the ventricular mean electrical axis is then perpendicular to the limb leads, leading to large variations in ECG configuration even among healthy horses. From an electrophysiological point of view, the leads instead should be parallel to the electrical axis to minimize variability. Objective Develop an improved method for obtaining 12‐lead ECGs in horses based on electrophysiology and cardiac electrical vectors relevant to horses. Animals Thirty‐five healthy Standardbred horses. Methods Two ECGs obtained at rest; 1 ECG with the electrodes placed according to the method developed in the present study, the Copenhagen method, and 1 ECG following existing guidelines. Results In the Copenhagen method, we repositioned the limb electrodes to the thorax to better capture the electrical activity of the heart. Variation in the mean electrical axis decreased dramatically with the Copenhagen method (SD decreased from 24.6° to 1.6°, P < .001). Consequently, this new method provided stable ECGs with repeatable configurations. Conclusions and Clinical Importance With this novel method, the ECG is recorded with respect to the electric axis to fully realize the potential of 12‐lead ECG in horses. The Copenhagen method delivered more consistent and reliable ECG recordings compared to existing guidelines. The Copenhagen method potentially allows for expanded use of 12‐lead ECGs in equine medicine.