• 1. Gelzer ARM, Kraus MS, Rishniw M, et al. Combination therapy with mexiletine and sotalol suppresses inherited ventricular arrhythmias in German Shepherd Dogs better than mexiletine or sotalol monotherapy: a randomized cross-over study. J Vet Cardiol 2010;12:93106.

    • Search Google Scholar
    • Export Citation
  • 2. Spier AW, Meurs KM. Evaluation of spontaneous variability in the frequency of ventricular arrhythmias in Boxers with arrhythmogenic right ventricular cardiomyopathy. J Am Vet Med Assoc 2004;224:538541.

    • Search Google Scholar
    • Export Citation
  • 3. Spier AW, Meurs KM. Assessment of heart rate variability in Boxers with arrhythmogenic right ventricular cardiomyopathy. J Am Vet Med Assoc 2004;224:534537.

    • Search Google Scholar
    • Export Citation
  • 4. Miller RH, Lehmkuhl LB, Bonagura JD, et al. Retrospective analysis of the clinical utility of ambulatory electrocardiographic (Holter) recordings in syncopal dogs: 44 cases (1991–1995). J Vet Intern Med 1999;13:111122.

    • Search Google Scholar
    • Export Citation
  • 5. Poincaré H. Calculus of probabilities and electrodynamics, In: Science and hypothesis. New York: The Science Press, 1905;218–224, 257272.

    • Search Google Scholar
    • Export Citation
  • 6. Lorenz E. Deterministic nonperiodic flow. J Atmos Sci 1963;20:130141.

  • 7. Nayak SK, Bit A, Dey A, et al. A review on the nonlinear dynamical system analysis of electrocardiogram signal. J Healthc Eng [serial online]. 2018;2018:119. Available at: www.hindawi.com/journals/jhe/2018/6920420/ Accessed Nov 19, 2018.

    • Search Google Scholar
    • Export Citation
  • 8. Blake RR, Shaw DJ, Culshaw GJ. Poincaré plots as a measure of heart rate variability in healthy dogs. J Vet Cardiol 2018;20:2032.

  • 9. Esperer HD, Oehler M. Automatic quantification of the Poincaré plot asymmetry of NN-interval recordings. Physiol Meas 2010;31:395413.

    • Search Google Scholar
    • Export Citation
  • 10. Thomsen MB, Volders PGA, Beekman JDM, et al. Beat-to-beat variability of repolarization determines proarrhythmic outcome in dogs susceptible to drug-induced torsades de pointes. J Am Coll Cardiol 2006;48:12681276.

    • Search Google Scholar
    • Export Citation
  • 11. Thomsen MB, Truin M, van Opstal JM, et al. Sudden cardiac death in dogs with remodeled hearts is associated with larger beat-to-beat variability of repolarization. Basic Res Cardiol 2005;100:279287.

    • Search Google Scholar
    • Export Citation
  • 12. Gladuli A, Moise NS, Hemsley S, et al. Poincaré plots and tachograms reveal beat patterning in sick sinus sndrome with supraventricular tachycardia and varying AV nodal block. J Vet Cardiol 2011;13:6370.

    • Search Google Scholar
    • Export Citation
  • 13. Moïse NS, Gladuli A, Hemsley SA, et al. “Zone of avoidance”: RR interval distribution in tachograms, histograms, and Poincaré plots of a Boxer dog. J Vet Cardiol 2010;12:191196.

    • Search Google Scholar
    • Export Citation
  • 14. Esperer HD, Esperer C, Cohen RJ. Cardiac arrhythmias imprint specific signatures on Lorenz plots. Ann Noninvasive Electrocardiol 2008;13:4460.

    • Search Google Scholar
    • Export Citation
  • 15. Zhang L, Guo T, Xi B, et al. Automatic recognition of cardiac arrhythmias based on the geometric patterns of Poincare plots. Physiol Meas 2015;36:283301.

    • Search Google Scholar
    • Export Citation
  • 16. Borracci RA, Montoya Pulvet JD, Ingino CA, et al. Geometric patterns of time-delay plots from different cardiac rhythms and arrhythmias using short-term EKG signals. Clin Physiol Funct Imaging 2018;38:856863.

    • Search Google Scholar
    • Export Citation
  • 17. Gelzer ARM, Moïse NS, Vaidya D, et al. Temporal organization of atrial activity and irregular ventricular rhythm during spontaneous atrial fibrillation: an in vivo study in the horse. J Cardiovasc Electrophysiol 2000;11:773784.

    • Search Google Scholar
    • Export Citation
  • 18. Moïse NS, Dugger DA, Brittain D, et al. Relationship of ventricular tachycardia to sleep/wakefulness in a model of sudden cardiac death. Pediatr Res 1996;40:344350.

    • Search Google Scholar
    • Export Citation
  • 19. Oka T, Nakatsu T, Kusachi S, et al. Double-sector Lorenz plot scattering in an R-R interval analysis of patients with chronic atrial fibrillation: incidence and characteristics of vertices of the double-sector scattering. J Electrocardiol 1998;31:227235.

    • Search Google Scholar
    • Export Citation
  • 20. Pedich W, Popiolek J, Tobiaszewska D. The mechanism of the silent zone on Lorenz plots in atrial fibrillation. Rocz Akad Med Bialymst 1998;43:232244.

    • Search Google Scholar
    • Export Citation
  • 21. Lamb AP, Meurs KM, Hamlin RL. Correlation of heart rate to body weight in apparently normal dogs. J Vet Cardiol 2010;12:107110.

  • 22. Meurs KM, Spier AW, Wright NA, et al. Use of ambulatory electrocardiography for detection of ventricular premature complexes in healthy dogs. J Am Vet Med Assoc 2001;218:12911292.

    • Search Google Scholar
    • Export Citation
  • 23. Moïse NS. From cell to cageside: autonomic influences on cardiac rhythms in the dog. J Small Anim Pract 1998;39:460468.

  • 24. Pan Y, Fanfang Z, Ru L, et al. The characteristics of RR-Lorenz plot in persistent atrial fibrillation patients complicating with escape beats and rhythm. Zhonghua Xin Xue Guan Bing Za Zhi 2014;42:481483.

    • Search Google Scholar
    • Export Citation
  • 25. Katohno J, Nakai K, Itoh C, et al. Analysis of the preceding R-R interval and the coupling interval on premature ventricular contractions. Rinsho Byori 1994;42:419424.

    • Search Google Scholar
    • Export Citation
  • 26. Climent AM, Guillem MDLS, Husser D, et al. Poincaré surface profiles of RR intervals: a novel noninvasive method for the evaluation of preferential AV nodal conduction during atrial fibrillation. IEEE Trans Biomed Eng 2009;56:433442.

    • Search Google Scholar
    • Export Citation

Advertisement

Visual representations of canine cardiac arrhythmias with Lorenz (Poincaré) plots

View More View Less
  • 1 1Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607.

Abstract

OBJECTIVE

To characterize the patterns associated with Lorenz plots (LPs) or Poincaré plots derived from the Holter recordings of dogs with various cardiac rhythms.

ANIMALS

77 dogs with 24-hour Holter recordings.

PROCEDURES

A 1-hour period from the Holter recordings from each of 20 dogs without arrhythmias and from each of 57 dogs with arrhythmias (10 each with supraventricular premature complexes, complex supraventricular ectopy, ventricular premature complexes, complex ventricular ectopy, and atrial fibrillation, and 7 with high-grade second-degree atrioventricular block) were used to generate the LPs. Patterns depicted in the LPs were described.

RESULTS

Arrhythmia-free Holter recordings yielded LPs with a Y-shaped pattern and variable silent zones. Recordings with single premature complexes yielded LPs with double side and triple side lobes. Complex ectopy was denoted by dots clustered in the lower left corner of the LPs. The LPs of recordings with atrial fibrillation had fan patterns consistent with a nonlinear relationship between atrial electrical impulses and atrioventricular nodal conduction. The recordings with atrioventricular block yielded LPs with island patterns consistent with variable atrioventricular nodal conduction.

CONCLUSIONS AND CLINICAL RELEVANCE

Distinct LP patterns were identified for common cardiac rhythms of dogs, supportive of nonrandom mechanisms as the cause of most rhythms. Visual interpretation of an LP generated from a Holter recording may aid in determining the arrhythmia type and understanding the arrhythmia's mechanism in dogs and other species.

Abstract

OBJECTIVE

To characterize the patterns associated with Lorenz plots (LPs) or Poincaré plots derived from the Holter recordings of dogs with various cardiac rhythms.

ANIMALS

77 dogs with 24-hour Holter recordings.

PROCEDURES

A 1-hour period from the Holter recordings from each of 20 dogs without arrhythmias and from each of 57 dogs with arrhythmias (10 each with supraventricular premature complexes, complex supraventricular ectopy, ventricular premature complexes, complex ventricular ectopy, and atrial fibrillation, and 7 with high-grade second-degree atrioventricular block) were used to generate the LPs. Patterns depicted in the LPs were described.

RESULTS

Arrhythmia-free Holter recordings yielded LPs with a Y-shaped pattern and variable silent zones. Recordings with single premature complexes yielded LPs with double side and triple side lobes. Complex ectopy was denoted by dots clustered in the lower left corner of the LPs. The LPs of recordings with atrial fibrillation had fan patterns consistent with a nonlinear relationship between atrial electrical impulses and atrioventricular nodal conduction. The recordings with atrioventricular block yielded LPs with island patterns consistent with variable atrioventricular nodal conduction.

CONCLUSIONS AND CLINICAL RELEVANCE

Distinct LP patterns were identified for common cardiac rhythms of dogs, supportive of nonrandom mechanisms as the cause of most rhythms. Visual interpretation of an LP generated from a Holter recording may aid in determining the arrhythmia type and understanding the arrhythmia's mechanism in dogs and other species.

Contributor Notes

Dr. Adin's present address is the College of Veterinary Medicine, University of Florida, Gainesville, FL 32608.

Address correspondence to Dr. Adin (adind@ufl.edu).