The next heartbeat: Creating dynamic and histographic Poincareplots for the assessment of cardiac rhythms

Flanders, WH; Moise, NS; Pariaut, R; Sargent, J

Abstract

The rhythm of the heart is not a stationary phenomenon, and therefore, incorporation of the dynamic Poincareplot and tachogram provides additional diagnostic information to complement and expand waveform (P-QRST) analyses from the electrocardiogram. Although pattern assessment of the Poincareplot and tachogram can provide an appraisal for normal and abnormal rhythms and serve as a potential means for machine-learned rhythm diagnoses, time-selected windows of beat-to-beat variability permit more detailed examination. As such, expanded criteria for rhythm diagnoses, identification of arrhythmic triggers, global appreciation of rhythm changes, and recognition of patterns that provoke mechanistic questions may be gleaned from the use of the methods reviewed in this report. More specifically, these methods demonstrate that limitations exist in the reliance on traditional measures of heart rate variability in the dog due to the non-linear beat-to-beat rhythm of sinus arrhythmia in the species. Behavior of arrhythmias based on coupling intervals, repeating patterns, preceding triggers of beat-to-beat variability, and circumstantial evidence of atrioventricular nodal conduction during atrial flutter and fibrillation are a few examples of discovery founded in these techniques. The open access website, The Next Heartbeat (https://thenextheartbeat.com/), permits anyone to implement these methods in the assessment of long-term electrocardiographic examinations (Holter monitoring) so that, as yet to be revealed, features of the beating heart through time may be discovered. (C) 2022 Elsevier B.V. All rights reserved.

Citation

Flanders, W., Moise, N., Pariaut, R., & Sargent, J. (2022). The next heartbeat: Creating dynamic and histographic Poincareplots for the assessment of cardiac rhythms. Journal of Veterinary Cardiology, 42, 1-13. https://doi.org/10.1016/j.jvc.2022.04.003

• Journal Article Type: Article
• Acceptance Date: Apr 28, 2022
• Online Publication Date: Aug 1, 2022
• Publication Date: 2022
• Deposit Date: Aug 8, 2023
• Print ISSN: 1760-2734
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 42
• Pages: 1-13
• DOI: https://doi.org/10.1016/j.jvc.2022.04.003
• Keywords: Heart rate variability; Holter monitoring; Beat-to-beat variability; Long-term electrocardiography; Lorenz plot; RATE-VARIABILITY; ATRIAL-FIBRILLATION; CANINE; ARRHYTHMIAS; PATTERNS; PLOTS