Using a wearable electrocardiogram (ECG) patch adapted for 7-day monitoring in the horse

Background: Arrhythmias can cause poor performance and sudden death in horses. Long-term (>24 h) electrocardiogram (ECG) monitoring has been used to identify arrhythmias in humans and is superior to short-term monitoring for transient arrhythmia detection. Televet is the current equine gold-standard ECG device. The Cardea SOLO™ (CS) is a single-use monitor with automated ECG analysis software allowing ECG monitoring for 7 days. Objective: Our objective was to validate the performance of the CS compared to the Televet. Study Design: Method validation. Methods: ECGs were performed on 12 healthy horses simultaneously using both devices for 24 h on day 1 and day 7, with the CS left in place for all 7 days. Each ECG was manually reviewed to identify correctly and incorrectly classified complexes. Generalised linear models were used to identify differences in the arrhythmia classifications and the proportion of unusable minutes. For eight horses, Bland–Altman analysis and correlation were performed to test for agreement between the two devices for standard ECG measurements. Results: The CS recorded and analysed ECGs for up to 7-days without adverse effects in all horses. The proportion of readable ECG decreased markedly after day 5 and CS identified more false positive premature complexes than Televet. The correlation between devices for ECG measurements ranged from good to excellent. Main Limitations: The major limitations of our study are the relatively small sample size (n = 12) and the challenge in starting both devices at the same time led to only eight horses being included in the device measurement comparisons. The CS is a single lead ECG which may have led to incorrectly classified premature depolarisation types on manual inspection. Conclusions: This study demonstrates the CS utility for 5-day ECG monitoring and screening for arrhythmias in healthy horses. CS utility for the detection of pathological arrhythmias requires further investigation.