Smarter Smart Phone: Stall-side ECG

By Adam Marcus

A smartphone app that measures electrical activity in the heart is accurate enough to provide stall-side screening for arrhythmias, researchers have found.

Previous studies have supported the utility of smartphone electrocardiograms (SpECG) for detecting rhythm and heart rate in horses. The new work, from a group at CEU Cardenal Herrera University in Valencia, Spain, shows that the apps appeared to be as effective as conventional ECGs at identifying atrial fibrillation and other anomalies—provided users take measurements from both sides of an animal’s thorax.

“Electrocardiography has been mostly reserved for referral centers, and for most clinicians the costs and the training required to interpret ECGs has prevented a wider use in the general equine population. Now, every equine vet has the possibility to have an ECG in their pocket at a very affordable cost,” said Ignacio Corradini, MV, MSc, DipECEIM, who led the study.

The app takes about 5 minutes to use and requires little training. “Another exciting thing for veterinarians is that the ECG could be included in regular health checks or even prepurchase examinations,” Dr. Corradini added. “We believe that this opens the door for earlier detection, increasing the chances of successful outcomes in the treatment of equine arrhythmias in the near future.”

For their study, Dr. Corradini and his colleagues tested an SpECG app (AliveCor Veterinary Heart Monitor AC-002) on 50 horses ranging in age from 1 month to 31 years. As the investigators noted, the electrical sensors designed for mobile phones cannot be separated, as they can with conventional ECGs, so to compensate they took measurements on both sides of the animals’ thoraxes. They also compared the readings with those from a traditional ECG.

Of the 50 horses, 15 were found to have a spontaneous arrhythmia on traditional ECG, including atrial fibrillation, sinus pause and atrioventricular block. The SpECG detected all of those, they reported, although in one case, the anomaly appeared only when the app was used on the right side of the thorax.

A Smartphone app appears to be as effective as conventional ECGs at identifying atrial fibrillation.

Image courtesy of Dr. Ignacio Corradini

To use the app optimally, veterinarians should take 1-minute measurements from each side of the thorax, according to Dr. Corradini. “That’s because according to our study, recording an ECG from the right side provided additional information that was useful to help pick-up and characterize arrhythmias,” he said.

Dr. Corradini said that, for the moment, the app is appropriate only as a screening tool. “The smartphone ECG is a good screening method, meaning that once an arrhythmia is picked up, the tracings should be sent to a specialist for evaluation,” Dr. Corradini told Modern Equine Vet. “If the arrhythmia is believed to be clinically important, it will most likely require the use of specialized equipment to make a definitive diagnosis. For the time being, no specific antiarrhythmic treatments should be attempted based solely on the information obtained by a smartphone ECG.”

For more information:

Corradini I, Fernandez-Ruiz A, Barba M, et al. Stall-side screening potential of a smartphone electrocardiogram recorded over both sides of the thorax in horses. JAVMA. 2020 April 28 [Epub ahead of print] https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.15795 Kraus MS, Rishniw M, Divers TJ, et al. Utility and accuracy of a smartphone-based electrocardiogram device as compared to a standard base-apex electrocardiogram in the horse. Res Vet Sci. 2019;125:141-147. doi: 10.1016/j.rvsc.2019.05.018. Epub 2019 Jun DOI: 10.1016/j.rvsc.2019.05.018 https://pubmed.ncbi.nlm.nih.gov/31228737/#:~:text=Conclusions%3A%20The%20smartphone%2Dacquired%20 ECG,ECGs%2C%20resulting%20in%20a%20misdiagnosis.