Long-term use of an implantable loop recorder for ECG recording in horses

Potential arrhythmias recorded by cardiac monitors using the built-in human algorithm are as follows: total number of episodes, ventricular tachycardia, asystole, bradycardia, atrial tachycardia, atrial fibrillation and the percentage of time spent in atrial tachycardia or atrial fibrillation. Long-term use of an insertable cardiac monitor (loop recorder) has been reported in one horse earlier, but its accurate role as a diagnostic tool is still unclear. The aim of the present study was to investigate the long-term applicability of the Reveal XT cardiac monitor for recording cardiac arrhythmias in adult horses. The Reveal XT cardiac monitor was implanted in 12 horses under sedation in standing position. Median duration of data recording calculated for the population was 1,169 days. The number of false positive detections of asystole and bradycardia was extremely high in all horses. For atrial fibrillation, false positive detection occurred in five and false negative detection occurred in one horse. The present study showed that the long-term use of the Reveal XT cardiac monitor is feasible, well-tolerated and the devices work reliably, without complications. The human algorithm could not be used for automatic detection of arrhythmic episodes in the study population. The device could detect atrial fibrillation in horses, but the recorded AF burden was inaccurate and the stored ECGs had to be manually interpreted. Because the human analyser algorithm of this cardiac monitor fails to identify bradyarrhythmias in horses based on our results, this instrument is not capable for accurately determining the aetiology of episodic collapse in this species.