Key result
3D-VCG differentiates left from right origins of ventricular premature depolarizations in horses with ~99% accuracy.
Why the study?
Cardiac arrhythmias are common in horses, but noninvasive methods to identify arrhythmogenic foci are limited despite the importance of localization for diagnosis and treatment.
Does delta 12-lead ECG and VCG accurately identify the origin of focally induced atrial and ventricular premature depolarizations in horses?
Does delta 12-lead ECG and VCG accurately identify the origin of focally induced atrial and ventricular premature depolarizations in horses?
Combined delta 12-lead ECG and VCG provides accurate, noninvasive chamber-level localization of arrhythmia origins in horses, with 3D-VCG offering superior spatial resolution and 2D-VCG providing practical applicability.
Hypothesis-generating for 3D-VCG in ventricular origin localization; larger veterinary studies needed before clinical adoption.
Background Cardiac arrhythmias are common in horses, but their clinical and prognostic relevance remains poorly defined. Despite the importance of localization for diagnosis and treatment, noninvasive methods to identify arrhythmogenic foci are limited. Hypothesis/Objectives Evaluate the ability of delta (Δ) 3- and 12-lead ECGs and 2-dimensional (2D) and 3-dimensional (3D) vectorcardiography (VCG) to identify the site of origin of focally induced atrial and ventricular premature depolarizations in horses. Animals Eight healthy horses underwent 2 electrophysiological studies, 1 standing, and 1 under general anesthesia. Methods Premature atrial and ventricular complexes were induced by intracardiac pacing at 29 anatomical sites. Simultaneous Δ 12-lead ECG and VCG recordings were obtained. Mean vector directions were analyzed, and classification accuracy was assessed at the chamber, regional, and site-specific levels. Results Distinct pacing sites produced reproducible and location-specific activation patterns. For differentiating left- from right-sided origins, 3D-VCG had 99% and 82% accuracies for ventricular and atrial origins, respectively. The simplified Δ-based 2D-VCG also showed strong performance on the chamber level, with accuracies of 94% and 78%, respectively. Accuracy was lower for fine-grained intra-chamber localization, especially in the atria. Conclusions and clinical importance Although 3D-VCG offers superior spatial resolution, 2D-VCG provides a good balance between diagnostic accuracy and practical applicability, especially for left- vs right-sided localization. Combined Δ 12-lead ECG and VCG enables accurate, noninvasive chamber-level localization of arrhythmia origins in horses. Standardized application in larger cohorts with naturally occurring arrhythmias may support targeted ablation strategies and improve arrhythmia management and sudden cardiac death risk stratification.
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Paulussen et al. (2026) studied Focally induced atrial and ventricular premature depolarizations (n=8). Delta (Δ) 12-lead ECG and 2D/3D vectorcardiography was evaluated on Accuracy for differentiating left- from right-sided origins of premature depolarizations. 3D-vectorcardiography accurately differentiated left- from right-sided origins of premature depolarizations in horses (99% ventricular, 82% atrial), with 2D-VCG showing 94% and 78% accuracy.
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