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An electrocardiogram (ECG) is a graph of the heart`s electrical current, which allows evaluation of heart
rate, rhythm and conduction. Identification of conduction problems within the heart begins with a
general understanding of the heart`s anatomy, conduction system and how the electrical activity
corresponds to waveforms on an ECG. Veterinary technicians should be proficient at obtaining a
diagnostic ECG, identifying normal and abnormal complexes on an ECG tracing, and recognizing when
medical intervention might be needed.
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
Fig. 1
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
Fig. 2
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
The ST segment signifies the end of ventricular conduction/depolarization and the beginning of
ventricular repolarization. An ST segment should be consistent with the baseline. A significantly
elevated or depressed ST segment may indicate myocardial injury.
The T wave indicates ventricular repolarization and can have a positive or negative deflection on the
graph.
Fig. 3
If the QRS complex appears of normal height and duration, then we can assume that the initiating
impulse originated above the A-V node. When the QRS complex appears wide and bizarre, we can
assume that the impulse initiating that complex originated at an ectopic pacemaker within the
ventricles.
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
ECG Classification
Arrhythmias are generally classified for disturbances of impulse formation, impulse conduction, or both.
Many times impulse formation disturbances can be characterized with words like: bradycardia,
tachycardia, premature (if the impulse is generated early) or fibrillation (rapid, unsynchronized
impulses). Impulse conduction disturbances are characterized by a block along the conduction pathway
and are usually named for place in which the block occurs and/or designated a degree to which the
block occurs. Alternatively some arrhythmias do not fit neatly into either classification.
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
Practice.
Case 1: A 4 year-old bulldog presents for a routine surgery. An ECG is obtained as part of a pre-
operative database.
Name: Sinus arrhythmia, a.k.a. normal sinus arrhythmia. Especially common in brachycephalic breeds,
when respiratory rate speeds up during inhalation and slows during exhalation.
Treatment: No treatment required.
Case 2: A 14 year-old cocker spaniel presented with a 3 day history of vomiting and syncopal
episodes.
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
Case 3: A 7 year-old Labrador presents with pale mucus membranes and collapsed in the back yard.
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
Case 5: A 4 year old Doberman presents with exercise intolerance and lethargy.
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
Case 7: A 13 year-old Fox Terrier presented for a 24 hour history of weakness and collapse.
First-degree AV block looks like a normal sinus rhythm, however, the P-R intervals are consistently long
and do not vary. The prolonged P-R interval indicates a delay in conduction through the AV node.
Generally patients are asymptomatic.
Second-degree AV Block, Mobitz Type I:
This rhythm is characterized by P-R intervals that become progressively longer with each complex until
finally the impulse fails to conduct through the AV node (dropped QRS complex). This is a predictable
rhythm with the next impulse conducting through the AV node and the cycle repeats.
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
This rhythm is characterized by a regular atrial rate (uniform, consistent P waves); however some P
waves are not followed by a QRS complex. Because the ventricular rate may be significantly lower than
the atrial rate, cardiac output can be severely affected.
Impulses from the atria are completely blocked at the AV node. Since no impulses make it past the AV
node to the ventricles, the intrinsic ventricular rate kicks in and can be as low as 20 bpm. The wide and
bizarre complexes are ventricular escape beats.
Case 8: A 6 year-old DSH presents with two day history of straining in the litterbox.
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
Once atrial activity has ceased, the next progression is unstable ventricular activity and ultimately death.
Practice:
Case 9: 3 year-old Golden retriever, hit-by-car 36 hours ago.
HR?
Rhythm?
P waves:
QRS:
P-R interval:
Name:
Treat?
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ECG Interpretation for the Veterinary Technician Amanda Adams, LVT, VTS (ECC)
VCA Veterinary Specialty Center of Seattle
HR?
Rhythm?
P waves:
QRS:
P-R interval:
Name:
Treat?
Resources:
Battaglia, Andrea M. Samll Animal Emergency and Critical Care. Philadelphia: Saunders, 2001. Print.
Tilley, Larry P., Francis W.K. Smith, and Michael S. Miller. Cardiology. Denver: American Animal Hospital
Association, 1990. Print.
Tilley, Larry P., Michael S. Miller, and Francis W.K. Smith. Canine and Feline Cardiac Arrhythmias. Philadelphia:
Lea & Febiger, 1993. Print.
Tilley, Larry P., and Naomi L. Burtnick. ECG for the Small Animal Practioner. Jackson, WY: Teton NewMedia,
1999. Print.
Fig. 1 research.vet.upenn.edu
Fig. 2 Tilley, LP. Feline cardiac arrhythmias. Vet Clin North Am 1977;7:274
Fig. 3 ecgtest.org
Fig. 4 medicine.mcgill.ca
Fig. 5 Mayo Clinic Proceedings December 2007 vol. 82 no. 12 1553-1561
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