Poincaré plots and tachograms reveal beat patterning in sick sinus syndrome with supraventricular tachycardia and varying AV nodal block

• Published in: Journal of veterinary cardiology Vol. 13; no. 1; pp. 63 - 70
• Main Authors: Gladuli, Andrea, Moïse, N. Sydney, Hemsley, Shari A., Otani, Niels F.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-03-2011
• Subjects: Animals; Anti-Arrhythmia Agents - therapeutic use; Atenolol - therapeutic use; Atrioventricular Block - pathology; Atrioventricular Block - therapy; Atrioventricular Block - veterinary; AV block; Canine; Circadian Rhythm; Dog Diseases - pathology; Dog Diseases - therapy; Dogs; electrocardiography; Electrocardiography - veterinary; heart; heart rate; highlands; Holter monitoring; Male; Pacemaker, Artificial - veterinary; Poincaré plots; Sick Sinus Syndrome - pathology; Sick Sinus Syndrome - therapy; Sick Sinus Syndrome - veterinary; Sinus node; sinuses; Tachycardia, Supraventricular - pathology; Tachycardia, Supraventricular - therapy; Tachycardia, Supraventricular - veterinary; terriers; Holter monitoring; Sinus node; Poincaré plots; AV block; Canine
• ISSN: 1760-2734; 1875-0834
• DOI: 10.1016/j.jvc.2010.12.001

Using 24-h ambulatory electrocardiography, the RR intervals of all beats were determined in a West Highland white terrier with sick sinus syndrome characterized by long sinus pauses, bradycardia, supraventricular tachycardia (SVT) and varying degrees of atrioventricular (AV) heart block. Distinctive patterns of bradycardia and 1:1, 2:1, 3:1, 4:1 and 5:1 AV block associated with SVT were evident in the tachogram (RR interval distribution over time) and Poincaré plots (short-term heart rate variability plots of RRn versus RRn
+
1). These patterns differed from those of abrupt alteration in cycle length during long sinus pauses or bursts of supraventricular tachycardia. Recognition of such patterns may direct attention to time points for which close attention to the cardiac rhythm should be evaluated in the full-disclosure of the 24-h ECG recording.