{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:54:57Z","timestamp":1793382897843,"version":"4.5.0"},"reference-count":26,"publisher":"American Veterinary Medical Association (AVMA)","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec id=\"sc_a1\">\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The Lewis lead is an EGC configuration used to detect atrial activity and its relationship with ventricular activity. However, no equivalent configuration has been proposed in veterinary medicine. Therefore, this study explored new bipolar lead configurations to evaluate atrial depolarization and investigated their characteristics by comparing them with conventional leads. The authors hypothesized that a lead with a high absolute value of the P wave (|P|) and a high ratio of the P wave to the QRS complex (|P|\/|QRS|) might be an appropriate configuration.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a2\">\n<jats:title>ANIMALS<\/jats:title>\n<jats:p>6 laboratory Beagles were used.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a3\">\n<jats:title>PROCEDURES<\/jats:title>\n<jats:p>Electrocardiograms were recorded using bipolar limb leads (I, II, III, aVL, aVF, and aVR) and unipolar precordial leads (C<jats:sub>2<\/jats:sub>, C<jats:sub>3<\/jats:sub>, C<jats:sub>4<\/jats:sub>, C<jats:sub>5<\/jats:sub>, C<jats:sub>6<\/jats:sub>, M<jats:sub>1<\/jats:sub>, M<jats:sub>2<\/jats:sub>, M<jats:sub>5<\/jats:sub>, M<jats:sub>6<\/jats:sub>, 1st-R, CV<jats:sub>6<\/jats:sub>LL, and V<jats:sub>10<\/jats:sub>) in the standing position. The new bipolar leads were attached in the following configuration: the negative electrode was attached to M<jats:sub>6<\/jats:sub>, and the positive electrode was sequentially applied to M<jats:sub>1<\/jats:sub> and M<jats:sub>2<\/jats:sub>. The leads were named M<jats:sub>6<\/jats:sub>M<jats:sub>1<\/jats:sub> and M<jats:sub>6<\/jats:sub>M<jats:sub>2<\/jats:sub>.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a4\">\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The waveforms obtained using the new bipolar leads M<jats:sub>6<\/jats:sub>M<jats:sub>1<\/jats:sub> and M<jats:sub>6<\/jats:sub>M<jats:sub>2<\/jats:sub> showed significantly higher |P|\/|QRS| and |P| values than those obtained using conventional limb leads and precordial leads.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a5\">\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>The new leads achieved a specific enhancement of atrial activity conducted at a reduced ventricular amplitude and increased atrial amplitude, similar to the Lewis lead in human medicine. These findings suggest that M<jats:sub>6<\/jats:sub>M<jats:sub>1<\/jats:sub> and M<jats:sub>6<\/jats:sub>M<jats:sub>2<\/jats:sub> could be supplemental lead configurations to identify P waves without amplifying the QRS waves compared to conventional methods.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/ajvr.23.07.0151","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T14:23:47Z","timestamp":1700490227000},"source":"Crossref","is-referenced-by-count":2,"title":["A new bipolar precordial electrocardiographic lead configuration for specific evaluation of atrial depolarization in healthy dogs"],"prefix":"10.2460","volume":"85","author":[{"given":"Kentaro","family":"Kurogochi","sequence":"first","affiliation":[{"name":"JASMINE Veterinary Cardiovascular Medical Center, Tsuzuki, Yokohama, Kanagawa, Japan"},{"name":"Laboratory of Physiology II, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Chuo-ku, Sagamihara, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Orito","sequence":"additional","affiliation":[{"name":"Laboratory of Physiology II, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Chuo-ku, Sagamihara, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masami","family":"Uechi","sequence":"additional","affiliation":[{"name":"JASMINE Veterinary Cardiovascular Medical Center, Tsuzuki, Yokohama, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"6S","key":"B1","series-title":"J Electrocardiol","first-page":"S67","article-title":"Atrial fibrillation observed on surface ECG can be atrial flutter or atrial tachycardia","volume":"51","author":"Ghafoori E","year":"2018","unstructured":"Ghafoori E, Angel N, Dosdall DJ, MacLeod RS, Ranjan R. Atrial fibrillation observed on surface ECG can be atrial flutter or atrial tachycardia. J Electrocardiol. 2018;51(6S):S67\u2013S71. doi:10.1016\/j.jelectrocard.2018.07.010"},{"issue":"4","key":"B2","series-title":"J Electrocardiol","first-page":"315","article-title":"Electrocardiographic differentiation of atrial flutter from atrial fibrillation by physicians","volume":"32","author":"Knight BP","year":"1999","unstructured":"Knight BP, Michaud GF, Strickberger SA, Morady F. Electrocardiographic differentiation of atrial flutter from atrial fibrillation by physicians. J Electrocardiol. 1999;32(4):315\u2013319. doi:10.1016\/s0022-0736(99)90002-x"},{"issue":"2","key":"B3","series-title":"Am J Cardiol","first-page":"209","article-title":"Diagnostic accuracy of irregularly irregular RR intervals in separating atrial fibrillation from atrial flutter","volume":"98","author":"Krummen DE","year":"2006","unstructured":"Krummen DE, Feld GK, Narayan SM. Diagnostic accuracy of irregularly irregular RR intervals in separating atrial fibrillation from atrial flutter. Am J Cardiol. 2006;98(2):209\u2013214. doi:10.1016\/j.amjcard.2006.01.088"},{"key":"B4","series-title":"Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat","first-page":"1176","article-title":"Cardiac arrhythmias","author":"Ettinger SJ","year":"2017","unstructured":"Ettinger SJ, Feldman EC, Cote E. Cardiac arrhythmias. In: Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat. 8th ed. Elsevier; 2017:1176\u20131200."},{"issue":"11","key":"B5","series-title":"J Cardiovasc Electrophysiol","first-page":"1251","article-title":"Accurate ECG diagnosis of atrial tachyarrhythmias using quantitative analysis: a prospective diagnostic and cost-effectiveness study","volume":"21","author":"Krummen DE","year":"2010","unstructured":"Krummen DE, Patel M, Nguyen H, et al. 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