Finger on the pulse: Harnessing Technology to Tame the Beat

Alerte Digital Vet was proud to sponsor the Australian Veterinary Association’s recent webinar, Finger on the Pulse, highlighting the growing role of Holter monitoring in veterinary cardiac assessment.

Our Key Opinion Leaders (KOLs), Dr Chad Berman and Dr Lydia Hambrook, shared their expertise during this insightful session.

As digital technologies and AI continue to transform veterinary medicine, the webinar explored how AI-assisted ECG interpretation can support more accurate diagnoses, improve clinical confidence and enhance patient care in everyday practice.

While a standard in-clinic ECG provides an important snapshot of cardiac rhythm, some of the most clinically significant abnormalities are intermittent. Holter monitoring offers veterinarians a longer view capturing rhythm continuously during normal activity, rest and sleep.

That additional data can help clinicians investigate unexplained episodes, identify occult arrhythmias, screen at-risk breeds and assess treatment response.

From a snapshot to a 24-hour view

Holter monitoring can provide valuable insights when a short ECG does not capture the event a veterinarian is trying to investigate.

Common applications include:

• Investigating unexplained symptoms such as exercise intolerance, weakness or syncope.
• Detecting intermittent arrhythmias that may not occur during an in-clinic ECG.
• Monitoring treatment response, including ventricular rate control in atrial fibrillation.
• Supporting breed screening for cardiomyopathies and rhythm disturbances.
• Assessing performance and working animals, where clinically significant arrhythmias may emerge during activity.
• Supporting peri-anaesthetic assessment where underlying cardiovascular disease is suspected.

Why breed screening helps

Holter monitoring can play an important role in screening breeds predisposed to cardiac disease, including Dobermans, Boxers, Cavalier King Charles Spaniels, Greyhounds and others.

In conditions such as dilated cardiomyopathy (DCM), rhythm abnormalities can sometimes develop before obvious structural changes are detected by echocardiography. Identifying these changes earlier can help veterinarians determine appropriate monitoring and management strategies.

For Dobermans, for example, annual echocardiography and Holter monitoring are commonly incorporated into DCM screening programs.

Looking for the arrhythmias that don't happen on cue

The value of prolonged monitoring becomes particularly apparent in arrhythmogenic conditions.

In Boxers, arrhythmogenic right ventricular cardiomyopathy (ARVC) can produce ventricular premature complexes and ventricular tachycardia, sometimes before obvious structural heart disease develops.

Similarly, Holter monitoring can help investigate suspected sick sinus syndrome, where bradycardia, sinus arrest or sinoatrial block may be intermittent.

In one case discussed in the context of prolonged monitoring, a patient with previously documented bradycardia developed a heart rate of approximately 20 beats per minute under anaesthesia. Subsequent Holter monitoring identified 4,764 sinus pauses, ranging from 2.5 to 11.2 seconds.

These are the kinds of events that can be difficult to capture in a brief consultation.

And it's not just dogs

Holter monitoring also has applications in feline cardiology, where prolonged recordings can help identify clinically important arrhythmias, including atrial fibrillation and terminal rhythm changes.

Across both dogs and cats, the principle is the same: the longer you monitor, the greater the opportunity to capture an intermittent event.

Supporting better cardiac decisions

As veterinary cardiology continues to evolve, technologies that provide clinicians with more comprehensive, real-world data have an increasingly important role to play.

The Finger on the Pulse webinar highlighted how Holter monitoring can complement physical examination, resting ECG and echocardiography - providing a more complete picture of cardiac rhythm and supporting diagnosis, prognosis and treatment decisions.

At Alerte Digital Vet, we’re proud to support the veterinary community and conversations that help advance accessible, data-driven cardiac care.

Watch the webinar here: