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Köster LS, Zhu X, Smith CK, Aisa J. Single center retrospective clinical audit and comparison of outcome between epicardial and transvenous endocardial permanent pacemaker implantations in dogs. PLoS One 2023; 18:e0290029. [PMID: 38015932 PMCID: PMC10683988 DOI: 10.1371/journal.pone.0290029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/01/2023] [Indexed: 11/30/2023] Open
Abstract
The aim of this retrospective cohort study was to provide a single-center clinical audit of complications for single chamber permanent pacemaker implantation (PPI) techniques and determine if the clinical parameters, PPI technique or complications were associated with outcome. The electronic medical records were searched for dogs treated for bradyarrhythmia with PPI. Data related to presenting complaint, signalment of the dog, ECG diagnosis, echocardiographic findings, PPI technique, and programing of the pacemaker were recorded. Survival length (days) was recorded as the last veterinary visit; if the dog was dead the reason was documented. Cumulative survival of each pacemaker was examined by a Kaplan-Meier survival curve and the two techniques compared with a logrank test. Chi-square was used to determine the association between major complications and death. A total of 66 dogs with 52 transvenous and 30 epicardial PPIs were included. All epicardial pacemakers were implanted via transdiaphragmatic approach. A total of 31 life-threatening complications were reported. There were nine deaths related to major complications (13.6% of the study sample). The median follow-up period was 366 days, with a median survival of 255 days, and a significant difference in cumulative survival of each pacemaker (P = 0.01) between epicardial (93 days, range 0-1882 days) and transvenous (334 days, range 0-2745) PPIs but no significant difference in cumulative survival between the two techniques when only the first pacemaker was considered (p = 0.07). The presence of a major complications had a significant association with death due to pacemaker complications (P<0.001). The decision to perform epicardial PPI in failed transvenous PPI patients may have skewed the cumulative survival as was evident in the lack of significant difference in survival when only first PPI were examined. Major complication rates between the two techniques were similar and the authors consider both techniques equally reliable to manage symptomatic bradycardia in dogs.
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Affiliation(s)
- Liza S. Köster
- Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, United States of America
| | - Xiaojuan Zhu
- Office of Information Technology, University of Tennessee, Knoxville, TN, United States of America
| | - Christopher K. Smith
- Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, United States of America
| | - Josep Aisa
- Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, United States of America
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2
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Machida N, Sasaki T, Kimura Y, Hirakawa A. The anatomical basis of third-degree atrioventricular block in dogs with atrioventricular valve endocardiosis. J Comp Pathol 2023; 201:63-69. [PMID: 36709730 DOI: 10.1016/j.jcpa.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/30/2022] [Accepted: 12/29/2022] [Indexed: 01/30/2023]
Abstract
The cardiac conduction system was examined histologically in 13 canine cases of atrioventricular (AV) valve endocardiosis with third-degree AV block. In all cases, gross examination revealed marked thickening and distortion of the base of the central fibrous body (CFB) and varying degrees of endocardial thickening of the upper portion of the ventricular septum (VS) as well as marked thickening of the mitral and tricuspid valve leaflets due to myxomatous degeneration. Microscopically, the thickened and distorted CFB had encased or trapped, either partly or totally, the underlying penetrating and branching portions of the AV bundle. The myxomatous and/or fibrofatty tissue, which had proliferated at the base of the extensive CFB, protruded into or encroached on the AV bundle, causing severe (51-75%) to very severe (76% or more) reduction of the conduction fibres. The upper portions of the left and right bundle branches were involved in the endocardial thickening due to degenerative and fibrotic changes at the uppermost VS; however, both bundle branches were much less severely affected than the AV bundle, the degree of reduction of the conduction fibres ranging from mild (25% or less) to moderate (26-50%). These observations suggest that the sites most vulnerable to lesions in the AV conduction system are the penetrating and branching portions of the AV bundle, which would represent the anatomical basis for third-degree AV block in canine cases of AV valve endocardiosis.
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Affiliation(s)
- Noboru Machida
- Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan.
| | - Takafumi Sasaki
- Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Yusuke Kimura
- Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
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Pires A, Raheb S, Monteith G, Colpitts ME, Chong A, O'Sullivan ML, Fonfara S. Heart rate distribution in dogs with third degree atrioventricular block and rate responsive pacemakers. J Vet Cardiol 2022; 43:70-80. [PMID: 36044810 DOI: 10.1016/j.jvc.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION In dogs, single lead ventricular pacing, ventricular sensing, inhibition response, rate adaptive (VVIR) pacemakers are routinely used to treat third degree atrioventricular block. The objectives of this study were to investigate the heart rate distribution in dogs with VVIR pacemakers, and report changes when activity settings were adjusted. ANIMALS Eighteen client-owned dogs with VVIR pacemakers for third degree atrioventricular block. MATERIALS AND METHODS This observational study consisted of a review of medical records of dogs with VVIR pacemakers. For dogs with >50% of paced beats at the lower pacing rate, the activity daily living (ADL) and exertion responses were increased. Re-evaluations were performed after 6-12 months. RESULTS Heart rate distribution similar to healthy dogs was absent for all dogs. In nine dogs, the ADL and exertion responses were increased to the highest level. Of these, three dogs showed no improvement in heart rate distribution; for two dogs, one with an epicardial pacemaker, several activity settings were adjusted and pacing at higher heart rates was observed at re-evaluation. Four dogs died or were lost to follow-up. Clinical signs had resolved for all dogs after pacemaker implantation. CONCLUSION Default activity settings of VVIR pacemakers do not result in heart rate distribution equivalent to healthy dogs. Increasing the ADL and exertion response settings to the highest levels did not improve the pacemaker rate response. Further investigations into the role of dog size, generator positioning, pacemaker settings, and whether rate responsiveness is required for dogs' quality and quantity of life are warranted.
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Affiliation(s)
- A Pires
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - S Raheb
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - G Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - M E Colpitts
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - A Chong
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - M L O'Sullivan
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, 550 University Ave, Charlottetown, Prince Edward Island, C1A 4P3, Canada
| | - S Fonfara
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
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Ohmori T, Matsumura Y, Yoshimura A, Morita S, Hasegawa H, Hirao D, Fukushima R. Efficacy of cilostazol in canine bradyarrhythmia. Front Vet Sci 2022; 9:954295. [PMID: 36061105 PMCID: PMC9427924 DOI: 10.3389/fvets.2022.954295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Recently, cilostazol, a phosphodiesterase III inhibitor, has been described as alternative medical treatment for canine bradyarrhythmia in cases for which pacemaker implantation was not indicated or available. In this retrospective study, we investigated the use and efficacy of cilostazol in dogs with bradyarrhythmia in Japan. Dogs that had been brought to the Tokyo University of Agriculture and Technology Animal Medical Center and 23 veterinary hospitals in Japan and been treated with cilostazol initially as the only therapeutic strategy for bradyarrhythmia between January 2010 and August 2021 were included in this study. Survival analyses were performed using Cox proportional hazards analysis, the log-rank test, and the generalized Wilcoxon test to evaluate the efficacy of cilostazol. Fifty-nine privately owned dogs were included in this study. In the survival time analysis, the risk of death was significantly lower and the survival rate was higher in cases in which cilostazol was administered at 10 mg/kg or more per dose. A third-degree atrioventricular block also significantly increased the risk of death and was associated with a lower survival rate. However, in some patients with a third-degree atrioventricular block, there was an increase in the ventricular rate and improvement in clinical symptoms without disappearance or decrease of the atrioventricular block. This study had several important findings that have not previously been reported concerning the use of cilostazol for canine bradyarrhythmia, including the appropriate dose in a clinical setting and the efficacy and prognosis according to the type of bradyarrhythmia.
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Affiliation(s)
| | | | | | | | | | | | - Ryuji Fukushima
- Animal Medical Center, Tokyo University of Agriculture and Technology, Fuchu-shi, Tokyo, Japan
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Alvarez-Sanchez A, Townsend KL, LeBlanc NL, Milovancev M, Scollan KF, Heatley J, Hoppes S, Saunders AB, Gordon SG, Pesce K, Swift ST, Brenner E, Thomason JD, Eshar D. Epicardial pacemaker implantation and outcome in eight pet ferrets (Mustela putorius furo). J Vet Cardiol 2022; 41:44-56. [DOI: 10.1016/j.jvc.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
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Pegram C, Woolley C, Brodbelt DC, Church DB, O'Neill DG. Disorder predispositions and protections of Labrador Retrievers in the UK. Sci Rep 2021; 11:13988. [PMID: 34262062 PMCID: PMC8280121 DOI: 10.1038/s41598-021-93379-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 06/21/2021] [Indexed: 02/06/2023] Open
Abstract
The Labrador Retriever is one of the most popular dog breeds worldwide, therefore it is important to have reliable evidence on the general health issues of the breed. Using anonymised veterinary clinical data from the VetCompass Programme, this study aimed to explore the relative risk to common disorders in the Labrador Retriever. The clinical records of a random sample of dogs were reviewed to extract the most definitive diagnoses for all disorders recorded during 2016. A list of disorders was generated, including the 30 most common disorders in Labrador Retrievers and the 30 most common disorders in non-Labrador Retrievers. Multivariable logistic regression was used to report the odds of each of these disorders in 1462 (6.6%) Labrador Retrievers compared with 20,786 (93.4%) non-Labrador Retrievers. At a specific-level of diagnostic precision, after accounting for confounding, Labrador Retrievers had significantly increased odds of 12/35 (34.3%) disorders compared to non-Labrador Retrievers; osteoarthritis (OR 2.83) had the highest odds. Conversely, Labrador Retrievers had reduced odds of 7/35 (20.0%) disorders; patellar luxation (OR 0.18) had the lowest odds. This study provides useful information about breed-specific disorder predispositions and protections, which future research could evaluate further to produce definitive guidance for Labrador Retriever breeders and owners.
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Affiliation(s)
- Camilla Pegram
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, AL9 7TA, Herts, UK.
| | - Charlotte Woolley
- The Roslin Institute and the Royal (Dick), School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG, UK
| | - Dave C Brodbelt
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, AL9 7TA, Herts, UK
| | - David B Church
- Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, AL9 7TA, Herts, UK
| | - Dan G O'Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, AL9 7TA, Herts, UK
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Frantz EW, Tjostheim SS, Palumbo A, Kellihan HB, Stepien RL. A retrospective evaluation of the indications, complications, and outcomes associated with epicardial pacemakers in 20 cats from a single institution. J Vet Cardiol 2021; 36:89-98. [PMID: 34118563 DOI: 10.1016/j.jvc.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The objective of this retrospective study was to describe the indications, complications, and long-term outcomes in a group of cats that received an epicardial pacing (EP) system. ANIMALS Twenty client-owned cats. MATERIALS AND METHODS Medical records were reviewed for signalment, presenting complaint, primary electrocardiogram (ECG) diagnosis, presence of structural heart disease, presence of congestive heart failure (CHF), presence of major or minor complications, and survival time. RESULTS The majority of cats were presented for syncope (n = 11), and the most common ECG diagnosis was advanced second-degree atrioventricular block (n = 9). Fifteen cats (15/20, 75%) had one or more major or minor complications. One cat died in the perioperative period as a result of a major complication. None of the variables evaluated were associated with a statistically significant increase in the occurrence of major or minor complications. The most common major complication was loss of ventricular capture (seven instances in six cats), which was successfully treated in all cases by increasing pacemaker output or replacing both the lead and the pulse generator. The most common minor complications were arrhythmias (n = 7) and sensing issues (n = 8). The overall median survival time (MST) was 948 days. No statistical difference in survival time was identified between cats that experienced a major complication and those that did not. CONCLUSIONS Although complications were common in this feline population after EP, major and minor complications were successfully treated.
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Affiliation(s)
- E W Frantz
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA
| | - S S Tjostheim
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA.
| | - A Palumbo
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA
| | - H B Kellihan
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA
| | - R L Stepien
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA
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8
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Spalla I, Smith GW, Chang YM, Luis Fuentes V, Connolly DJ. Paroxysmal high-grade second-degree and persistent third-degree atrioventricular block in cats. J Vet Cardiol 2021; 36:20-31. [PMID: 34051641 DOI: 10.1016/j.jvc.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/01/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Both paroxysmal high-grade second-degree and persistent third-degree atrioventricular block (AVB) are recognised in cats. Our aim was to document the presentation, echocardiographic data, comorbidities and outcome in affected cats from a single referral hospital, including those that underwent epicardial pacemaker implantation (EPI). ANIMALS, MATERIALS AND METHODS This retrospective study included 64 cats diagnosed with persistent third-degree or paroxysmal high-grade AVB, for which detailed patient history was available. Non-parametric testing, Kaplan-Meier curves and Cox proportional hazard testing were performed. RESULTS Atrioventricular block was persistent in 43 cats (67%) and paroxysmal in 21 (33%). Forty-seven cats (74%) were referred for cardiac complaints (e.g. collapse, arrhythmia, tachypnea), 6 (9%) had non-specific complaints and AVB was an incidental finding in 11 cats (17%). Median duration of clinical signs prior to presentation was 21 days (1-1138 days). Thirty-nine (63%) cats had echocardiographic abnormalities; 13 (20%) presented with congestive heart failure. Forty-five (70%) cats had one or more comorbidities. Fifteen cats underwent EPI with immediate resolution of signs in 12 cats. Following EPI, two and four cats experienced major and minor complications, respectively. Forty-seven cats died; median survival time was 799 days (all-cause mortality). Cardiac-related death occurred in 17 cats (36%); median survival in these cats was 132 days. Heart failure on presentation was the only independent risk factor for cardiac death (p=0.002). CONCLUSIONS Outcome in cats with AVB was variable, although most had good medium- to long-term survival. Cardiac death occurred in a minority of cats. Pacemaker implantation was effective in relieving clinical signs.
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Affiliation(s)
- I Spalla
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom; Ospedale Veterinario San Francesco, via Isaac Newton 2, 20148 Milano, Italy.
| | - G W Smith
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - Y-M Chang
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - V Luis Fuentes
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - D J Connolly
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
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9
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Colpitts ME, Fonfara S, Monteith G, Pires AR, Wong A, Raheb S, Lynne O'Sullivan M. Characteristics and outcomes of cats with and without pacemaker placement for high-grade atrioventricular block. J Vet Cardiol 2021; 34:37-47. [PMID: 33548737 DOI: 10.1016/j.jvc.2020.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Available information on characteristics and outcome in cats with high-grade atrioventricular block (AVB) that receive a pacemaker is limited. ANIMALS Twenty-two privately owned cats presenting with high-grade AVB. MATERIALS AND METHODS Medical records were retrospectively examined. Cats were grouped as having received a pacemaker (PACE group) or not having received a pacemaker (non-PACE group). Clinical characteristics and outcomes of groups were evaluated. RESULTS There were 10 cats in the PACE group and 12 cats in the non-PACE group. At presentation, syncope or seizure-like behavior (p = 0.004) and bradycardia (p = 0.043) were more common in the PACE than the non-PACE group. Historical lethargy (p = 0.015) and dull mentation (p = 0.045) were more common in the non-PACE group, as was clinically relevant systemic disease. Pacemaker placement improved syncope or seizure-like behavior in 100% of cats. The degree of AVB at presentation was not associated with pacemaker placement nor the future degree of AVB. The major complication rate of pacemaker placement was 40%. Intergroup survival was not significantly different (PACE group 1278 days, 95% confidence interval: 0-2145 days; non-PACE group 213 days, confidence interval: 1-not available, p = 0.77). CONCLUSIONS Pacemaker placement improved clinical signs in cats with high-grade AVB. A difference in survival time could not be demonstrated between cats that received and did not receive a pacemaker in this retrospective study. High-grade AVB can be transient and accompanied by systemic disease in some cats.
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Affiliation(s)
- M E Colpitts
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 28 College Ave W, Guelph, Ontario, N1G 2W1, Canada
| | - S Fonfara
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 28 College Ave W, Guelph, Ontario, N1G 2W1, Canada
| | - G Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 28 College Ave W, Guelph, Ontario, N1G 2W1, Canada
| | - A R Pires
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 28 College Ave W, Guelph, Ontario, N1G 2W1, Canada
| | - A Wong
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 28 College Ave W, Guelph, Ontario, N1G 2W1, Canada
| | - S Raheb
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 28 College Ave W, Guelph, Ontario, N1G 2W1, Canada
| | - M Lynne O'Sullivan
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 28 College Ave W, Guelph, Ontario, N1G 2W1, Canada.
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Miller L, Gozalo‐Marcilla M, Culshaw G, Panti A. Successful transcutaneous pacing following ventricular standstill during anaesthetic induction in a dog with third‐degree atrioventricular block. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lucy Miller
- Royal Dick School of Veterinary Studies and The Roslin InstituteThe University of EdinburghRoslin, MidlothianUK
| | - Miguel Gozalo‐Marcilla
- Royal Dick School of Veterinary Studies and The Roslin InstituteThe University of EdinburghRoslin, MidlothianUK
| | - Geoff Culshaw
- Royal Dick School of Veterinary Studies and The Roslin InstituteThe University of EdinburghRoslin, MidlothianUK
| | - Ambra Panti
- Royal Dick School of Veterinary Studies and The Roslin InstituteThe University of EdinburghRoslin, MidlothianUK
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11
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Sasaki T, Saeki C, Hirakawa A, Machida N. Pathological Features of Complete Atrioventricular Block in Dogs with Lymphocytic Myocarditis. J Comp Pathol 2019; 174:18-25. [PMID: 31955799 DOI: 10.1016/j.jcpa.2019.10.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
The cardiac conduction system was examined histologically in 12 canine cases of lymphocytic myocarditis with complete atrioventricular (AV) block. Histological analysis showed active myocarditis characterized by intense infiltration of mononuclear cells, primarily lymphoid, associated with degeneration and necrosis of the adjacent cardiomyocytes. Additionally, there was healing or healed myocarditis manifested by disappearance of cardiomyocytes and replacement fibrosis. This destructive inflammatory process of lymphocytic myocarditis involved the whole of the AV conduction system, resulting in loss and deletion of the conduction fibres, as well as the myocardium of all chambers. Such total or subtotal destruction of the AV conduction system caused by the inflammatory changes was thought to have set the stage for blocking AV conduction of cardiac impulses, but the aetiology of the lymphocytic myocarditis was not elucidated.
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Affiliation(s)
- T Sasaki
- Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo
| | - C Saeki
- Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo
| | - A Hirakawa
- Pet Clinic Hallelujah, 2544-1 Nakabaru, Kasuya, Kasuya-gun, Fukuoka, Japan
| | - N Machida
- Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo.
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12
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Iwasa N, Nishii N, Takashima S, Kobatake Y, Nomura S, Iwasa K, Iwasa T, Suzuki T, Machida N, Kitagawa H. Long-term management of high-grade atrioventricular block using cilostazol in a cat. JFMS Open Rep 2019; 5:2055116919878913. [PMID: 31673397 PMCID: PMC6804363 DOI: 10.1177/2055116919878913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary A 12-year-old neutered female domestic shorthair cat was admitted for syncope. Clinical signs and electrocardiography revealed high-grade atrioventricular (AV) block. Treatment with cilostazol ameliorated the clinical signs and arrhythmia. However, the high-grade AV block recurred on several occasions. After 640 days, the cat presented again with clinical deterioration owing to reoccurrence of the arrhythmia and it died 11 days later. Histopathological examination revealed a loss of conduction cells within the His bundle. Relevance and novel information To our knowledge, this is the first report of high-grade AV block treated with cilostazol in a cat. Treatment with cilostazol prolonged survival for 650 days without pacemaker implantation. Histological findings suggested that the AV block was related to fibrosis of the impulse conduction system.
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Affiliation(s)
- Naoki Iwasa
- Hashima Animal Hospital, Gifu, Japan.,Laboratory of Veterinary Internal Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
| | - Naohito Nishii
- Laboratory of Veterinary Internal Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
| | - Satoshi Takashima
- Laboratory of Veterinary Internal Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
| | - Yui Kobatake
- Laboratory of Veterinary Internal Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
| | - Saki Nomura
- Laboratory of Veterinary Internal Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
| | | | | | | | - Noboru Machida
- Department of Veterinary Clinical Oncology, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Hitoshi Kitagawa
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, Okayama University of Science, Ehime, Japan
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13
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Ward J, McLaughlin A, Burzette R, Keene B. The effect of a surgical safety checklist on complication rates associated with permanent transvenous pacemaker implantation in dogs. J Vet Cardiol 2019; 22:72-83. [DOI: 10.1016/j.jvc.2018.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/09/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
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Santilli RA, Giacomazzi F, Porteiro Vázquez DM, Perego M. Indications for permanent pacing in dogs and cats. J Vet Cardiol 2019; 22:20-39. [PMID: 30709617 PMCID: PMC7185536 DOI: 10.1016/j.jvc.2018.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 12/25/2022]
Abstract
Pacemaker implantation is considered as a standard procedure for treatment of symptomatic bradycardia in both dogs and cats. Advanced second-degree and third-degree atrioventricular blocks, sick sinus syndrome, persistent atrial standstill, and vasovagal syncope are the most common rhythm disturbances that require pacing to either alleviate clinical signs or prolong survival. Most pacemakers are implanted transvenously, using endocardial leads, but rarely epicardial leads may be necessary. To decide whether a patient is a candidate for pacing, as well as which pacing modality should be used, the clinician must have a clear understanding of the etiology, the pathophysiology, and the natural history of the most common bradyarrhythmias, as well as what result can be achieved by pacing patients with different rhythm disturbances. The goal of this review was, therefore, to describe the indications for pacing by evaluating the available evidence in both human and veterinary medicine. We described the etiology of bradyarrhythmias, clinical signs and electrocardiographic abnormalities, and the choice of pacing modality, taking into account how different choices may have different physiological consequences to selected patients. It is expected that this review will assist veterinarians in recognizing arrhythmias that may require permanent pacing and the risk-benefit of each pacing modality and its impact on outcome.
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Affiliation(s)
- R A Santilli
- Clinica Veterinaria Malpensa, Viale Marconi 27, 21017 Samarate, Varese, Italy; Department of Clinical Sciences, Cornell University, Ithaca, NY, USA.
| | - F Giacomazzi
- Clinica Veterinaria Malpensa, Viale Marconi 27, 21017 Samarate, Varese, Italy
| | | | - M Perego
- Clinica Veterinaria Malpensa, Viale Marconi 27, 21017 Samarate, Varese, Italy
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15
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Karlin ET, Rush JE, Nobrega EA. Synchronous diaphragmatic contraction associated with dual-chamber transvenous pacing in a dog. J Vet Cardiol 2018; 22:106-112. [PMID: 30503648 DOI: 10.1016/j.jvc.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 10/16/2018] [Accepted: 10/24/2018] [Indexed: 11/25/2022]
Abstract
A 3-year-old, 20-kg, spayed female, mix-breed dog received a dual-chamber pacemaker for management of symptomatic 3rd-degree atrioventricular block. Synchronous diaphragmatic contraction was documented to occur with atrial pacing. Various methods to reduce the occurrence of pacemaker-related phrenic nerve stimulation are discussed.
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Affiliation(s)
- E T Karlin
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton, MA 01536, USA
| | - J E Rush
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton, MA 01536, USA.
| | - E A Nobrega
- Boston Scientific Corporation, 3 Scimed Place, Maple Grove, MN 55311, USA
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16
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Oxford EM, Giacomazzi FB, Moïse NS, Santilli RA. Clinical and electrocardiographic presentations of transient trifascicular block in three cats. J Vet Cardiol 2018; 20:204-212. [DOI: 10.1016/j.jvc.2018.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/06/2018] [Accepted: 02/14/2018] [Indexed: 10/17/2022]
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17
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Ward J, DeFrancesco T, Tou S, Atkins C, Griffith E, Keene B. Outcome and survival in canine sick sinus syndrome and sinus node dysfunction: 93 cases (2002–2014). J Vet Cardiol 2016; 18:199-212. [DOI: 10.1016/j.jvc.2016.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 03/29/2016] [Accepted: 04/08/2016] [Indexed: 12/01/2022]
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18
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Wada T, Ohara H, Nakamura Y, Yokoyama H, Cao X, Izumi-Nakaseko H, Ando K, Murakoshi N, Sato A, Aonuma K, Takahara A, Nakazato Y, Sugiyama A. Impacts of Surgically Performed Renal Denervation on the Cardiovascular and Electrophysiological Variables in the Chronic Atrioventricular Block Dogs - Comparison With Those of Amiodarone Treatment. Circ J 2016; 80:1556-63. [PMID: 27250918 DOI: 10.1253/circj.cj-16-0198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND In order to begin to precisely clarify the impact of renal denervation on the blood pressure, atrial fibrillation and ventricular tachyarrhythmias, in addition to proarrhythmic potential, its cardiovascular effects were assessed by using the chronic complete atrioventricular block dogs. METHODS AND RESULTS Cardiohemodynamic and electrophysiological effects, together with neurohumoral factors and/or electrolytes, were assessed before and 4 weeks after either renal denervation (n=5) or amiodarone treatment (n=6). Amiodarone hydrochloride was given orally to the animals every day in a dose of 200 mg/day for the first 7 days followed by 100 mg/day for the following 21 days. The renal denervation decreased the systolic pressure, idioventricular rate, prolonged ventricular effective refractory period, and slightly suppressed the adrenergic tone and the renin-angiotensin-aldosterone system, but hardly affected the atrial effective refractory period and terminal repolarization period. Amiodarone prolonged the atrial effective refractory period, whereas no significant change was detected in the other variables. CONCLUSIONS Surgically performed renal denervation may possess the anti-ventricular tachyarrhythmic rather than anti-atrial fibrillatory potentials, and it also modestly decreased the blood pressure. Thus, currently obtained information may be used as guidance for better understanding the utility and limitation of renal denervation against various types of cardiovascular diseases. (Circ J 2016; 80: 1556-1563).
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Affiliation(s)
- Takeshi Wada
- Department of Pharmacology, Faculty of Medicine, Toho University
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19
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Vezzosi T, Marchesotti F, Tognetti R, Domenech O. ECG of the Month. Atrioventricular block (AVB). J Am Vet Med Assoc 2016; 248:1004-6. [PMID: 27074607 DOI: 10.2460/javma.248.9.1004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Santilli RA, Porteiro Vázquez DM, Vezzosi T, Perego M. Long-term Intrinsic Rhythm Evaluation in Dogs with Atrioventricular Block. J Vet Intern Med 2015; 30:58-62. [PMID: 26572234 PMCID: PMC4913642 DOI: 10.1111/jvim.13661] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 09/23/2015] [Accepted: 10/08/2015] [Indexed: 11/30/2022] Open
Abstract
Background Atrioventricular block (AVB) is a conduction abnormality along the atrioventricular node that, depending on etiology, may lead to different outcomes. Objectives To evaluate variations of intrinsic rhythm (IR) in dogs that underwent pacemaker implantation (PMI). Animals Medical records of 92 dogs affected by 3rd degree atrioventricular block (3AVB), advanced 2nd degree AVB (2AVB), paroxysmal 3AVB, 2:1 2AVB, or 3AVB with atrial fibrillation (AF) were retrospectively reviewed. Method The patient IR was documented with telemetry on the day of 1 – (95% CI, 1–2), 33 – (95% CI, 28–35), 105 – (95%CI, 98–156), and 275 days (95%CI, 221–380) after PMI. According to AVB grade at different examinations, AVB was defined as progressed, regressed, or unchanged. Results In 48 dogs, 3AVB remained unchanged, whereas in 7 it regressed. Eight cases of 2AVB progressed, 3 regressed and 2 remained unchanged. Eight cases of paroxysmal 3AVB progressed and 3 remained unchanged. Four dogs affected by 2:1 2AVB progressed, 2 regressed, and 1 remained unchanged. All cases with 3AVB with AF remained unchanged. Regression occurred within 30 days after PMI, whereas progression was documented at any time. Variations in IR were associated with type of AVB (P < .03) and time of follow‐up (P < .0001). Conclusions and clinical importance The degree of AVB assessed at the time of PMI should not be considered definitive because more than one‐third of the cases in this study either progressed or regressed. Additional studies would be necessary to elucidate possible causes for transient AVB in dogs.
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Affiliation(s)
- R A Santilli
- Clinica Veterinaria Malpensa, Samarate, Varese, Italy
| | | | - T Vezzosi
- Ospedale Didattico Veterinario "Mario Modenato", Dipartimento di Scienze Veterinarie, Università di Pisa, San Piero a Grado (Pisa), Italy
| | - M Perego
- Clinica Veterinaria Malpensa, Samarate, Varese, Italy
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21
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Ward JL, DeFrancesco TC, Tou SP, Atkins CE, Griffith EH, Keene BW. Complication rates associated with transvenous pacemaker implantation in dogs with high-grade atrioventricular block performed during versus after normal business hours. J Vet Intern Med 2015; 29:157-63. [PMID: 25619513 PMCID: PMC4858108 DOI: 10.1111/jvim.12512] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 09/04/2014] [Accepted: 10/28/2014] [Indexed: 12/04/2022] Open
Abstract
Background Transvenous pacemaker implantation in dogs is associated with a relatively high complication rate. At our institution, pacemaker implantation in dogs with high‐grade atrioventricular block (HG‐AVB) frequently is performed as an after‐hours emergency. Hypothesis Among dogs with HG‐AVB, the rate of major complications is higher when pacemakers are implanted after hours (AH) compared to during business hours (BH). Animals Client‐owned dogs with HG‐AVB that underwent transvenous pacemaker implantation between January 2002 and December 2012 at the North Carolina State University Veterinary Teaching Hospital. Methods Retrospective medical record review. Two‐year follow‐up was required for complications analysis. Results Major complications occurred in 14/79 dogs (18%) and included lead dislodgement, lead or generator infection, lead or generator migration, and pacing failure. Incidence of major complications was significantly higher AH (10/36, 28%) compared to BH (4/43, 9%; P = .041), and all infectious complications occurred AH. Median survival time for all dogs was 27 months and did not differ between AH and BH groups for either all‐cause (P = .70) or cardiac (P = .40) mortality. AH dogs were younger than BH dogs (P = .010), but there were no other clinically relevant differences between BH and AH groups in terms of demographic, clinical, or procedural variables. Conclusions and Clinical Importance At our institution, AH transvenous pacemaker placement is associated with a higher rate of major complications (especially infections) compared to BH placement. This difference may be because of a variety of human factor differences AH versus BH.
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Affiliation(s)
- J L Ward
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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22
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Ware WA, Reina-Doreste Y, Stern JA, Meurs KM. Sudden death associated with QT interval prolongation and KCNQ1 gene mutation in a family of English Springer Spaniels. J Vet Intern Med 2015; 29:561-8. [PMID: 25779927 PMCID: PMC4895492 DOI: 10.1111/jvim.12550] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 12/22/2014] [Accepted: 01/06/2015] [Indexed: 01/04/2023] Open
Abstract
Background A 5‐year‐old, healthy English Springer Spaniel died suddenly 4 months after delivering a litter of 7 puppies. Within 4 months of the dam's death, 3 offspring also died suddenly. Hypothesis Abnormal cardiac repolarization, caused by an inherited long QT syndrome, is thought to be responsible for arrhythmias leading to sudden death in this family. Animals Four remaining dogs from the affected litter and 11 related dogs. Methods Physical examination and resting ECG were done on the littermates and 9 related dogs. Additional tests on some or all littermates included echocardiogram with Doppler, Holter monitoring, and routine serum biochemistry. Blood for DNA sequencing was obtained from all 15 dogs. Results Three of 4 littermates examined, but no other dogs, had prolonged QT intervals with unique T‐wave morphology. DNA sequencing of the KCNQ1 gene identified a heterozygous single base pair mutation, unique to these 3 dogs, which changes a conserved amino acid from threonine to lysine and is predicted to change protein structure. Conclusions and Clinical Importance This family represents the first documentation in dogs of spontaneous familial QT prolongation, which was associated with a KCNQ1 gene mutation and sudden death. Although the final rhythm could not be documented in these dogs, their phenotypic manifestations of QT interval prolongation and abnormal ECG restitution suggested increased risk for sudden arrhythmic death. The KCNQ1 gene mutation identified is speculated to impair the cardiac repolarizing current IKs, similar to KCNQ1 mutations causing long QT syndrome 1 in humans.
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Affiliation(s)
- W A Ware
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA
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23
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Permanent dual chamber epicardial pacemaker implantation in two dogs with complete atrioventricular block. J Vet Cardiol 2015; 17:154-60. [PMID: 25595612 DOI: 10.1016/j.jvc.2014.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 10/22/2014] [Accepted: 11/12/2014] [Indexed: 11/23/2022]
Abstract
Between November 2013 and December 2013, two dogs with complete atrioventricular (AV) block had a permanent, dual chamber epicardial pacing system implanted. Steroid-eluting unipolar, button-type epicardial leads(a) were sutured to the right atrial appendage and right ventricular wall via a right thoracotomy in both dogs. The pacemakers were programmed in VDD mode. Permanent dual chamber epicardial pacemaker implantation was successful in both dogs with no intra-operative complications. One dog had an acute onset of neurologic signs two days post-operatively that resolved within 24 h. Both dogs have had complete resolution of the clinical signs related to the bradyarrhythmia, and one dog has had complete resolution of chylothorax. One dog had a major lead complication characterized by intermittent loss of capture that resolved by increasing the pacemaker output. Based on the outcome of these two cases, implantation of permanent dual chamber epicardial pacing systems is possible in dogs providing an alternative to dual chamber transvenous systems.
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24
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De Monte V, Staffieri F, Birettoni F, Bufalari A. Ketamine as a part of anaesthetic management in a dog with twiddler's syndrome. J Small Anim Pract 2013; 55:116-20. [PMID: 24117717 DOI: 10.1111/jsap.12139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An 11-year-old male German shepherd dog was referred for possible pacemaker implantation. A routine 6-lead electrocardiogram revealed a third-degree atrio-ventricular block with a heart rate of 40 to 45 beats/minute. A transvenous pacemaker implantation procedure was scheduled. The dog was premedicated with 10 µg/kg acepromazine and 5 mg/kg pethidine. A dose of 5 mg/kg ketamine and 0·2 mg/kg diazepam were used for induction and isoflurane in O2 and a constant rate infusion of ketamine (20 to 30 µg/kg/minute) were administered for maintenance of general anaesthesia. Due to a twiddler's syndrome, the pacemaker had to be repositioned. For the second procedure, the same protocol was employed except for a lower dose of ketamine both for induction (3 mg/kg) and constant rate infusion (10 to 15 µg/kg/minute). Ketamine appeared to be useful for both management of anaesthesia and cardiac pacemaker implantation in the absence of a temporary pacemaker.
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Affiliation(s)
- V De Monte
- Università degli studi di Perugia, Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Sezione di Clinica Chirurgica e Radiodiagnostica, Via S. Costanzo, 4 - 06126, Perugia, Italy
| | - F Staffieri
- Università degli Studi di Bari "Aldo Moro" Dipartimento delle Emergenze e dei Trapianti di Organi Sezione di Cliniche Veterinarie e Produzioni Animali, SP per Casamassima km 3-70010, Valenzano (Bari), Italy
| | - F Birettoni
- Università degli studi di Perugia, Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Sezione di Clinica Medica, Via S. Costanzo, 4 - 06126, Perugia, Italy
| | - A Bufalari
- Università degli studi di Perugia, Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Sezione di Clinica Chirurgica e Radiodiagnostica, Via S. Costanzo, 4 - 06126, Perugia, Italy
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25
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DeFrancesco TC. Management of cardiac emergencies in small animals. Vet Clin North Am Small Anim Pract 2013; 43:817-42. [PMID: 23747262 DOI: 10.1016/j.cvsm.2013.03.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cardiac emergencies are life-threatening conditions that must be diagnosed quickly to avoid delays in therapy. A timely and accurate diagnosis leads to early relief of symptoms and improved survival. This article provides both a comprehensive review and updated management recommendations for common cardiac emergencies in dogs and cats. Specifically, the article confers updates for the efficient clinical recognition of decompensated cardiac patients, including focused echocardiography, cardiac biomarkers, and electrocardiogram interpretation. This article also reviews the latest recommendations for the treatment of heart failure (including the use of pimobendan) and the management of arrhythmias, pericardial effusion, and aortic thromboembolism.
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Affiliation(s)
- Teresa C DeFrancesco
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC 27607, USA.
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26
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Visser LC, Keene BW, Mathews KG, Browne WJ, Chanoit G. Outcomes and Complications Associated With Epicardial Pacemakers in 28 Dogs and 5 Cats. Vet Surg 2013; 42:544-50. [DOI: 10.1111/j.1532-950x.2013.12020.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 06/01/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Lance C. Visser
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine, The Ohio State University; Columbus, OH
| | - Bruce W. Keene
- Department of Clinical Sciences; College of Veterinary Medicine, North Carolina State University; Raleigh, NC
| | - Kyle G. Mathews
- Department of Clinical Sciences; College of Veterinary Medicine, North Carolina State University; Raleigh, NC
| | - William J. Browne
- School of Veterinary Sciences; University of Bristol; Langford, Bristol; UK
| | - Guillaume Chanoit
- School of Veterinary Sciences; University of Bristol; Langford, Bristol; UK
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27
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Genovese DW, Estrada AH, Maisenbacher HW, Heatwole BA, Powell MA. Procedure times, complication rates, and survival times associated with single-chamber versus dual-chamber pacemaker implantation in dogs with clinical signs of bradyarrhythmia: 54 cases (2004–2009). J Am Vet Med Assoc 2013; 242:230-6. [DOI: 10.2460/javma.242.2.230] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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28
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Complete atrioventricular block secondary to cardiac lymphoma in a dog. J Vet Cardiol 2012; 14:537-9. [DOI: 10.1016/j.jvc.2012.04.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 04/15/2012] [Accepted: 04/18/2012] [Indexed: 11/24/2022]
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Nakamura RK, Zimmerman SA. ECG of the Month. Second-degree atrioventricular block in a cat. J Am Vet Med Assoc 2012; 241:433-4. [PMID: 22852566 DOI: 10.2460/javma.241.4.433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Reid K Nakamura
- Advanced Veterinary Care Center, 15926 Hawthorne Blvd, Lawndale, CA 90260, USA.
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30
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Saunders AB. The diagnosis and management of age-related veterinary cardiovascular disease. Vet Clin North Am Small Anim Pract 2012; 42:655-68, vi. [PMID: 22720807 DOI: 10.1016/j.cvsm.2012.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The American Veterinary Medical Association reported 81.7 million cats and 72.1 million dogs in the United States, with more than 10% over 11 years of age. Disorders of the cardiovascular system are one of the most commonly encountered disease entities in the aging pet population. This article reviews the diseases affecting older cats and dogs including how to make the diagnosis and when to treat while keeping in mind the unique aspects of comorbid conditions and polypharmacy situations encountered while managing pets with cardiovascular disease.
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Affiliation(s)
- Ashley B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA.
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Affiliation(s)
- Randolph L Winter
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, USA.
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32
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Affiliation(s)
- Reid K Nakamura
- Advanced Veterinary Care Center, 15926 Hawthorne Blvd, Lawndale, CA 90260, USA.
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33
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Baron Toaldo M, Critelli M, Santilli RA. ECG of the month. Trifascicular block causing syncope. J Am Vet Med Assoc 2011; 239:438-40. [PMID: 21838580 DOI: 10.2460/javma.239.4.438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Marco Baron Toaldo
- Department of Veterinary Medical Science, School of Veterinary Medicine, University of Bologna, Via Tolara di Sopra 50, I-40064 Ozzano Emilia, Bologna, Italy
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34
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Trafny DJ, Oyama MA, Wormser C, Reynolds CA, Singletary GE, Peddle GD. Cardiac troponin-I concentrations in dogs with bradyarrhythmias before and after artificial pacing. J Vet Cardiol 2010; 12:183-90. [PMID: 21030328 DOI: 10.1016/j.jvc.2010.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 07/22/2010] [Accepted: 07/23/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To quantify cardiac troponin-I (cTnI) concentration in dogs with symptomatic bradyarrhythmias before and after artificial pacing and to correlate cTnI concentration with diagnosis, echocardiographic parameters, serology, and outcome. ANIMALS, MATERIALS AND METHODS Medical records from the University of Pennsylvania from 2006 to 2009 were reviewed, and 14 dogs with cTnI assay results before and after pacemaker were identified. The ECG diagnosis included complete atrioventricular block (AVB), sick sinus syndrome, 2nd degree AVB, and atrial standstill. Serology, presence of premature beats, echocardiographic measurements, and pacing modality were recorded. RESULTS Mean cTnI concentration was elevated both pre- and post-pacing, and was significantly higher pre-pacing vs. post-pacing. Post-pacing cTnI concentration in 9 of 14 dogs (64%) remained above the reference range. Four dogs yielded high serum titers for Bartonella spp. Four dogs with markedly increased cTnI concentration had progressive left ventricular enlargement and myocardial failure as compared to pre-pacing examination. CONCLUSIONS Elevated cTnI concentration suggests that cardiac injury persists after artificial pacing in dogs with bradyarrhythmias. Myocarditis secondary to Bartonella spp. or other causes may be an important cause of AVB in dogs. Prospective studies investigating the correlation of cTnI to potential etiology and development of post-pacing LV dysfunction and outcome are needed.
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Affiliation(s)
- Dennis J Trafny
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, MJR-VHUP-Cardiology, 3900 Delancey St., Philadelphia, PA 19104, United States
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35
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Hildebrandt N, Stertmann W, Wehner M, Schneider I, Neu H, Schneider M. Dual Chamber Pacemaker Implantation in Dogs with Atrioventricular Block. J Vet Intern Med 2009; 23:31-8. [DOI: 10.1111/j.1939-1676.2008.0233.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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36
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Peckens NK, Lefbom BK. ECG of the Month. Atrial Fibrillation with third-degree atrioventricular block (AVB) and a slow ventricular escape rhythm that was coupled with ventricular premature contractions. J Am Vet Med Assoc 2008; 232:1642-4. [PMID: 18518804 DOI: 10.2460/javma.232.11.1642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Neal K Peckens
- Chesapeake Veterinary Cardiology Associates, 416 Maple Ave, Vienna, VA 22180, USA
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