Analysis of Heart Rate Variability in Newborns Dogs with Different Types of Delivery during the First 35 Days of Life

The present study aimed to evaluate the influence of the autonomic nervous system on cardiovascular function during the first 35 days of life in different types of delivery, using heart rate variability (HRV) indices. Thirty newborns were equally divided into two groups based on delivery type: eutocic delivery (EG) and emergency cesarean section (CG). Electrocardiographic evaluation was performed at birth (T0), 24 h postpartum (T1), and at 7, 14, 21, 28, and 35 days of life (T2 to T6). Physical parameters, neonatal reflexes, and Apgar scores were recorded. Over 35 days, the values of the time domain indices were higher in the GE group and increased with age. In the frequency domain, the low frequency (LF) index was higher in the CG, and the opposite occurred for the high frequency (HF) index. Since the CG presented lower HRV than the EG, it was shown that the type of delivery should be considered for the assessment of autonomic nervous system activity in neonates. Thus, as predictive factors of vitality, HRV and Apgar scores can help in the face of neonatal depression, demonstrating that delivery by emergency cesarean section can predispose newborns to delays in the autonomic influence on the heart.

Short-term Heart Rate Variability Analysis in Healthy Dogs of Different Ages

Background: The modulation of heart rate by autonomic nervous system may be evaluated by the heart rate variability (HRV), which illustrates the fluctuations between RR intervals. To evaluate this analysis, the intervals between 2 QRS complexes are measured. In general, high HRV values are expected in healthy individuals; otherwise, low values are indicative of organism dysfunction. Studies conducted in healthy humans show that HRV suffers reduction with ageing and that there is autonomic immaturity in neonates. The aim of this study was to describe the characteristic pattern of cardiac autonomic behavior in healthy dogs in different age groups through short-term HRV analysis.Materials, Methods & Results: A total of 87 healthy dogs were studied. HRV was analyzed in time and frequency domain, using Holter and heart rate monitor. It was observed that puppies (below one year old) presented a lower parasympathetic predominance and, consequently, lower HRV values on time domain (SDNN, PNN50% e RMSSD) compared to the other 2 groups and on frequency domain (LF, HF and LF/HF) compared to the adult animals group (between 1 and 7-year-old), which presented higher HRV values when compared to the other groups. Elderly dogs (over 8-year-old) exhibited a natural tendency to decrease cardiac parasympathetic HRV indexes.Discussion: The use of the HRV method as a prognostic index and as an arrhythmogenic marker for various canine heart diseases presents interesting perspectives. However, before it may be employed for these purposes, a better understanding should be established regarding the physiological behavior of autonomic cardiac modulation in different age groups to serve as a basis for future analyses. This study observed that puppies presented higher values for HR and, therefore, shorter RR intervals than the other groups (adult and elderly dogs), what was observed on Holter and heart rate monitor methods (HRM). There were significant differences between puppies and the other 2 groups (adults and elderly) for all time-domain variables using both methods (Holter and HRM methods). SDNN was significantly lower in puppies compared to adults and elderly dogs. In addition, both RMSSD and PNN50%, which were more reliable over shorter periods of time, also presented means and medians that were significantly lower in puppies. Regarding frequency-domain HRV parameters observed on Holter method, these indexes were decreased on the elderly group compared to adult dogs, which is a possible effect of aging. Also, puppies revealed lower frequency-domain HRV parameters on both methods when compared to adult dogs. The influence of age on HRV is possibly related to the stage of development of an individual, starting at conception up to the maturity in relation to the mechanisms that cause variations in HR. There are studies in humans that suggest a gradual increase in parasympathetic activity during childhood, followed by a steady decrease as aging occur. The present study observed the same pattern in dogs. The balance between sympathetic and parasympathetic systems is influenced by age in dogs, which alters HRV values in the short-term. The HRV method´s analysis is relatively simple and non-invasive for assessing cardiac autonomic function; also, it is widely used in human medicine as a risk measure for sudden cardiac death. The 24-hour HRV analysis is highly challenging, as it is time-consuming, expensive, delays diagnosis, and has a large number of artifacts; in this way, standards for its short-term analysis were developed. Keywords: cardiology, autonomic nervous system, heart rate monitor, Holter.

Evaluation of heart rate variability and behavior of electrocardiographic parameters in dogs affected by chronic Monocytic Ehrlichiosis

Canine Monocytic Ehrlichiosis (CME) is a systemic disease prevalent in the entire world caused by the obligate intracellular bacteria Ehrlichia canis. The occurrence of myocarditis with a high prevalence of arrhythmias in dogs affected by this disease in the cytopenic phase has already been proven. This study aims to evaluate the concentrations of CK MB, cTnI and NT-proBNP in dogs affected by Ehrlichia canis in the chronic phase since the intense stimulation of the immune system can lead to myocarditis; to evaluate if the condition can lead to arrhythmic events and, if so, define their frequency and classification through conventional and ambulatory electrocardiogram tests (Holter method) for a period of 24 hours; to analyze heart rate variability in the time domain and whether the condition can lead to autonomic imbalance; and to determine the survival rate of affected dogs, identifying possible risk factors for mortality at this stage of the disease. For this purposes, we evaluated clinical, hematological and biochemical data, as well as the concentrations of cardiac biomarkers Creatine Kinase-MB (CK MB), Cardiac Troponin I (cTnI) and N-terminal pro-peptide natriuretic type B (NT-proBNP). We also analyzed conventional and ambulatory electrocardiography (24-hour Holter) and heart rate variability (HRV) in 20 dogs afflicted by cytopenic CME in the chronic phase of the disease (G1) and compared the results with a control group comprised of ten healthy dogs (G2). G1 was monitored during the treatment for 28 days, during which eight (8) of the 20 infected dogs died (40%). Anorexia, vomiting, fatigue, hypoalbuminemia, heart murmurs and increased concentrations of alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were common clinical signs. The mean concentrations of cTnI and CKMB were significant (0.24 ng / mL ± 0.5, 229 ± 205 IU / mL) in comparison to the control group (0.042 ± 0.07 ng / mL, 126 ± 46.12 IU / mL). No significant differences were observed between NT-proBNP concentrations in G1 (135.46 ± 29.7) and G2 (138.28 ± 19.77). Nine of the twenty dogs (45%) presented a high frequency of arrhythmias during 24-hour recording, ranging from first and second-degree atrioventricular block, ventricular and supraventricular ectopic events and sinus tachycardia. No sinus pause was observed. One dog had 120 episodes of unsustained ventricular tachycardia and two episodes of sustained ventricular tachycardia. The short-term and long-term HRV data, represented by SDNN (ms), SDANN (ms) and pnn50 (%) were also significant lower (83 ± 65, 56.05 ± 37.3 and 14.56 ± 20, respectively) in comparison to the healthy animals (268 ± 74.6, 168.3 ± 39.14 and 55.87 ± 12.8, respectively). These results suggest that cytopenic CME is characterized by an arrhythmogenic component and intense stimulation of the sympathetic autonomic nervous system in the heart, reflecting an imbalance in the activity of the ANS.

Pacemaker Implant in a Dog with Sick Sinus Syndrome

Background: Sick sinus syndrome is characterized by the presence of arrhythmias, including persistent sinus bradycardia, sinus arrest and paroxysmal atrial tachyarrhythmia. It commonly occurs in elderly dogs, especially miniature schnauzers; however, it is also detected in dachshunds and pugs. Reports of clinical signs by animal owners are not always clear and precise, which may result in erroneous interpretations by veterinarians; consequently, the use of inappropriate therapies. The present work aims to describe clinical aspects and findings from tests related to sick sinus syndrome (SSS) and presents the case of a female schnauzer with SSS.Case: A 10-year-old female dog (schnauzer, 8.6 kg) attended the Veterinary Hospital of the FMVZ-UNESP - Botucatu. The owner mentioned convulsive episodes, but a thorough medical history and patient assessment revealed that the dog exhibited episodes of syncope. During the physical examination, cardiac auscultation revealed the heart rate to be 56 beats per minute (bpm), and there was a presence of pauses. Also during cardiac auscultation, a holosystolic heart murmur was verified, with a focus on the mitral and tricuspid valves. The electrocardiogram showed the presence of sinus arrest with escape rhythms, pauses of 10 s and the presence of bradycardia-tachycardia syndrome. A Holter monitor was used to establish the diagnosis of SSS. The patient presented with significant episodes of syncope during outpatient care, and based on the clinical manifestation, drug therapy was initiated. The prescribed medications were aminophylline 20 mg/ kg TID, enalapril maleate 0.5 mg/kg BID, spironolactone 1 mg/kg SID and furosemide 2 mg/kg BID. After the start of treatment, there was a reduction in the frequency of episodes of syncope. Three weeks after diagnosis, a pacemaker device was implanted. Currently, clinical signs are absent.Discussion: Sinus node dysfunction is one of the main reasons for pacemaker implantation. It is usually diagnosed based on clinical signs and the presence of sinus bradycardia and sinus pauses in electrocardiograms or Holter monitoring. The diagnosis of SSS is limited to cases in which the patient does not present with abnormalities in an electrocardiogram. Syncope is a clinical sign commonly present in patients with dysfunction of the sinus node, and episodes of syncope were reported by the owner of the dog referred to in the present report. A thorough medical history and physical examination must be performed to diagnose SSS because erroneous diagnosis and incorrect interpretations of clinical signs can lead to the misuse of medications. The treatment of choice for SSS is an implantable pacemaker device; however, because the method is not widely used in Brazil, a second option is drug treatment. In the present report, after implantation of a pacemaker, clinical signs ceased, and the patient was in good general health and could return to her normal activities. Sick sinus syndrome is a disease commonly found in schnauzers. There is a need for detailed histories and complementary exams because the clinical signs do not always correlate with electrocardiographic findings. The implantation of a pacemaker is the treatment of choice and is effective for the condition, but its use is not uniformly accessible throughout the country.

Scaling Relationships Among Heart Rate, Electrocardiography Parameters, and Body Weight

Although heart rate (HR) is one of the most important clinical parameters determined via physical examinations, little information is available on the normal HR in dogs, which may be related to the high variability of body weight (BW) in this species. HR is determined by the discharge rate of the sinus node, which is dependent on the autonomic nervous system and the release of catecholamines. The allometric relationship between BW and HR in different species has been described as inversely proportional; however, this relationship has been refuted. Certain authors have reported that the relationship between HR and BW in dogs is based on temperament as well as sympathetic autonomic stimulation of the sinus node in small breeds compared with large breeds. The aim of this study was to analyze the effects of weight, sex, age and temperament on the HR, heart rate variability and serum catecholamine (epinephrine and norepinephrine) levels in dogs. We evaluated 48 adult dogs of both sexes and various breeds and ages and divided the dogs into 5 BW groups: <5kg (n = 8), 5-10kg (n = 10), 10-25kg (n = 10), 25-45kg (n = 10), and >45kg (n = 10). The measured parameters were HR, breath rate (BR) and body temperature. We also performed an ambulatory electrocardiogram and electrocardiography (ECG) test for 24 hours (Holter monitor) and determined the serum levels of the catecholamines epinephrine and norepinephrine. We observed correlations between HR and sex; differences among the weight groups with respect to ECG variables and epinephrine levels; and differences among the temperament categories for certain clinical parameters, such as HR and BR. Age affected the R wave amplitude, and an allometric relationship was not observed between HR and BW in the dogs. Our results indicated that weight was associated with variations in the ECG variables; age and sex were associated with variations in HR; and temperament had a significant influence on the HR and BR of the dogs.