1
|
Gómez-Torres F, Ballesteros-Acuña L, Ruíz-Sauri A. Histopathological changes in the electrical conduction of cardiac nodes after acute myocardial infarction in dogs and horses, compared with findings in humans: A histological, morphometrical, and immunohistochemical study. Vet World 2023; 16:2173-2185. [PMID: 38023272 PMCID: PMC10668561 DOI: 10.14202/vetworld.2023.2173-2185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aim The heart conduction system is responsible for the occurrence of various types of cardiac arrhythmia. This study aimed to histologically and morphometrically describe damaged cardiac nodes during acute myocardial infarction and to compare them with normal tissues in dogs and horses. Materials and Methods This study describes the morphometry of cardiac nodes in five dogs and five elderly horses that succumbed to sudden cardiac death (SCD). A computerized morphometric study was conducted to determine the number of cells composing the nodes, different shape and size parameters of nodes, and their relationship with degenerative changes due to cardiac conditions. Results In both species, the sinoatrial node (SAN) was ovoid in shape whereas the atrioventricular node (AVN) was pyramidal in shape. The percentage of collagen fibers inside the SAN of dogs (47%) and horses (50%) was found to be higher than that of cells. In contrast, the percentage of cells in the AVN of dogs (24%) and horses (16%) was higher than that of connective tissues. In the SAN, the area (p = 0.09), maximum diameter (<0.001), and mean diameter (0.003) of P cells were larger in dogs than in horses. Conclusion Overall, the SAN cells and surrounding cardiomyocytes in dogs and horses as well as the AVN cells in dogs that succumbed to SCD decreased in size compared with those in normal hearts.
Collapse
Affiliation(s)
- Fabián Gómez-Torres
- Department of Basic Sciences, School of Medicine, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Luis Ballesteros-Acuña
- Department of Basic Sciences, School of Medicine, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Amparo Ruíz-Sauri
- Department of Pathology, Faculty of Medicine, Universitat de Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| |
Collapse
|
2
|
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.
Collapse
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
| | | |
Collapse
|
3
|
Nissen SD, Saljic A, Kjeldsen ST, Jespersen T, Hopster-Iversen C, Buhl R. Cartilaginous Intrusion of the Atrioventricular Node in a Quarter Horse with a High Burden of Second-Degree AV Block and Collapse: A Case Report. Animals (Basel) 2022; 12:2915. [PMID: 36359039 PMCID: PMC9657453 DOI: 10.3390/ani12212915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/07/2022] [Accepted: 10/21/2022] [Indexed: 09/23/2024] Open
Abstract
Second-degree atrioventricular (AV) block is the most common cardiac arrhythmia in horses, affecting 40-90% depending on breed. Usually, the AV blocks occur while the horses are resting and disappear upon exercise and are, therefore, considered to be uneventful for horses. However, if the AV blocks occur frequently, this may result in syncope and collapse. Identifying the cause of second-degree AV block is difficult and often subscribed to high vagal tone. In this report, we present an eight-year-old Quarter horse with a high burden of second-degree AV blocks and multiple collapses. The clinical examination, including neurological examination, blood analysis, 24-h ECG recording and cardiac echocardiography, did not reveal any signs of general or cardiovascular disease besides a high burden of second-degree AV blocks (~300 blocks per hour) and a hyperechoic area in the AV nodal region. An implantable loop recorder (ILR) was inserted to monitor the cardiac rhythm. The ILR detected several consecutive second-degree AV blocks and pauses above 5 s. However, unfortunately, no recordings were available during the collapses. Eventually, the horse was euthanized and the heart inspected. The aortic root was severely cartilaginous and appeared to penetrate the AV node, especially in the His bundle region, possibly explaining the hampered AV conduction. Nevertheless, it is still uncertain if the AV nodal disruption caused the collapses and more knowledge on AV nodal diseases in horses is warranted.
Collapse
Affiliation(s)
- Sarah Dalgas Nissen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630 Taastrup, Denmark
| | - Arnela Saljic
- Institute of Pharmacology, West German Heart and Vascular Centre, University of Duisburg-Essen, 45117 Essen, Germany
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Sofie Troest Kjeldsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630 Taastrup, Denmark
| | - Thomas Jespersen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Charlotte Hopster-Iversen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630 Taastrup, Denmark
| | - Rikke Buhl
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630 Taastrup, Denmark
| |
Collapse
|
4
|
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.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Ryuji Fukushima
- Animal Medical Center, Tokyo University of Agriculture and Technology, Fuchu-shi, Tokyo, Japan
| |
Collapse
|
5
|
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.
Collapse
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.
| |
Collapse
|
6
|
Imai T, Ojiro R, Kimura Y, Machida N. Pathological Features of Persistent Atrial Standstill Syndrome in Three Dogs. J Comp Pathol 2020; 180:9-15. [PMID: 33222880 DOI: 10.1016/j.jcpa.2020.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/25/2020] [Accepted: 08/08/2020] [Indexed: 11/27/2022]
Abstract
The hearts of three dogs, clinically diagnosed as having persistent atrial standstill syndrome (PAS), were studied post mortem. The most significant gross findings in the hearts of all three dogs were dilatation and marked reduction in the thickness of both atrial walls. Histopathologically, all three had widespread progressive loss of the atrial myocardium with replacement by fatty or fibrofatty tissue, consistent with atrial myopathy. The lesion mainly affected the upper half of both atria and was more severe in the epimyocardium and midmyocardium than in the endomyocardium. On the basis of these observations, it is proposed that the atrial myopathy commences in the upper regions of both atria and progresses downwards, as has been demonstrated electrophysiologically in PAS in humans, and extends from the epicardium towards the endocardium.
Collapse
Affiliation(s)
- Tomoko Imai
- Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Ryota Ojiro
- 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
| | - Noboru Machida
- Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan.
| |
Collapse
|
7
|
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
| |
Collapse
|
8
|
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.
Collapse
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.
| |
Collapse
|
9
|
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.
Collapse
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
| |
Collapse
|
10
|
Retrospective Analysis of Indications and Complications Related to Implantation of Permanent Pacemaker: 25 Years of Experience in 31 Dogs. J Vet Res 2019; 63:133-140. [PMID: 30989145 PMCID: PMC6458549 DOI: 10.2478/jvetres-2019-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 02/04/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction Pacemaker implantation is the only effective symptomatic treatment for life-threatening bradyarrhythmias. Major complications observed after implantation of cardiac pacemakers include lead dislocation, loss of pulse generator function, and inadequate stimulation. The aim of this retrospective single-centre study was to analyse the indications for pacemaker implantation and the incidence and types of complications associated with this procedure in dogs treated for symptomatic bradyarrhythmia. Material and Methods The retrospective analysis included 31 dogs with symptomatic bradyarrhythmia, implanted with permanent cardiac pacemakers in 1992-2017. The list of analysed variables included patient age, breed, sex, indication for pacemaker implantation, comorbidities, and the incidence of procedure-related complications along with the type thereof. Results The most common indication for pacemaker implantation was 3rd degree AVB, followed by SSS, advanced 2nd degree AVB, and PAS. Pacemaker implantation was associated with a 35% overall complication rate and 6.45% periprocedural mortality. There were no significant differences in terms of procedure-related complications with regard to age, sex, breed, indications for pacemaker implantation, or comorbidities. Conclusions Cardiac pacing is the only effective treatment of symptomatic bradycardia, but as an invasive procedure, may pose a risk of various complications, including death.
Collapse
|
11
|
Wesselowski S, Cusack K, Gordon SG, Jeffery N, Saunders AB. Artificial cardiac pacemaker placement in dogs with a cohort of myocarditis suspects and association of ultrasensitive cardiac troponin I with survival. J Vet Cardiol 2018; 22:84-95. [PMID: 30573438 DOI: 10.1016/j.jvc.2018.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Artificial cardiac pacemakers (APs) are a common treatment for symptomatic bradyarrhythmias in dogs, some of which may be triggered by underlying myocarditis. Severely elevated cardiac troponin I (cTnI) concentrations support a diagnosis of myocarditis. The association of ultrasensitive-cTnI (US-cTnI) concentration with survival in a large cohort of dogs receiving APs is not described. ANIMALS, MATERIALS, AND METHODS The study included 110 dogs receiving APs over a 5-year period. Medical records were retrospectively reviewed to characterize the entire population receiving APs, with further analysis in dogs with preprocedural US-cTnI concentrations (n = 64) classified as normal/group 1 (n = 11), mildly to moderately elevated/group 2 (n = 27), and severely elevated/myocarditis suspects/group 3 (n = 26). RESULTS Median survival time was 1079 days for the entire population, 1167 days for group 2, 949 days for group 3, and not met in group 1. There was not a statistically significant difference in survival between group 2 and group 3. Overall, US-cTnI had a mild, negative association with survival. Age had a stronger negative association. Infectious etiologies were identified in a minority of group 3 cases. A possible association between severely elevated US-cTnI and a sudden death outcome was noted. CONCLUSIONS The negative association of US-cTnI with survival outcomes was mild, with age having a larger effect. Although a sudden death outcome may be seen more commonly in myocarditis suspects, group 3 survival time was similar to that of the entire canine population. Plausible infectious causes of myocarditis were infrequently identified.
Collapse
Affiliation(s)
- S Wesselowski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA.
| | - K Cusack
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA
| | - S G Gordon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA
| | - N Jeffery
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA
| | - A B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA
| |
Collapse
|
12
|
Menicagli F, Lanza A, Sbrocca F, Baldi A, Spugnini EP. A case of advanced second-degree atrioventricular block in a ferret secondary to lymphoma. Open Vet J 2016; 6:68-70. [PMID: 27200273 PMCID: PMC4833871 DOI: 10.4314/ovj.v6i1.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/08/2016] [Indexed: 11/26/2022] Open
Abstract
A female ferret was referred as an emergency for severe respiratory distress symptoms. At presentation, the patient was listlessness, dyspnoeic, and hyper-responsive. The clinical examination evidenced dyspnea with cyanosis, altered cardiac rhythm, and hepatomegaly. Electrocardiography showed an advanced second-degree atrioventricular (AV) block. The liver aspirate was diagnostic for lymphoma. The patient did not respond to supportive therapy and rapidly died. Post-mortem exams confirmed the presence of lymphoma with hepatic involvement. Moreover, a pericardial lymphocytic infiltration and a widespread myocardial nodular localization of lymphoma were evidenced as well. This condition was probably the cause of the cardiac arrhythmia. To the best of our knowledge, ours is the first report of cardiac lymphoma causing heart block in ferrets.
Collapse
Affiliation(s)
- F Menicagli
- Gianicolense Veterinary Centre, Via Lorenzo Valla 25/b, 00152 Rome, Italy
| | - A Lanza
- Gianicolense Veterinary Centre, Via Lorenzo Valla 25/b, 00152 Rome, Italy
| | - F Sbrocca
- Gianicolense Veterinary Centre, Via Lorenzo Valla 25/b, 00152 Rome, Italy
| | - A Baldi
- Second University of Naples, Naples, Italy
| | - E P Spugnini
- SAFU, Regina Elena Cancer Institute, Via delle Messi d' Oro 156, 00158 Rome, Italy
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Abstract
OBJECTIVE To review indications, procedures, and prognosis for common cardiovascular emergencies requiring intervention in small animals. ETIOLOGY Pericardial effusion, symptomatic bradycardia, and heartworm-induced caval syndrome are examples of clinical scenarios commonly requiring intervention. Pericardial effusion in small animals occurs most frequently from cardiac neoplasia, idiopathic pericarditis, or congestive heart failure. Indications for temporary pacing include transient bradyarrhythmias, ingestions resulting in chronotropic incompetence, and emergency stabilization of critical bradyarrhythmias. Caval syndrome results from a large dirofilarial worm burden, pulmonary hypertension, and mechanical obstruction of right-sided cardiac output with resultant hemolysis and organ dysfunction. DIAGNOSIS The diagnosis of pericardial effusion is suspected from signalment and physical findings and confirmed with cardiac ultrasound. Symptomatic bradycardias often present for syncope and definitive diagnosis derives from an ECG. Caval syndrome is diagnosed upon clinical, hematologic, and ultrasonographic evidence of severe heartworm infestation, cardiovascular compromise, and/or mechanical hemolysis. THERAPY Pericardial effusion is alleviated by pericardiocentesis in the emergency setting, though may require further intervention for long-term palliation. Temporary transvenous pacing can be performed emergently to stabilize the symptomatic patient with a bradyarrhythmia. Dirofilariasis leading to caval syndrome requires urgent heartworm extraction. PROGNOSIS The prognosis for pericardial effusion is dependent upon the underlying etiology; the prognosis for cardiac pacing is favorable, and the prognosis for caval syndrome is grave if untreated and guarded to fair if heartworm extraction is performed.
Collapse
Affiliation(s)
- Brian A Scansen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA.
| |
Collapse
|
15
|
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.
Collapse
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
| | | | | | | | | | | |
Collapse
|
16
|
Fonfara S, Loureiro JF, Swift S, James RA, Pereira YM, Lopez-Alvarez J, Summerfield N, Dukes-McEwan J. English springer spaniels with significant bradyarrhythmias-presentation, troponin I and follow-up after pacemaker implantation. J Small Anim Pract 2010; 51:155-61. [DOI: 10.1111/j.1748-5827.2009.00867.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
17
|
Kaneshige T, Machida N, Nakao S, Doiguchi O, Katsuda S, Yamane Y. Complete Atrioventricular Block Associated with Lymphocytic Myocarditis of the Atrioventricular Node in Two Young Adult Dogs. J Comp Pathol 2007; 137:146-50. [PMID: 17673248 DOI: 10.1016/j.jcpa.2007.05.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Accepted: 05/28/2007] [Indexed: 11/19/2022]
Abstract
A histological investigation of the atrioventricular (AV) conduction system was performed in two young adult dogs with complete AV block. In both cases, infiltration of lymphocytes and plasma cells into the AV node and loss and disappearance of the conduction fibres were observed. Such inflammatory lesions of the AV conduction system were associated with complete AV block. The aetiology of these changes and the cause of its location at the AV node were not elucidated.
Collapse
Affiliation(s)
- T Kaneshige
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| | | | | | | | | | | |
Collapse
|