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Perego M, Pariaut R, Moïse NS, Lombardo SF, Cavallini D, Santilli R. Electrocardiographic patterns of ventricular pre-excitation in dogs with right-sided accessory pathways. Vet Res Commun 2023; 47:1393-1403. [PMID: 36864330 DOI: 10.1007/s11259-023-10088-z] [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: 11/16/2022] [Accepted: 02/24/2023] [Indexed: 03/04/2023]
Abstract
INTRODUCTION The aim of the study was to describe the electrocardiographic features of ventricular pre-excitation (VPE) patterns characterized by the presence of delta (δ) wave, short P-δQRS interval, wide δQRS complexes in dogs with right-sided accessory pathways. ANIMALS, MATERIALS AND METHODS Twenty-six dogs with a confirmed accessory pathways (AP) via electrophysiological mapping were included. All dogs underwent a complete physical examination, 12-lead ECG, thoracic radiography, echocardiographic examination and electrophysiologic mapping. The AP were located in the following regions: right anterior, right posteroseptal, right posterior. The following parameters were determined: P-δQRS interval, δQRS duration, δQRS axis, δQRS morphology, δ-wave polarity, Q-wave, R-wave, R'-wave, S-wave amplitude, and R/S ratio. RESULTS In lead II, the median δQRS complex duration was 82.4 (IQR 7.2) and the median P-δQRS interval duration was 54.6 (IQR 4.2) msec. The median δQRS complex axis in the frontal plane was: + 68° (IQR 52.5) for right anterior APs, - 24 ° (IQR 24) for right postero-septal APs, - 43.5 ° (IQR 27.25) for right posterior APs (P = 0.007). In lead II, the polarity of the δ wave was positive in 5/5 right anterior APs and negative in 7/11 postero-septal APs and 8/10 in right posterior APs. In precordial leads of all dogs, R/S was ≤ 1 in V1 and > 1 in all leads from V2 to V6. CONCLUSION Surface electrocardiogram can be used to distinguish right anterior APs from right posterior and right postero-septal ahead of an invasive electrophysiological study.
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Affiliation(s)
- Manuela Perego
- Cardiovascular Division, Clinica Veterinaria Malpensa, Via Marconi 27, Samarate, Varese, 21017, Italy.
| | - Romain Pariaut
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - N Sydney Moïse
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Sergio Federico Lombardo
- Cardiovascular Division, Clinica Veterinaria Malpensa, Via Marconi 27, Samarate, Varese, 21017, Italy
| | - Damiano Cavallini
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna, Ozzano dell'Emilia, BO, 40064, Italy
| | - Roberto Santilli
- Cardiovascular Division, Clinica Veterinaria Malpensa, Via Marconi 27, Samarate, Varese, 21017, Italy
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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2
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Belachsen O, Bouvard J, Oliveira P, Sargent J. Segmental septal dyskinesia associated with an accessory pathway and preexcitation in two Golden Retriever dogs. J Vet Cardiol 2021; 36:6-13. [PMID: 34034141 DOI: 10.1016/j.jvc.2021.04.004] [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: 06/28/2020] [Revised: 03/23/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
Ventricular preexcitation secondary to anterograde conduction through an accessory pathway was diagnosed in two Golden Retriever dogs. Both dogs demonstrated similar segmental myocardial thinning and systolic dyskinesia of the basal interventricular wall on echocardiography. These changes are widely recognised in people with ventricular preexcitation but have not been previously described in dogs. Ventricular preexcitation should be considered as a potential cause for segmental wall motion abnormalities in these two dogs.
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Affiliation(s)
- O Belachsen
- Southern Counties Veterinary Specialists, 6 Forest Corner Farm, Ringwood, BH24 3JW, UK.
| | - J Bouvard
- The Royal (Dick) School of Veterinary Studies, Division of Clinical Veterinary Sciences, University of Edinburgh, Edinburgh, UK
| | - P Oliveira
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, SG5 3HR, UK
| | - J Sargent
- Southern Counties Veterinary Specialists, 6 Forest Corner Farm, Ringwood, BH24 3JW, UK
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Sheehan NK, Tjostheim SS. ECG of the Month. J Am Vet Med Assoc 2021; 257:273-276. [PMID: 32657656 DOI: 10.2460/javma.257.3.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Friederich J, Seuß AC, Wess G. The role of atrial fibrillation as a prognostic factor in doberman pinschers with dilated cardiomyopathy and congestive heart failure. Vet J 2020; 264:105535. [PMID: 33012438 DOI: 10.1016/j.tvjl.2020.105535] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 12/29/2022]
Abstract
Atrial fibrillation (AF) in congestive heart failure (CHF) is associated with a high risk of mortality and shorter survival times in human and veterinary medicine. A retrospective review of medical records was performed to evaluate the impact of AF on survival times in Doberman Pinschers with dilated cardiomyopathy (DCM). Time of first onset of CHF and its role as a prognostic factor were also determined, as were predictors of AF development. Forty-eight client-owned purebred Doberman Pinschers with DCM and CHF were included; 23 dogs presented with AF and 25 dogs did not develop AF until immediately before cardiac-related death. Dogs with AF survived for significantly shorter times than those without AF (P = 0.043). For dogs with AF, mean and median survival times were 88.2 days and 22 days, respectively (range, 42.1-134.4 days); mean and median survival times for dogs without AF were 150.7 days and 98 days, respectively (range, 98.5-203 days). AF increased the risk of cardiac-related death (hazard ratio [HR], 2.371; 95% confidence intervals [CI], 1.14-4.95; P = 0.021). Biventricular and right atrial dilation was only present in dogs with AF and right atrial enlargement was the only significant predictor of AF after multivariate analysis (P < 0.001). Dogs with AF had significantly higher mean heart rates than dogs without AF (201 beats per min [bpm] vs. 132 bpm; P < 0.001). In conclusion, AF in Doberman Pinschers with DCM and CHF increased the risk of cardiac-related death and reduced survival time.
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Affiliation(s)
- J Friederich
- Clinic of Small Animal Medicine, LMU University, Veterinärstr. 13, 80539, Munich, Germany
| | - A C Seuß
- Clinic of Small Animal Medicine, LMU University, Veterinärstr. 13, 80539, Munich, Germany
| | - G Wess
- Clinic of Small Animal Medicine, LMU University, Veterinärstr. 13, 80539, Munich, Germany.
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Greet V, Sargent J, Brannick M, Fuentes VL. Supraventricular tachycardia in 23 cats; comparison with 21 cats with atrial fibrillation (2004-2014). J Vet Cardiol 2020; 30:7-16. [PMID: 32585443 DOI: 10.1016/j.jvc.2020.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Supraventricular tachycardia (SVT) has not been well described in cats. The aim of this study was to describe the signalment, clinical findings, and outcome for cats with SVT versus cats with atrial fibrillation (AF). ANIMALS Forty-four client owned cats are included in the study. 23 cats with SVT and 21 with AF. METHODS This is a retrospective study. Clinical characteristics were compared between groups using a two-sample t-test or Mann-Whitney U test. Kaplan-Meier survival curves were generated to assess for impact of rhythm diagnosis, presence of ventricular arrhythmia, left atrial diameter, heart rate and congestive heart failure (CHF) status on cardiac death. Differences in survival between groups were compared using Mantel-Cox logrank comparison of Kaplan-Meier survival curves. RESULTS Cats with supraventricular arrhythmias most commonly presented with respiratory distress (10 of 44 cats). Cats with AF had a slower median heart rate (220 [range: 180-260 beats per minute (bpm)] compared with cats with SVT (300 [range: 150-380] bpm, p < 0.001). All cats with AF had structural heart disease, whereas 4 cats with SVT had no structural abnormalities. Left atrial diameter was significantly larger in cats with AF (23.7 (16.2-40.1) mm compared with 19.1 (12.8-31.4) mm in SVT cats; p = 0.02). Median survival was 58 days (1-780) in cats with AF and 259 days (2-2295) in cats with SVT (p = 0.1). Cats with signs of CHF had a shorter survival time (p = 0.001). CONCLUSIONS Most cats with AF or SVT have advanced structural heart disease. Some cats with SVT had structurally normal hearts, suggesting that SVT in cats is not always a consequence of atrial enlargement.
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Affiliation(s)
- V Greet
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom.
| | - J Sargent
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - M Brannick
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - V L Fuentes
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
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Wright KN, Connor CE, Irvin HM, Knilans TK, Webber D, Kass PH. Atrioventricular accessory pathways in 89 dogs: Clinical features and outcome after radiofrequency catheter ablation. J Vet Intern Med 2018; 32:1517-1529. [PMID: 30216552 PMCID: PMC6189389 DOI: 10.1111/jvim.15248] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 05/10/2018] [Accepted: 05/24/2018] [Indexed: 11/29/2022] Open
Abstract
Background Atrioventricular accessory pathways (APs) in dogs have been reported rarely. Data regarding clinical presentation and long‐term outcome after radiofrequency catheter ablation (RFCA) are limited. Hypothesis/Objectives To study clinical features, electrophysiologic characteristics, and outcome of RFCA in dogs with APs. Animals Eighty‐nine dogs presented consecutively for RFCA of APs. Methods Case series. Results Labrador retrievers (47.2% of dogs) and male dogs (67.4% of dogs) were most commonly affected. Labrador retrievers were more likely to be male than non‐Labrador breeds (P = .043). Clinical signs were nonspecific and most commonly included lethargy and gastrointestinal signs. Concealed APs were more prevalent in Labrador retrievers than other breeds (P = .001). Right‐sided APs (91.7%) predominated over left‐sided (8.3%). Tachycardia‐induced cardiomyopathy (TICM) occurred in 46.1% of dogs, with complete resolution or substantial improvement noted on one‐month postablation echocardiograms. Radiofrequency catheter ablation successfully eliminated AP conduction long term in 98.8% of dogs in which it was performed. Complications occurred in 5/89 dogs. Recurrence in 3 dogs was eliminated long term with a second procedure. Clinical Importance/Conclusions Accessory pathways are challenging to recognize in dogs because of nonspecific clinical signs, frequency of concealed APs that show no evidence of their presence during sinus rhythm, and intermittent occurrence of tachyarrhythmias resulting from APs. Tachycardia‐induced cardiomyopathy commonly occurs with AP‐mediated tachycardias and should be considered in any dog presenting with a dilated cardiomyopathic phenotype because of its good long‐term prognosis with rhythm control. Radiofrequency catheter ablation is a highly effective method for eliminating AP conduction and providing long‐term resolution.
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Affiliation(s)
- Kathy N Wright
- Department of Cardiology, MedVet Medical & Cancer Centers for Pets, Cincinnati, Ohio
| | - Chad E Connor
- Wright-Patterson Air Force Base Medical Center, Wright-Patterson AFB, Ohio.,Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Holly M Irvin
- Department of Cardiology, MedVet Medical & Cancer Centers for Pets, Cincinnati, Ohio
| | - Timothy K Knilans
- Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Dawn Webber
- Department of Cardiology, MedVet Medical & Cancer Centers for Pets, Cincinnati, Ohio
| | - Philip H Kass
- Department of Population Health and Reproduction, University of California-Davis, Davis, California
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Santilli RA, Mateos Pañero M, Porteiro Vázquez DM, Perini A, Perego M. Radiofrequency catheter ablation of accessory pathways in the dog: the Italian experience (2008-2016). J Vet Cardiol 2018; 20:384-397. [PMID: 30131290 DOI: 10.1016/j.jvc.2018.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Accessory pathways (APs) in dogs are mostly right-sided, display nondecremental conduction, and mediate atrioventricular reciprocating tachycardias (AVRTs). Radiofrequency catheter ablation (RFCA) is considered the first-line therapy in human patients to abolish electrical conduction along APs. ANIMALS Seventy-six consecutive client-owned dogs. MATERIAL AND METHODS Retrospective study to describe the precise anatomical distribution and the electrophysiologic characteristics of APs in a large population of dogs and to evaluate long-term success and complication rates of RFCA. RESULTS Eighty-three APs were identified in 76 dogs (92.1% with single APs and 7.9% with multiple APs); 96.4% were right-sided, 3.6% left-sided. Conduction along the APs was unidirectional and retrograde in 68.7% of the cases and bidirectional in 31.3%. Accessory pathways presented retrograde decremental properties in 6.5% of the cases. They mediated orthodromic AVRT in 92.1% of the cases and permanent junctional reciprocating tachycardia in 6.5%. In one case, no AVRT could be induced. In 97.4% of dogs, RFCA was attempted with an acute success rate of 100%. In 7.7% of cases, recurrence of the tachycardia occurred within 18 months, followed by a second definitively successful ablation. A major complication requiring pacemaker implantation was identified in 2.6% of dogs. DISCUSSION Accessory pathway distribution and electrophysiologic properties in these 76 dogs were similar to previous report. Long-term success and complication rates of RFCA in dogs appeared very similar to results of humans. CONCLUSION Radiofrequency catheter ablation of APs can be performed with a high success rate and low incidence of complications.
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Affiliation(s)
- R A Santilli
- Clinica Veterinaria Malpensa, Viale Marconi 27, 21017 Samarate, Varese, Italy.
| | - M Mateos Pañero
- Clinica Veterinaria Malpensa, Viale Marconi 27, 21017 Samarate, Varese, Italy
| | | | - A Perini
- 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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Bove CM, Ames MK, Scansen BA. ECG of the Month. J Am Vet Med Assoc 2017; 251:1383-1386. [PMID: 29190199 DOI: 10.2460/javma.251.12.1383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Santilli RA, Santos LFN, Perego M. Permanent junctional reciprocating tachycardia in a dog. J Vet Cardiol 2013; 15:225-30. [PMID: 23962684 DOI: 10.1016/j.jvc.2013.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 05/07/2013] [Accepted: 06/07/2013] [Indexed: 11/19/2022]
Abstract
A 5-year-old male English Bulldog was presented with a 1-year history of paroxysmal supraventricular tachycardia (SVT) partially responsive to amiodarone. At admission the surface ECG showed sustained runs of a narrow QRS complex tachycardia, with a ventricular cycle length (R-R interval) of 260 ms, alternating with periods of sinus rhythm. Endocardial mapping identified the electrogenic mechanism of the SVT as a circus movement tachycardia with retrograde and decremental conduction along a concealed postero-septal atrioventricular pathway (AP) and anterograde conduction along the atrioventricular node. These characteristics were indicative of a permanent junctional reciprocating tachycardia (PJRT). Radiofrequency catheter ablation of the AP successfully terminated the PJRT, with no recurrence of tachycardia on Holter monitoring at 12 months follow-up.
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Affiliation(s)
- Roberto A Santilli
- Clinica Veterinaria Malpensa, Viale Marconi 27, 21017 Samarate, Varese, Italy.
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Santilli R, Perego M, Crosara S, Gardini F, Bellino C, Moretti P, Spadacini G. Utility of 12-Lead Electrocardiogram for Differentiating Paroxysmal Supraventricular Tachycardias in Dogs. J Vet Intern Med 2008; 22:915-23. [DOI: 10.1111/j.1939-1676.2008.0127.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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