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Gavic EA, Stauthammer CD, Masters AK, Morgan KRS, Rendahl A, Ciccozzi M, Beekmann K, George R, Herrold E, Markovic LE, Schober K, Tjostheim SS, Wright K. Clinical, electrocardiographic, and diagnostic imaging features and outcomes in cats with electrocardiographic diagnosis of ventricular pre-excitation: a retrospective study of 23 cases (2010-2022). J Vet Cardiol 2024; 56:97-109. [PMID: 39423603 DOI: 10.1016/j.jvc.2024.09.003] [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: 01/03/2024] [Revised: 09/15/2024] [Accepted: 09/16/2024] [Indexed: 10/21/2024]
Abstract
INTRODUCTION/OBJECTIVES Ventricular pre-excitation (VPE) occurs when atrial electrical impulses prematurely excite the ventricles through an aberrant muscle bundle known as an accessory pathway (AP). Orthodromic atrioventricular reciprocating tachycardia is a re-entrant, narrow complex supraventricular tachycardia (SVT), maintained through retrograde conduction over an AP. The study aimed to describe patient signalments, clinical signs, electrocardiographic (ECG) and diagnostic imaging features, treatments, prognostic variables, and outcomes in cats with ECG diagnosis of VPE. ANIMALS Twenty-three cats diagnosed with VPE between January 2010 and August 2022 were included in this study. MATERIALS AND METHODS This was a multicenter, retrospective study with 23 cats diagnosed with VPE between January 2010 and August 2022. Ventricular pre-excitation diagnosis was based on ECG evidence of shortened PR interval, delta wave, and prolonged QRS duration. The median survival time (MST) was estimated by the Kaplan-Meier curve. Log-rank tests were performed to assess for an association between clinical signs or presence of structural heart disease on the MST. RESULTS Fourteen (60.8%) cats with VPE also had SVT documented on ECG, with seven of 14 with ECG confirmation of orthodromic atrioventricular reciprocating tachycardia. Four (17.4%) cats had suspected AP-mediated tachyarrhythmia based on associated clinical signs. Common presenting signs included collapse (15/23; 65.2%) and respiratory distress (14/23; 60.8%). Five (21.7%) cats were asymptomatic. Heart rate during SVT ranged from 310 to 420 bpm (median: 375 bpm). Initial treatment included atenolol (10/18), sotalol (5/18), diltiazem (2/18), and amiodarone (1/18). From the date of diagnosis, MST was 1872 days (5.1 years). CONCLUSIONS The majority of cats with VPE also had symptomatic SVT. The prognosis for cats with VPE is considered good with an MST of greater than five years.
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Affiliation(s)
- E A Gavic
- University of Minnesota, Veterinary Medical Center, Cardiology Department, 1365 Gortner Avenue, Saint Paul, MN 55108, USA.
| | - C D Stauthammer
- University of Minnesota, Veterinary Medical Center, Cardiology Department, 1365 Gortner Avenue, Saint Paul, MN 55108, USA
| | - A K Masters
- University of Minnesota, Veterinary Medical Center, Cardiology Department, 1365 Gortner Avenue, Saint Paul, MN 55108, USA
| | - K R S Morgan
- University of Minnesota, Veterinary Medical Center, Cardiology Department, 1365 Gortner Avenue, Saint Paul, MN 55108, USA
| | - A Rendahl
- University of Minnesota, Veterinary Medical Center, Cardiology Department, 1365 Gortner Avenue, Saint Paul, MN 55108, USA
| | - M Ciccozzi
- University of Minnesota, Veterinary Medical Center, Cardiology Department, 1365 Gortner Avenue, Saint Paul, MN 55108, USA
| | - K Beekmann
- MedVet Cincinnati, 3964 Red Bank Road, Fairfax, OH 45227, USA
| | - R George
- Animal Emergency and Referral Center of Minnesota, 1160 Helmo Avenue North, Oakdale, MN 55128, USA
| | - E Herrold
- The Ohio State University Veterinary Medical Center, 601 Vernon L Tharp Street, Columbus, OH 43210, USA
| | - L E Markovic
- Department of Small Animal Medicine and Surgery, University of Georgia, College of Veterinary Medicine, 501 D. W. Brooks Drive, Athens, GA 30602, USA
| | - K Schober
- The Ohio State University Veterinary Medical Center, 601 Vernon L Tharp Street, Columbus, OH 43210, USA
| | - S S Tjostheim
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA
| | - K Wright
- MedVet Cincinnati, 3964 Red Bank Road, Fairfax, OH 45227, USA
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Sala GP, Wotton P, Ivasovic F. Ventricular pre-excitation in an elderly cat. J Vet Cardiol 2024; 55:15-18. [PMID: 39059142 DOI: 10.1016/j.jvc.2024.06.002] [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: 11/05/2023] [Revised: 06/19/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024]
Abstract
An 18-year-old female neutered Domestic Shorthair cat was referred for investigation of seizure-like episodes. Physical and neurological examination were unremarkable, as were systemic arterial blood pressure, cardiac troponin I, complete blood count and biochemistry profile. Diagnostic tests included transthoracic echocardiography which ruled out any structural cardiomyopathy, and electrocardiography which showed an underlying regular wide QRS-complex rhythm with pronounced shortening of the PR interval. Considering the findings, a diagnosis of suspected ventricular pre-excitation secondary to an accessory pathway was made. Further investigations were declined and, as no periods of tachycardia were seen on the five-minute electrocardiogram, no antiarrhythmic treatment was started.
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Affiliation(s)
- G P Sala
- The University of Glasgow Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, 464 Bearsden Road, Glasgow G61 1QH, United Kingdom
| | - P Wotton
- The University of Glasgow Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, 464 Bearsden Road, Glasgow G61 1QH, United Kingdom
| | - F Ivasovic
- The University of Glasgow Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, 464 Bearsden Road, Glasgow G61 1QH, United Kingdom.
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Melis C, Beijerink N, Santilli R. Spontaneous pre-excited supraventricular tachycardias in a Labrador Retriever. J Vet Cardiol 2024; 54:57-62. [PMID: 39033720 DOI: 10.1016/j.jvc.2024.05.004] [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: 12/10/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 07/23/2024]
Abstract
A four-year-old Labrador Retriever was presented for intermittent tachycardia. The electrocardiogram showed sinus rhythm conducted with ventricular pre-excitation and short runs of orthodromic atrioventricular reciprocating tachycardia. Four months later, the rhythm degenerated into a symptomatic sustained tachycardia, suspected to be pre-excited atrial fibrillation, a potentially life-threatening rhythm in the presence of an accessory pathway with a short refractory period. Two days after initiating oral diltiazem, the dog deteriorated and represented with sustained orthodromic atrioventricular reciprocating tachycardia, which was terminated by a precordial chest thump. It proceeded to sinus rhythm with ventricular pre-excitation followed by an episode of pre-excited focal atrial tachycardia. A bolus of lidocaine IV successfully restored sinus rhythm and sotalol treatment was started. The dog clinically recovered but died spontaneously 24 h later. This is the first case report that describes spontaneous pre-excited focal atrial tachycardia.
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Affiliation(s)
- C Melis
- Veterinaire Specialisten, Reutseplein 3, Vught, 5264 PN, the Netherlands.
| | - N Beijerink
- Veterinaire Specialisten, Reutseplein 3, Vught, 5264 PN, the Netherlands
| | - R Santilli
- Clinica Veterinaria Malpensa, Viale Marconi, 27, 21017, Samarate, VA, Italy; College of Veterinary Medicine, Cornell University, 930 Campus Road, 14853, Ithaca, NY, USA
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Romito G, Gemma N, Dondi F, Mazzoldi C, Fasoli S, Cipone M. Efficacy and safety of antiarrhythmic therapy in dogs with naturally acquired tachyarrhythmias treated with amiodarone or sotalol: a retrospective analysis of 64 cases. J Vet Cardiol 2024; 53:20-35. [PMID: 38608438 DOI: 10.1016/j.jvc.2024.03.002] [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: 07/22/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION/OBJECTIVE Studies on the use of amiodarone or sotalol are limited in dogs. Therefore, this study aimed to provide data on the efficacy and safety of these drugs in dogs with ventricular tachyarrhythmia (VT) and/or supraventricular tachyarrhythmia (SvT). ANIMALS, MATERIALS, AND METHODS Dogs with VT and/or SvT treated with amiodarone or sotalol as a first-line therapy were retrospectively evaluated. Signalment, clinical, diagnostic, therapeutic, and outcome data were retrieved. For VT, efficacy was demonstrated through a decrease of the Lown-Wolf grade to less than five or a reduction of at least 85% in the number of ventricular premature complexes observed on Holter monitoring. For SvT, efficacy was represented by cardioversion or a reduction in the mean heart rate on Holter monitoring ≤140 beats/min. Treatment-related side effects (TRSEs) were classified as clinically relevant and irrelevant. Statistical analysis was performed to compare data before and after antiarrhythmic prescription. RESULTS Sixty-four dogs were included. Amiodarone and sotalol were efficacious in treating both VT (85.7% and 90.0% of cases, respectively) and SvT (75% and 71.4% of cases, respectively). No significant differences were found when comparing their efficacy rates in dogs with VT and SvT (P=0.531 and 0.483, respectively). Clinically relevant TRSEs were rare with both amiodarone and sotalol (8.3% and 5% of cases, respectively), while clinically irrelevant TRSEs occurred more frequently with amiodarone (29.2%) than with sotalol (10%). DISCUSSION In dogs with tachyarrhythmias, amiodarone and sotalol are generally efficacious and safe, as clinically relevant TRSEs seem rare. CONCLUSIONS This study provides novel data on the effects of amiodarone and sotalol in dogs with tachyarrhythmias.
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Affiliation(s)
- G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy.
| | - N Gemma
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - F Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - C Mazzoldi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - S Fasoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - M Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
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Hellemans A, Duytschaever M, Van Steenkiste G, van Loon G, Bosmans T, Mampaey G, Smets P. Successful high-resolution three-dimensional electroanatomical mapping and radiofrequency catheter ablation of a posteroseptal accessory pathway in a dog using CARTO 3. J Vet Cardiol 2023; 51:207-213. [PMID: 38198978 DOI: 10.1016/j.jvc.2023.12.002] [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: 08/21/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
A one-year-and-seven-month-old, 28 kg, male castrated crossbreed dog was presented for supraventricular tachycardia causing recurrent episodes of anorexia and lethargy. Sotalol (2.2 mg/kg q12 h) reduced the frequency of symptomatic episodes but did not provide full relief. Three-dimensional electroanatomical mapping was performed at the Ghent University Small Animal Teaching hospital using the CARTO 3. Right atrial activation mapping identified the earliest atrial activation right posteroseptal, near the tricuspid annulus. Fast retrograde ventriculoatrial conduction during tachycardia and extrastimulus testing confirmed the presence of a concealed right posteroseptal accessory pathway. Six radiofrequency catheter ablation applications were delivered, and tachycardia remained uninducible. The dog recovered well from the procedure. Sotalol was stopped three weeks later, and no more clinical signs were noted by the owner. Repeated 24-hour electrocardiography monitoring on day one and at 1, 3, and 12 months after the procedure showed no recurrence of tachycardia.
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Affiliation(s)
- A Hellemans
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - M Duytschaever
- Department of Cardiology, AZ Sint-Jan Brugge, Ruddershove 10, 8000 Brugge, Belgium
| | - G Van Steenkiste
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - G van Loon
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - T Bosmans
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - G Mampaey
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - P Smets
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Battaia S, Perego M, Cavallini D, Santilli R. Localization and characterization of atrial depolarization waves on the surface electrocardiogram in dogs with rapid supraventricular tachycardia. J Vet Intern Med 2023; 37:1992-2002. [PMID: 37715347 PMCID: PMC10658594 DOI: 10.1111/jvim.16845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Supraventricular tachycardias (SVTs), despite having various anatomical substrates and pathophysiological mechanisms, frequently show similar electrocardiographic presentations. OBJECTIVES To locate and characterize atrial deflections (ADs) on 12-lead electrocardiograms in dogs with sustained rapid SVT and assess the utility of different electrocardiographic variables in differentiating types of tachycardia. ANIMALS Ninety-two dogs with orthodromic atrioventricular reciprocating tachycardia, 17 with atrial flutter, 33 with focal atrial tachycardia recorded and confirmed by electrophysiological study, and 40 dogs with sinus tachycardia. METHODS Atrial deflection position on the 12-lead surface electrocardiogram was assessed according to the sequence of intracardiac activation. Its features were evaluated together with the relationship between AD and QRS complex interval (AD-R) and QRS complex and AD interval (R-AD). RESULTS Orthodromic atrioventricular reciprocating tachycardia was characterized by an AD-AD interval of 213 ± 30 ms, mean electrical axis (MEA) of AD of -90 (-90/-78)°, R-AD interval of 75 (65-80) ms, and R-AD/AD-R of 0.54 (0.45-0.64). Atrial flutter was characterized by an AD-AD interval of 199 ± 57 ms, MEA of 76° (72/81), R-AD of 120 (72-144) ms, and R-AD/AD-R of 0.81 (0.63-1.13). Focal atrial tachycardia was characterized by an AD-AD interval of 270 ± 38 ms, MEA of 49 (-72/76)°, R-AD of 160 (120-200) ms, and R-AD/AD-R of 1.45 (0.92-1.67). Sinus tachycardia was characterized by an AD-AD interval of 292 ± 31 ms, MEA of 66° (52/73), R-AD of 215 (192-222) ms, and R-AD/AD-R of 2.68 (2.25-3.08). CONCLUSIONS AND CLINICAL IMPORTANCE Analyzing AD on 12-lead electrocardiogram is helpful in differentiating the most common SVTs in dogs.
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Affiliation(s)
- Stefano Battaia
- Clinica Veterinaria Malpensa, AniCuraSamarateVareseItaly
- Ospedale Veterinario I Portoni Rossi, AniCuraBolognaZola PredosaItaly
| | - Manuela Perego
- Clinica Veterinaria Malpensa, AniCuraSamarateVareseItaly
- Ospedale Veterinario I Portoni Rossi, AniCuraBolognaZola PredosaItaly
| | - Damiano Cavallini
- Department of Veterinary Medical SciencesUniversity of BolognaBolognaOzzano dell'EmiliaItaly
| | - Roberto Santilli
- Clinica Veterinaria Malpensa, AniCuraSamarateVareseItaly
- Department of Clinical Sciences, College of Veterinary MedicineCornell UniversityIthacaNew YorkUSA
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Hsue W, Gagnon AL. Treating Stubborn Cardiac Arrhythmias-Looking Toward the Future. Vet Clin North Am Small Anim Pract 2023; 53:1415-1428. [PMID: 37541824 DOI: 10.1016/j.cvsm.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
As animals can develop significant side effects or remain refractory while on antiarrhythmic medical therapy for tachyarrhythmias, interventional therapies are progressively being explored. This review will highlight the principles and utilities of implantable cardioverter-defibrillators, electrophysiological mapping and catheter ablation, three-dimensional electroanatomical mapping, and stereotactic arrhythmia radiotherapy. In particular, three-dimensional electroanatomical mapping is emerging as an adjunct electrophysiology tool to facilitate activation, substrate, and pace mapping for intuitive analysis of complex tachyarrhythmias. Unlike antiarrhythmic medications, these modalities offer potential for decreasing risk of sudden death and even permanent termination of tachyarrhythmias.
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Affiliation(s)
- Weihow Hsue
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, 930 Campus Road, Ithaca, NY 14853, USA.
| | - Allison L Gagnon
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California - Davis, One Shields Avenue, Davis, CA 95616, USA.
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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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Sidler M, Santarelli G, Kovacevic A, Novo Matos J, Schreiber N, Baron Toaldo M. Ventricular pre-excitation in cats: 17 cases. J Vet Cardiol 2023; 47:70-82. [PMID: 37267820 DOI: 10.1016/j.jvc.2023.04.005] [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: 07/07/2022] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Atrioventricular accessory pathways are abnormal electrical connections between the atria and ventricles that predispose to ventricular pre-excitation (VPE) and tachycardias. ANIMALS Seventeen cats with VPE and 15 healthy matched-control cats. MATERIAL AND METHODS Multicenter case-control retrospective study. Clinical records were searched for cats with VPE, defined as preserved atrioventricular synchrony, reduced PQ interval, and increased QRS complex duration with a delta wave. Clinical, electrocardiography, echocardiographic, and outcome data were collated. RESULTS Most cats with VPE were male (16/17 cats), non-pedigree cats (11/17 cats). Median age and mean body weight were 5.4 years (0.3-11.9 years) and 4.6 ± 0.8 kg, respectively. Clinical signs at presentation included lethargy (10/17 cats), tachypnea (6/17 cats), and/or syncope (3/17 cats). In two cats, VPE was an incidental finding. Congestive heart failure was uncommon (3/17 cats). Nine (9/17) cats had tachyarrhythmias: 7/9 cats had narrow QRS complex tachycardia and 2/9 cats had wide QRS complex tachycardia. Four cats had ventricular arrhythmias. Cats with VPE had larger left (P < 0.001) and right (P < 0.001) atria and thicker interventricular septum (P = 0.019) and left ventricular free wall (P = 0.028) than controls. Three cats had hypertrophic cardiomyopathy. Treatment included different combinations of sotalol (5/17 cats), diltiazem (5/17 cats), atenolol (4/17 cats), furosemide (4/17 cats), and platelet inhibitors (4/17 cats). Five cats died, all from cardiac death (median survival time 1882 days [2-1882 days]). CONCLUSIONS Cats with VPE had a relatively long survival, albeit showing larger atria and thicker left ventricular walls than healthy cats.
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Affiliation(s)
- M Sidler
- Division of Cardiology, Clinic for Small Animal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - G Santarelli
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Utrecht, the Netherlands
| | - A Kovacevic
- Division of Small Animal Cardiology, Department of Veterinary Clinical Medicine, Vetsuisse Faculty, University of Bern, Switzerland
| | - J Novo Matos
- Queen's Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, UK
| | - N Schreiber
- Division of Cardiology, Clinic for Small Animal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland.
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Buschmann E, Van Steenkiste G, Boussy T, Vernemmen I, Schauvliege S, Decloedt A, van Loon G. Three-dimensional electro-anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: A case report. J Vet Intern Med 2023; 37:728-734. [PMID: 36866668 PMCID: PMC10061177 DOI: 10.1111/jvim.16668] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 02/07/2023] [Indexed: 03/04/2023] Open
Abstract
We describe the diagnosis and treatment of an atrioventricular accessory pathway (AP) in a horse using 3-dimensional electro-anatomical mapping (3D EAM) and radiofrequency catheter ablation (RFCA). During routine evaluation of the horse, intermittent ventricular pre-excitation was identified on the ECG, characterized by a short PQ interval and abnormal QRS morphology. A right cranial location of the AP was suspected from the 12-lead ECG and vectorcardiography. After precise localization of the AP using 3D EAM, ablation was performed and AP conduction was eliminated. Immediately after recovery from anesthesia an occasional pre-excited complex still was observed, but a 24-hour ECG and an ECG during exercise 1 and 6 weeks after the procedure showed complete disappearance of pre-excitation. This case shows the feasibility of 3D EAM and RFCA to identify and treat an AP in horses.
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Affiliation(s)
- Eva Buschmann
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Glenn Van Steenkiste
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Tim Boussy
- Department of CardiologyAZ GroeningeKortrijkBelgium
| | - Ingrid Vernemmen
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Stijn Schauvliege
- Department of Large Animal Surgery, and Anaesthesia and Orthopaedics, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Annelies Decloedt
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Gunther van Loon
- Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
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Aoki T, Niimi S. Two cases of new-born puppies with transient pulmonary edema. VETERINARY RESEARCH FORUM : AN INTERNATIONAL QUARTERLY JOURNAL 2023; 14:237-241. [PMID: 37181856 PMCID: PMC10170463 DOI: 10.30466/vrf.2022.546719.3349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/01/2022] [Indexed: 05/16/2023]
Abstract
Acute pulmonary edema in puppies generally occurs due to congenital left-right shunts such as patent ductus arteriosus or large ventricular septal defects. Herein, we presented two cases of puppies with no apparent congenital cardiovascular disease. Case 1: A 12-day-old male Labrador Retriever, weighing 1.15 kg, was unable to suckle sufficiently from its dam and exhibited laboured breathing. Pulmonary edema was identified in all lung lobes by radiography, furthermore, echocardiography revealed significant enlargement of the left side of the heart. Pulmonary edema secondary to volume overload was suspected and furosemide was administered. The respiratory status was improved on the following day. Pimobendan was administered orally in addition to furosemide and both were withdrawn 6 weeks later when the heart size was normalized. Case 2: A 15-day-old female Standard Poodle, weighing 0.68 kg, was less active than other littermates and exhibited laboured breathing. Radiography revealed pulmonary edema in the right posterior lobe, dilatation of the caudal vena cava and ascites. Echocardiography revealed significant enlargement of the left atrium and ventricle perhaps owing to decreased left ventricular contractility. Furosemide and pimobendan were administered. One week later, appetite was improved and supraventricular tachycardia of 375 bpm was observed. Therefore, tachycardia-induced dilated cardiomyopathy was suspected which returned to sinus rhythm with diltiazem treatment, however, it was recurred. Upon sotalol monotherapy, a normal heart size was observed seven months later. In conclusion, we encountered two new-born puppies with transient pulmonary edema that were temporarily treated with pimobendan and furosemide.
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Affiliation(s)
- Takuma Aoki
- Correspondence Takuma Aoki. DVM, PhD Department of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan E-mail:
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Regada SF, Silva J, Matos JN. ECG of the Month. J Am Vet Med Assoc 2022; 260:1-3. [PMID: 35507512 DOI: 10.2460/javma.21.07.0329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sandra F Regada
- 1Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Joel Silva
- 1Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.,2North Downs Specialists Referrals, Surrey, United Kingdom
| | - Jose Novo Matos
- 1Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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Sanford JK, Morgan KRS, Stauthammer CD. ECG of the Month. J Am Vet Med Assoc 2022; 260:1-3. [PMID: 35417406 DOI: 10.2460/javma.20.07.0399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jordan K Sanford
- 1Cardiology Department, Veterinary Medical Center, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN.,2Animal Medical Center, New York, NY
| | - Keaton R S Morgan
- 1Cardiology Department, Veterinary Medical Center, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN
| | - Christopher D Stauthammer
- 1Cardiology Department, Veterinary Medical Center, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN
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Crooks AV, Hsue W, Tschabrunn CM, Gelzer AR. Feasibility of electroanatomic mapping and radiofrequency catheter ablation in Boxer dogs with symptomatic ventricular tachycardia. J Vet Intern Med 2022; 36:886-896. [PMID: 35307868 PMCID: PMC9151449 DOI: 10.1111/jvim.16412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022] Open
Abstract
Background Treatment for Boxers with ventricular tachycardia (VT) is limited. Electroanatomic mapping (EAM) facilitates identification of arrhythmogenic substrate for radiofrequency catheter ablation (RFCA). Objective Describe the use of EAM to guide RFCA in Boxers with VT. Animals Five client‐owned Boxers with symptomatic VT or persistent VT despite antiarrhythmic medications. Methods Case series evaluating clinical, EAM, and before and after RFCA Holter data. Results Sustained VT was inducible in 3 dogs, but required aggressive stimulation protocols. Low‐voltage areas consistent with electroanatomic scar were found in 2 dogs, located at the right ventricular (RV) outflow tract and cranial RV. Two dogs had a focal activation pattern of VT and 1 dog had a reentrant mechanism. After RFCA, all dogs no longer collapsed and had fewer runs of VT, 3 of which had 0 runs of VT. Number of ventricular premature beats increased in 3 dogs and decreased in 2 dogs, 1 of which had nearly complete resolution of all arrhythmias. Procedural complications included ventricular fibrillation (n = 2) with successful defibrillation, bruising or hemorrhage at the vascular access site (n = 4), retroperitoneal hemorrhage (n = 1), aortic and mitral regurgitation (n = 1), onset of frequent supraventricular tachycardia (n = 1), and persistent right pelvic limb lameness (n = 1). Conclusions and Clinical Importance Electroanatomic mapping and RFCA are feasible in Boxers with VT. Based on this small cohort, RFCA may help decrease runs of VT and improve clinical signs. The anatomic substrate and electrophysiologic mechanisms are variable and require further study.
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Affiliation(s)
- Alexandra V. Crooks
- Department of Clinical Sciences and Advanced Medicine School of Veterinary Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | - Weihow Hsue
- Department of Clinical Sciences and Advanced Medicine School of Veterinary Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
- Cardiac Electrophysiology Section, Division of Cardiovascular Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA
| | - Cory M. Tschabrunn
- Cardiac Electrophysiology Section, Division of Cardiovascular Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA
| | - Anna R. Gelzer
- Department of Clinical Sciences and Advanced Medicine School of Veterinary Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
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Phillips V, Schauvliege S, Decloedt A, Van Steenkiste G, van Loon G. Anaesthetic management for cardiac 3D electro‐anatomical mapping and radiofrequency catheter ablation in a horse with sustained atrial tachycardia. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Victoria Phillips
- Willows Veterinary Centre and Referral Service Highlands Road Shirley UK
- Department of Surgery and Anaesthesia of Domestic Animals Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - Stijn Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - Annelies Decloedt
- Equine Cardioteam Department of Large Animal Internal Medicine Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - Glenn Van Steenkiste
- Equine Cardioteam Department of Large Animal Internal Medicine Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - Gunther van Loon
- Equine Cardioteam Department of Large Animal Internal Medicine Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
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Miralles‐Plaza I, McDonald HR. Cardioversion of supraventricular tachycardia in a cat with suspected Wolff–Parkinson–White syndrome in the absence of structural cardiac disease. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Three-dimensional electroanatomic mapping and radiofrequency catheter ablation of ventricular arrhythmia in a dog without structural heart disease. J Vet Cardiol 2021; 39:14-21. [PMID: 34923431 DOI: 10.1016/j.jvc.2021.11.001] [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: 07/10/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/22/2022]
Abstract
A 1.5-year-old, female-spayed mix-breed dog was presented with recurrent episodes of shaking and excessive panting attributed to drug-refractory ventricular arrhythmia (VA) characterized predominantly by incessant periods of ventricular bigeminy. The VA had a narrow QRS morphology, suggestive of an origin near the His bundle or fascicular system. Diagnostic evaluation found no structural heart disease or underlying etiology. Three-dimensional electroanatomic mapping and radiofrequency catheter ablation were pursued. Voltage mapping demonstrated normal bi-ventricular voltage (≥1.5 mV) without any fractionated or multicomponent electrograms, indicating the absence of ventricular myocardial scar. Pace mapping identified an endocardial origin of the VA at the basal anterior septum of the left ventricle, distal to the His bundle and near the left bundle branch. Two ablation lesions were delivered to this site, and a left bundle branch block was temporarily induced. The dog recovered uneventfully. One month later, the owners reported a remarkable improvement in clinical signs, and follow-up 48-h Holter monitor found complete resolution of VA.
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Vila BDCP, da Costa BN, Calderón Olaguivel KL, Dos Santos JP, de Oliveira ST, Duque Moreno JC, Sousa MG. ECG of the Month. J Am Vet Med Assoc 2021; 259:732-735. [PMID: 34516258 DOI: 10.2460/javma.259.7.732] [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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Brugada-Terradellas C, Hellemans A, Brugada P, Smets P. Sudden cardiac death: A comparative review of humans, dogs and cats. Vet J 2021; 274:105696. [PMID: 34148018 DOI: 10.1016/j.tvjl.2021.105696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 01/14/2023]
Abstract
Sudden death is one of the most common causes of death in humans in Western countries. Approximately 85% of these cases are of cardiac origin. In dogs and cats, sudden cardiac death (SCD) also commonly occurs, but fewer pathophysiological and prevalence data are available. Both structural, primarily 'electrical' and ischemic heart diseases are known to cause SCD, many of which share similar underlying arrhythmogenic mechanisms between humans and companion animals. As for underlying genetics, numerous mutations on multiple loci have been related to SCD in humans, but only a few mutations associated with dilated cardiomyopathy and SCD have been identified in dogs, e.g. in the phospholamban and titin genes. Information published from human medicine can therefore inform future veterinary studies, but also dogs and cats could act as spontaneous models of SCD in humans. Further research in both fields is therefore warranted to better understand the pathophysiology, genetics, and prevention of SCD.
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Affiliation(s)
- Celine Brugada-Terradellas
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - Arnaut Hellemans
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Pedro Brugada
- Pedro Brugada, Cardiovascular Division, UZ Brussel - VUB, Avenue du Laerbeek 101, 1090 Brussels, Belgium
| | - Pascale Smets
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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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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Cecchi F, Vezzosi T, Branchi G, Barsotti G, Macchioni F. Inbreeding and health problems prevalence in a colony of guide dogs: A cohort of 40 Labrador Retrievers. ACTA AGR SCAND A-AN 2020. [DOI: 10.1080/09064702.2020.1759679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- F. Cecchi
- Department of Veterinary Science, University of Pisa, Pisa, Italy
| | - T. Vezzosi
- Department of Veterinary Science, University of Pisa, Pisa, Italy
| | - G. Branchi
- Department of Veterinary Science, University of Pisa, Pisa, Italy
| | - G. Barsotti
- Department of Veterinary Science, University of Pisa, Pisa, Italy
| | - F. Macchioni
- Department of Veterinary Science, University of Pisa, Pisa, Italy
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Wright KN, Nguyenba T, Irvin HM. Lidocaine for chemical cardioversion of orthodromic atrioventricular reciprocating tachycardia in dogs. J Vet Intern Med 2019; 33:1585-1592. [PMID: 31222803 PMCID: PMC6639483 DOI: 10.1111/jvim.15546] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/28/2019] [Indexed: 11/27/2022] Open
Abstract
Background Typical atrioventricular accessory pathways (APs) are composed of myocardial cells. They provide electrical connections between atria and ventricles separate from the normal conduction system. Accessory pathways can participate in a macroreentrant circuit resulting in orthodromic atrioventricular reciprocating tachycardia (OAVRT). Hypothesis Because of ultrastructural similarities of typical AP cells to ventricular myocardial cells, we hypothesized lidocaine would be effective in blocking AP conduction, thus terminating OAVRT. Animals Thirty‐two consecutive client‐owned dogs presenting with narrow complex tachyarrhythmias were confirmed to have OAVRT by electrophysiologic study (EPS). Methods Prospective, nonrandomized, single‐arm study with lidocaine administered IV to dogs during OAVRT in 2 mg/kg boluses to a cumulative dose of 8 mg/kg or development of adverse effects. Electrocardiograms were monitored continuously. Subsequent EPS was performed to confirm OAVRT and the absence of other tachycardia mechanisms. Results Twenty‐seven dogs experienced OAVRT cardioversion with lidocaine, before or at the time of adverse effects. Orthodromic atrioventricular reciprocating tachycardia in 5 dogs did not cardiovert before adverse effects, precluding additional dosing. Median total lidocaine dose for cardioversion was 2 mg/kg (interquartile range, 2‐5.5 mg/kg). Dogs with right free wall APs had a significantly higher rate of cardioversion than did dogs with right posteroseptal APs. Conclusions and Clinical Importance Lidocaine successfully cardioverted OAVRT in 84.4% of dogs in our study before adverse effects precluded additional dosing. In 5 dogs with dose limited by adverse effects, it is unknown whether cardioversion would have occurred at a higher cumulative dose.
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Affiliation(s)
- Kathy N Wright
- Department of Cardiology, MedVet Medical and Cancer Centers for Pets, Cincinnati, Ohio
| | - Thaibinh Nguyenba
- Department of Cardiology, MedVet Medical and Cancer Centers for Pets, Worthington, Ohio
| | - Holly M Irvin
- Department of Cardiology, MedVet Medical and Cancer Centers for Pets, Cincinnati, Ohio
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Romito G, Summerfield N, Baron Toaldo M. Preexcitation alternans in a dog. J Vet Cardiol 2019; 24:1-6. [PMID: 31405550 DOI: 10.1016/j.jvc.2019.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/10/2019] [Accepted: 04/01/2019] [Indexed: 10/27/2022]
Abstract
Preexcitation alternans and orthodromic atrioventricular reciprocating tachycardia were diagnosed in a 3-month-old Boxer. The images described here show how conventional electrocardiographic techniques (12-lead surface electrocardiography, 24-hour Holter monitoring, and ladder diagram) can be interpreted to gain detailed information on presence of canine atrioventricular accessory pathways and their conduction properties.
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Affiliation(s)
- G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | | | - M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy.
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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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