1
|
Jeong HW, Menciotti G. Insulation break of the ventricular lead in a dog with a pacemaker. J Vet Cardiol 2023; 50:63-68. [PMID: 37931345 DOI: 10.1016/j.jvc.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 11/08/2023]
Abstract
A 10-year-old female spayed mixed breed dog that had a transvenous pacemaker implanted four years prior was presented for the evaluation of episodes of transient loss of consciousness without any history of trauma that were unresponsive to anticonvulsant therapies. Intermittent failure to capture coupled with low impedance and high capture threshold were noted upon interrogation of the pacemaker. Radiography and fluoroscopy demonstrated a possible break in the insulation of the lead. After the placement of another transvenous pacemaker, the dog had no additional syncopal episodes, and anticonvulsants were tapered off. The dog developed an implant infection from the newly placed pacemaker, which prompted the removal of the infected pacemaker and the implantation of an epicardial pacemaker. However, the epicardial lead dislodged seven days after placement, and the dog was euthanized. During necropsy, the first transvenous lead was removed, and the insulation break was visually confirmed. Although an insulation break is a rare delayed complication of pacemaker implantation, this report shows how the diagnosis, suspected by typical interrogation findings, can be aided by radiographic and fluoroscopic investigations.
Collapse
Affiliation(s)
- H W Jeong
- Department Small Animal Clinical Science, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA, USA.
| | - G Menciotti
- Department Small Animal Clinical Science, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| |
Collapse
|
2
|
Köster LS, Zhu X, Smith CK, Aisa J. Single center retrospective clinical audit and comparison of outcome between epicardial and transvenous endocardial permanent pacemaker implantations in dogs. PLoS One 2023; 18:e0290029. [PMID: 38015932 PMCID: PMC10683988 DOI: 10.1371/journal.pone.0290029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/01/2023] [Indexed: 11/30/2023] Open
Abstract
The aim of this retrospective cohort study was to provide a single-center clinical audit of complications for single chamber permanent pacemaker implantation (PPI) techniques and determine if the clinical parameters, PPI technique or complications were associated with outcome. The electronic medical records were searched for dogs treated for bradyarrhythmia with PPI. Data related to presenting complaint, signalment of the dog, ECG diagnosis, echocardiographic findings, PPI technique, and programing of the pacemaker were recorded. Survival length (days) was recorded as the last veterinary visit; if the dog was dead the reason was documented. Cumulative survival of each pacemaker was examined by a Kaplan-Meier survival curve and the two techniques compared with a logrank test. Chi-square was used to determine the association between major complications and death. A total of 66 dogs with 52 transvenous and 30 epicardial PPIs were included. All epicardial pacemakers were implanted via transdiaphragmatic approach. A total of 31 life-threatening complications were reported. There were nine deaths related to major complications (13.6% of the study sample). The median follow-up period was 366 days, with a median survival of 255 days, and a significant difference in cumulative survival of each pacemaker (P = 0.01) between epicardial (93 days, range 0-1882 days) and transvenous (334 days, range 0-2745) PPIs but no significant difference in cumulative survival between the two techniques when only the first pacemaker was considered (p = 0.07). The presence of a major complications had a significant association with death due to pacemaker complications (P<0.001). The decision to perform epicardial PPI in failed transvenous PPI patients may have skewed the cumulative survival as was evident in the lack of significant difference in survival when only first PPI were examined. Major complication rates between the two techniques were similar and the authors consider both techniques equally reliable to manage symptomatic bradycardia in dogs.
Collapse
Affiliation(s)
- Liza S. Köster
- Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, United States of America
| | - Xiaojuan Zhu
- Office of Information Technology, University of Tennessee, Knoxville, TN, United States of America
| | - Christopher K. Smith
- Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, United States of America
| | - Josep Aisa
- Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, United States of America
| |
Collapse
|
3
|
McGrath C, Dixon A, Hirst C, Bode EF, DeFrancesco T, Fries R, Gordon S, Hogan D, Martinez Pereira Y, Mederska E, Ostenkamp S, Sykes KT, Vitt J, Wesselowski S, Payne JR. Pacemaker-lead-associated thrombosis in dogs: a multicenter retrospective study. J Vet Cardiol 2023; 49:9-28. [PMID: 37541127 DOI: 10.1016/j.jvc.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 06/18/2023] [Accepted: 06/25/2023] [Indexed: 08/06/2023]
Abstract
INTRODUCTION Pacemaker implantation is the treatment of choice for clinically relevant bradyarrhythmias. Pacemaker-lead-associated thrombosis (PLAT) occurs in 23.0-45.0% of people with permanent transvenous pacemakers. Serious thromboembolic complications are reported in 0.6-3.5%. The incidence of PLAT in dogs is unknown. ANIMALS, MATERIALS AND METHODS multicenter retrospective study of seven centers with 606 client-owned dogs undergoing permanent pacemaker implantation between 2012 and 2019. 260 dogs with a transvenous pacemaker with echocardiographic follow-up, 268 dogs with a transvenous pacemaker without echocardiographic follow-up and 78 dogs with an epicardial pacemaker. RESULTS 10.4% (27/260) of dogs with transvenous pacemakers and echocardiographic follow-up had PLAT identified. The median time to diagnosis was 175 days (6-1853 days). Pacemaker-lead-associated thrombosis was an incidental finding in 15/27 (55.6%) dogs. Of dogs with a urine protein:creatinine ratio measured at pacemaker implantation, dogs with PLAT were more likely to have proteinuria at pacemaker implantation vs. dogs without PLAT (6/6 (100.0%) vs. 21/52 (40.4%), P=0.007). Urine protein:creatinine ratio was measured in 12/27 (44.4%) dogs at PLAT diagnosis, with proteinuria identified in 10/12 (83.3%) dogs. Anti-thrombotic drugs were used following the identification of PLAT in 22/27 (81.5%) dogs. The thrombus resolved in 9/15 (60.0%) dogs in which follow-up echocardiography was performed. Dogs with PLAT had shorter survival times from implantation compared to those without PLAT (677 days [9-1988 days] vs. 1105 days [1-2661 days], P=0.003). CONCLUSIONS Pacemaker-lead-associated thrombosis is identified in 10.4% (27/260) of dogs following transvenous pacing, is associated with proteinuria, can cause significant morbidity, and is associated with reduced survival times.
Collapse
Affiliation(s)
- C McGrath
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford House, Langford, Bristol, BS40 5DU, United Kingdom
| | - A Dixon
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford House, Langford, Bristol, BS40 5DU, United Kingdom
| | - C Hirst
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford House, Langford, Bristol, BS40 5DU, United Kingdom
| | - E F Bode
- Small Animal Teaching Hospital, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Wirral, CH64 7TE, United Kingdom
| | - T DeFrancesco
- College of Veterinary Medicine, North Carolina State Veterinary Hospital, 1052 William Moore Dr., Raleigh, NC, 27607, USA
| | - R Fries
- University of Illinois Veterinary Teaching Hospital, 1008 W Hazelwood Dr., Urbana, IL, 61802, USA
| | - S Gordon
- Texas A&M University Veterinary Medical Teaching Hospital, 408 Raymond Stotzer Pkwy, College Station, TX, 77845, USA
| | - D Hogan
- Purdue University Small Animal Hospital, West Lafayette, Indiana LYNN, 625 Harrison St., West Lafayette, IN, 47907, USA
| | - Y Martinez Pereira
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG, United Kingdom
| | - E Mederska
- Small Animal Teaching Hospital, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Wirral, CH64 7TE, United Kingdom
| | - S Ostenkamp
- Purdue University Small Animal Hospital, West Lafayette, Indiana LYNN, 625 Harrison St., West Lafayette, IN, 47907, USA
| | - K T Sykes
- Texas A&M University Veterinary Medical Teaching Hospital, 408 Raymond Stotzer Pkwy, College Station, TX, 77845, USA
| | - J Vitt
- University of Illinois Veterinary Teaching Hospital, 1008 W Hazelwood Dr., Urbana, IL, 61802, USA
| | - S Wesselowski
- Texas A&M University Veterinary Medical Teaching Hospital, 408 Raymond Stotzer Pkwy, College Station, TX, 77845, USA
| | - J R Payne
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford House, Langford, Bristol, BS40 5DU, United Kingdom.
| |
Collapse
|
4
|
Pires A, Raheb S, Monteith G, Colpitts ME, Chong A, O'Sullivan ML, Fonfara S. Heart rate distribution in dogs with third degree atrioventricular block and rate responsive pacemakers. J Vet Cardiol 2022; 43:70-80. [PMID: 36044810 DOI: 10.1016/j.jvc.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION In dogs, single lead ventricular pacing, ventricular sensing, inhibition response, rate adaptive (VVIR) pacemakers are routinely used to treat third degree atrioventricular block. The objectives of this study were to investigate the heart rate distribution in dogs with VVIR pacemakers, and report changes when activity settings were adjusted. ANIMALS Eighteen client-owned dogs with VVIR pacemakers for third degree atrioventricular block. MATERIALS AND METHODS This observational study consisted of a review of medical records of dogs with VVIR pacemakers. For dogs with >50% of paced beats at the lower pacing rate, the activity daily living (ADL) and exertion responses were increased. Re-evaluations were performed after 6-12 months. RESULTS Heart rate distribution similar to healthy dogs was absent for all dogs. In nine dogs, the ADL and exertion responses were increased to the highest level. Of these, three dogs showed no improvement in heart rate distribution; for two dogs, one with an epicardial pacemaker, several activity settings were adjusted and pacing at higher heart rates was observed at re-evaluation. Four dogs died or were lost to follow-up. Clinical signs had resolved for all dogs after pacemaker implantation. CONCLUSION Default activity settings of VVIR pacemakers do not result in heart rate distribution equivalent to healthy dogs. Increasing the ADL and exertion response settings to the highest levels did not improve the pacemaker rate response. Further investigations into the role of dog size, generator positioning, pacemaker settings, and whether rate responsiveness is required for dogs' quality and quantity of life are warranted.
Collapse
Affiliation(s)
- A Pires
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - S Raheb
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - G Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - M E Colpitts
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - A Chong
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - M L O'Sullivan
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, 550 University Ave, Charlottetown, Prince Edward Island, C1A 4P3, Canada
| | - S Fonfara
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| |
Collapse
|
5
|
de Carellán Mateo AG, Casamián-Sorrosal D. The perioperative management of small animals with previously implanted pacemakers undergoing anaesthesia. Vet Anaesth Analg 2021; 49:7-17. [PMID: 34916163 DOI: 10.1016/j.vaa.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/26/2020] [Accepted: 05/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE There is little information in the veterinary literature about the perioperative management of small animal patients with previously implanted pacemakers undergoing elective or emergency non-cardiac procedures. The purpose of this article is to review the current literature with regard to human patients, with previously implanted pacemakers, undergoing general anaesthesia. Using this and the current information on pacemakers and anaesthesia in dogs and cats, we provide recommendations for small animal patients in this situation. DATABASES USED Google Scholar, PubMed and CAB Abstracts using and interlinking and narrowing the search terms: "dog", "cat", "small animals", "anaesthesia", "pacemaker", "perioperative", "transvenous pacing", "temporary pacing". Scientific reports and human and small animal studies from the reference lists of the retrieved papers were reviewed. In addition, related human and veterinary cardiology and anaesthesia textbooks were also included to create a narrative review of the subject. CONCLUSIONS The best perioperative care for these animals comes from a multidisciplinary approach involving the anaesthetist, cardiologist, surgeon and intensive care unit team. When such an approach is not feasible, the anaesthetist should be familiar with pacemaker technology and how to avoid perioperative complications such as electromagnetic interference, lead damage and reprogramming of the device. The preanaesthetic assessment should be thorough. Information regarding the indication for pacemaker placement, complications during the procedure, location, type and programming of the pacemaker should be readily available. The anaesthetic management of these veterinary patients aims to preserve cardiovascular function while avoiding hypotension, and backup pacing should be available during the perioperative period. Further prospective studies are needed to describe the best perioperative care in small animals with a previously implanted pacemaker.
Collapse
Affiliation(s)
- Alejandra García de Carellán Mateo
- Anaesthesia and Analgesia Service, Teaching Veterinary Hospital, Department of Animal Medicine and Surgery, School of Veterinary Science, Catholic University of Valencia, Valencia, Spain.
| | - Domingo Casamián-Sorrosal
- Cardiology and Interventional Cardiology Service, Teaching Veterinary Hospital, Department of Animal Medicine and Surgery, School of Veterinary Science, Catholic University of Valencia, Valencia, Spain
| |
Collapse
|
6
|
Frantz EW, Tjostheim SS, Palumbo A, Kellihan HB, Stepien RL. A retrospective evaluation of the indications, complications, and outcomes associated with epicardial pacemakers in 20 cats from a single institution. J Vet Cardiol 2021; 36:89-98. [PMID: 34118563 DOI: 10.1016/j.jvc.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The objective of this retrospective study was to describe the indications, complications, and long-term outcomes in a group of cats that received an epicardial pacing (EP) system. ANIMALS Twenty client-owned cats. MATERIALS AND METHODS Medical records were reviewed for signalment, presenting complaint, primary electrocardiogram (ECG) diagnosis, presence of structural heart disease, presence of congestive heart failure (CHF), presence of major or minor complications, and survival time. RESULTS The majority of cats were presented for syncope (n = 11), and the most common ECG diagnosis was advanced second-degree atrioventricular block (n = 9). Fifteen cats (15/20, 75%) had one or more major or minor complications. One cat died in the perioperative period as a result of a major complication. None of the variables evaluated were associated with a statistically significant increase in the occurrence of major or minor complications. The most common major complication was loss of ventricular capture (seven instances in six cats), which was successfully treated in all cases by increasing pacemaker output or replacing both the lead and the pulse generator. The most common minor complications were arrhythmias (n = 7) and sensing issues (n = 8). The overall median survival time (MST) was 948 days. No statistical difference in survival time was identified between cats that experienced a major complication and those that did not. CONCLUSIONS Although complications were common in this feline population after EP, major and minor complications were successfully treated.
Collapse
Affiliation(s)
- E W Frantz
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA
| | - S S Tjostheim
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA.
| | - A Palumbo
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA
| | - H B Kellihan
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA
| | - R L Stepien
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. Madison, WI 53706, USA
| |
Collapse
|
7
|
Wilkes SE, Biller DS, Ross ES, Berke KA, Thomason JD. What Is Your Diagnosis? J Am Vet Med Assoc 2020; 255:1113-1115. [PMID: 31687901 DOI: 10.2460/javma.255.10.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
8
|
Abstract
Medical devices are defined as implantable if they are intended to remain in the body after the procedure. In veterinary medicine, use of such devices is marginal but may find some indications. Use in exotic pet medicine is even more challenging due to size restriction and the limited data available. This review focuses on the esophageal and tracheal stent in the case of stricture, ureteral stent and subcutaneous ureteral bypass in the case of ureteral obstruction, permanent urinary diversion in the case of bladder atony, and pacemaker in the case of severe arrythmias. Comparative aspects are developed.
Collapse
Affiliation(s)
- Minh Huynh
- Centre Hospitalier Vétérinaire Frégis, 43 Avenue Aristide Briand, Arcueil 94110, France.
| |
Collapse
|
9
|
Lozada Miranda B, Walton R, LeVine DN, Blong A, Ware W, Ward J. Use of rivaroxaban for treatment of cranial vena cava syndrome secondary to transvenous pacemaker lead thrombosis in a dog. J Vet Cardiol 2019; 25:7-13. [PMID: 31437785 DOI: 10.1016/j.jvc.2019.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/02/2019] [Accepted: 07/18/2019] [Indexed: 12/30/2022]
Abstract
A six-year-old Brussels griffon was presented for cervical swelling three months after implantation of a transvenous pacemaker. Transthoracic echocardiography demonstrated a thrombus associated with the pacemaker lead, partially obstructing right atrial inflow. The laboratory findings were consistent with protein-losing nephropathy. Initial medical therapy consisted of rivaroxaban (0.68 mg/kg orally every 24 hours), clopidogrel (2.5 mg/kg orally every 24 hours), and enalapril (0.5 mg/kg orally every 12 hours). Resolution of cervical and thoracic edema was noted within two weeks of initiating therapy. Recheck echocardiography two months and one year later revealed decreasing thrombus size despite worsening proteinuria. To the authors' knowledge, this is the first documented use of rivaroxaban for successful medical treatment of cranial vena cava syndrome caused by intracardiac pacemaker lead thrombosis in a hypercoagulable patient.
Collapse
Affiliation(s)
- B Lozada Miranda
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 S. Riverside Drive, Ames, IA 50011, USA
| | - R Walton
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 S. Riverside Drive, Ames, IA 50011, USA
| | - D N LeVine
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 S. Riverside Drive, Ames, IA 50011, USA
| | - A Blong
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 S. Riverside Drive, Ames, IA 50011, USA
| | - W Ware
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 S. Riverside Drive, Ames, IA 50011, USA
| | - J Ward
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 S. Riverside Drive, Ames, IA 50011, USA.
| |
Collapse
|
10
|
Argenziano MA, Doss MX, Tabler M, Sachinidis A, Antzelevitch C. Transcriptional changes associated with advancing stages of heart failure underlie atrial and ventricular arrhythmogenesis. PLoS One 2019; 14:e0216928. [PMID: 31083689 PMCID: PMC6513089 DOI: 10.1371/journal.pone.0216928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 05/01/2019] [Indexed: 01/14/2023] Open
Abstract
Background Heart failure (HF) is a leading cause of mortality and is associated with cardiac remodeling. Vulnerability to atrial fibrillation (AF) has been shown to be greater in the early stages of HF, whereas ventricular tachycardia/fibrillation develop during late stages. Here, we explore changes in gene expression that underlie the differential development of fibrosis and structural alterations that predispose to atrial and ventricular arrhythmias. Objective To study transcriptomic changes associated with the development of cardiac arrhythmias in early and late stages of heart failure. Methods Dogs were tachy-paced from right ventricle (RV) for 2–3 or 5–6 weeks (early and late HF). We performed transcriptomic analysis of right atria (RA) and RV isolated from control dogs and those in early and late HF. Transcripts with mean relative log2-fold change ≥2 were included in the differential analysis with significance threshold adjusted to p<0.05. Results Early HF remodeling was more prominent in RA with enrichment of extracellular matrix, circulatory system, wound healing and immune response pathways; many of these processes were not present in RA in late HF. RV showed no signs of remodeling in early HF but enrichment of extracellular matrix and wound healing in late HF. Conclusion Our transcriptomic data indicate significant fibrosis-associated transcriptional changes in RA in early HF and in RV in late HF, with strong atrial predominance. These alterations in gene expression are consistent with the development of arrhythmogenesis in atria in early but not late HF and in the ventricle in late but not early HF.
Collapse
Affiliation(s)
- Mariana A. Argenziano
- Children’s Hospital of Philadelphia, Department of Genetics, Philadelphia, Pennsylvania, United States of America
- Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, United States of America
| | - Michael Xavier Doss
- University of Cologne, Institute of Neurophysiology and Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Megan Tabler
- Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, United States of America
| | - Agapios Sachinidis
- University of Cologne, Institute of Neurophysiology and Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Charles Antzelevitch
- Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, United States of America
- Lankenau Heart Institute, Wynnewood, Pennsylvania, United States of America
- Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| |
Collapse
|
11
|
Mathews JS, Coleman AE, Atkins CE. ECG of the Month. J Am Vet Med Assoc 2017; 250:166-168. [PMID: 28058955 DOI: 10.2460/javma.250.2.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
12
|
Oyama MA, Hezzell MJ, Laughlin DS, Thorn CL, Kraus MS, Gelzer AR. Anodal stimulation in two dogs with transvenous permanent bipolar pacemakers. J Vet Cardiol 2016; 18:398-404. [PMID: 27613649 DOI: 10.1016/j.jvc.2016.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/05/2016] [Accepted: 07/24/2016] [Indexed: 11/20/2022]
Abstract
Management of symptomatic bradyarrhythmias such as complete atrioventricular block often involves permanent implantation of a transvenous pacemaker. Both during and after implantation, the operator can telemetrically assess and adjust a variety of electrical parameters associated with the pacemaker function in order to optimize the sensitivity, reliability, and power consumption of the device. Herein, we report an unexpected change in the paced electrocardiographic QRS complex morphology in two dogs undergoing bipolar pacing associated with changes in the pacemaker output amplitude settings first detected during threshold testing. The exclusivity of the electrocardiographic changes solely on pacemaker output settings, consistency between the surface electrocardiogram and ventricular endocardial electrogram, and resolution of this phenomenon when dogs were re-programmed to unipolar pacing is consistent with depolarization of the ventricular myocardium by the anodal electrode of the pacing lead at high pacemaker amplitudes. Anodal stimulation is a potential cause of varying QRS complex morphology witnessed during pacemaker evaluation and interrogation.
Collapse
Affiliation(s)
- M A Oyama
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, PA 19104, USA.
| | - M J Hezzell
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, PA 19104, USA
| | - D S Laughlin
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, PA 19104, USA
| | - C L Thorn
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, PA 19104, USA
| | - M S Kraus
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, PA 19104, USA
| | - A R Gelzer
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, PA 19104, USA
| |
Collapse
|
13
|
|
14
|
Thomason JD, Kraus MS, Fallaw TL, Calvert CA. Survival of 4 dogs with persistent atrial standstill treated by pacemaker implantation. Can Vet J 2016; 57:297-298. [PMID: 26933268 PMCID: PMC4751773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Pacemakers were implanted in 4 client-owned female dogs which had persistent atrial standstill. Three dogs were alive after 14 to 39 months and 1 dog was euthanized after 10.5 years. This report demonstrates that some dogs with persistent atrial standstill can survive for extended time periods.
Collapse
|
15
|
Coleman AE, Defrancesco TC, Chanoit G. Pacemaker malfunction due to mechanical failure of the lead-header interface. J Vet Cardiol 2012; 14:519-23. [PMID: 23158383 DOI: 10.1016/j.jvc.2012.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 05/01/2012] [Accepted: 07/04/2012] [Indexed: 11/19/2022]
Abstract
An 8 year old female spayed Boxer dog, diagnosed with concurrent vasovagal syncope and arrhythmogenic right ventricular cardiomyopathy, presented for routine evaluation approximately three months following epicardial pacemaker implantation. Routine device interrogation revealed intermittent loss of ventricular capture and intermittent failure to appropriately sense. Following evaluation of chronic impedance data, failure of the pacemaker lead-header interface or lead conductor fracture was suspected. Radiographic and pacemaker interrogator findings suggested incomplete lead insertion into the device header with intermittent loss of ventricular capture and variable pacemaker sensing. We hypothesize that either the presence of a loose or cross-threaded set screw or operator error at the time of device implantation may have caused this complication. This report details the diagnosis of mechanical failure of the lead-header interface, a complication not previously reported in a veterinary patient.
Collapse
Affiliation(s)
- Amanda E Coleman
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 501 D.W. Brooks Drive, Athens, GA 30602, USA
| | | | | |
Collapse
|
16
|
Burrage H. Sick sinus syndrome in a dog: treatment with dual-chambered pacemaker implantation. Can Vet J 2012; 53:565-568. [PMID: 23115373 PMCID: PMC3327600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 2-year-old male castrated boxer dog was presented because of a history of syncope. Electrocardiogram tracings obtained with a cardiac event monitor showed bradycardia culminating in asystole. Sick sinus syndrome was diagnosed and treated with transvenous implantation of a dual-chambered permanent pacemaker.
Collapse
Affiliation(s)
- Heather Burrage
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island.
| |
Collapse
|
17
|
Estrada A. Leading edge: Cardiac pacing site optimization. Compend Contin Educ Vet 2011; 33:E2. [PMID: 22180133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|
18
|
Fan Z, Yi X, Zhang L, Zhang YP. [Development of a digital cardiac pacemaker for animals and its application in medical research]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2010; 27:1030-1033. [PMID: 21089664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In this research and development project, we used the general microprocessor as a core to constitute the animal cardiac pacemaker in vitro. Control of the pacemaker's settings was carried out by transmitting parameters through a serial communication interface. Finally, our pacemaker reaches a satisfying test result in activating the cardiac outer membrane of the rabbits. Full digital pacemaker has high precision, good stability, and has an intuitive way to set parameters. Owing to its smaller size, lower cost, and easier mass production, the digital pacemaker is a good candidate to replace costly medical pacemakers for activating the animal's heart.
Collapse
Affiliation(s)
- Zhenzhong Fan
- Center of Information, First Affiliated Hospital, Hebei Medical University, Shijiazhuang 050031, China.
| | | | | | | |
Collapse
|
19
|
Lee S, Nam SJ, Hyun C. The optimal size and placement of transdermal electrodes are critical for the efficacy of a transcutaneous pacemaker in dogs. Vet J 2008; 183:196-200. [PMID: 19054701 DOI: 10.1016/j.tvjl.2008.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 10/01/2008] [Accepted: 10/18/2008] [Indexed: 11/17/2022]
Abstract
Transcutaneous cardiac pacing (TCP) can be used in dogs with a high risk for bradyarrhythmias prior to anesthesia, either in an emergency room or intensive care unit setting. Furthermore, TCP can also be used on patients diagnosed with bradyarrhythmias that require temporary pacing at the induction of anesthesia for the implantation of a permanent pacemaker. Despite the importance of TCP in emergency medicine, no studies have evaluated the optimal size and placement of the transdermal electrodes crucial for the efficacy of TCP in dogs. This study evaluated four different sizes of electrodes (10.5, 20, 30 and 40 cm2), and four different anatomical sites (anterior-posterior, left-right, apex-base, modified left-right) in order to optimize the efficacy of TCP in dogs. Electrodes with a surface area of 20 cm2 and a modified left-right placement minimized the pacing current and involuntary skeletal muscular contraction (muscular twitching) and so achieved the most optimal effect of TCP in dogs.
Collapse
Affiliation(s)
- Seungkeun Lee
- Korea Animal Hospital, Cheongju 361-829, Republic of Korea
| | | | | |
Collapse
|
20
|
Abstract
OBJECTIVES To document the outcome, survival and complications involved in pacemaker implantation in dogs in a retrospective study. METHODS Case records for all dogs in which pacemaker implantation was performed were reviewed. RESULTS A total of 104 dogs underwent pacemaker implantation. Dogs were presented with atrioventricular (AV) block (71), sick sinus syndrome (25) or vasovagal syncope (eight). Age at presentation varied from six months to 13 years with a median age of seven years and two months. The Labrador was the most commonly represented breed (17 cases). All but one dog survived pacemaker implantation, with 93 showing resolution of their clinical signs while 10 dogs showed intermittent residual signs. One-, three- and five-year survival estimates were 86, 65 and 39 per cent, respectively. Major complications after implantation were documented in 15 dogs and three of these led to fatalities. Minor complications were noted in 23 dogs. Sudden death occurred in six dogs three to 55 months following successful pacemaker implantation. CLINICAL SIGNIFICANCE Transvenous pacemaker implantation was successful in reducing or eliminating clinical signs in over 90 per cent of dogs with third-degree atrioventricular (AV) block or sick sinus syndrome. In dogs with vasovagal syncope, six of eight dogs had greatly reduced frequency of collapse and two became asymptomatic. Although the procedure was associated with complications, these were rarely life threatening and good survival was documented in the majority of cases.
Collapse
Affiliation(s)
- M S Johnson
- Veterinary Cardiorespiratory Centre, 43 Waverley Road, Kenilworth, Warwickshire CV8 1JL
| | | | | |
Collapse
|
21
|
Meier CK, Miller MW. ECG of the Month. Second-degree AV block. J Am Vet Med Assoc 2006; 229:1386-8. [PMID: 17078802 DOI: 10.2460/javma.229.9.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- C Kate Meier
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843
| | | |
Collapse
|
22
|
McMillan FD. Physiologic VDD versus nonphysiologic VVI pacing in canine 3rd degree atrioventricular block. J Vet Intern Med 2006; 20:1287; author reply 1287-8. [PMID: 17186838 DOI: 10.1892/0891-6640(2006)20[1287a:c]2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
|
23
|
Abstract
We reviewed the indications for age and breeds of dogs who received transvenous endocardial artificial pacemaker (AP) implantation (n = 105) and complications and survival thereafter at a single institution over a 6-year period. A third-degree atrioventricular (AV) block (59%) and sick sinus syndrome (SSS; 27%) were the most common indications, along with a high-grade second-degree AV block (9%) and atrial standstill (5%). The most common breeds identified were Labrador Retriever (n = 16; 11 with a third-degree AV block), American Cocker Spaniel (n = 14; 10 with SSS), and Miniature Schnauzer (n = 13; all with SSS). Common presenting complaints were syncope (n = 66) and exercise intolerance or lethargy (n = 25). Half of the dogs (n = 52) had a history of acute onset of clinical signs (<2 weeks). Mean survival time for the 60 dogs who died during the study period was 2.2 years (range, 0.1-5.8 years). Major complications occurred in 13% of dogs and included lead displacement (n = 7), sensing problems that led to syncope (n = 3), infection at the pacemaker site (n = 1), bleeding (n = 1), and ventricular fibrillation during implantation (n = 1; successfully defibrillated). Minor complications occurred in 11 dogs (11%). The success rate of transvenous AP implantation was comparatively high (all dogs survived the first 48 hours), and the complication rate was comparatively low when compared with a previous multicenter study, most likely because of how commonly the procedure was performed and supervisory experience.
Collapse
Affiliation(s)
- Gerhard Wess
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, USA.
| | | | | | | |
Collapse
|
24
|
Sanchez-Migallon Guzman D, Mayer J, Melidone R, McCarthy RJ, McCobb E, Kavirayani A, Rush JE. Pacemaker implantation in a ferret (Mustela putorius furo) with third-degree atrioventricular block. Vet Clin North Am Exot Anim Pract 2006; 9:677-87. [PMID: 16931390 DOI: 10.1016/j.cvex.2006.05.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
A 7.5-year-old castrated male ferret (Mustela putorius furo) was diagnosed with third-degree atrioventricular (AV) block. A monopolar epicardial pacemaker system was implanted, resulting in a regular, paced cardiac rhythm with third-degree AV block at 140 beats per minute. Over the next 2 months, the ferret developed anorexia, interstitial pneumonia, intermittent diarrhea, and hind-limb weakness and had a slow and progressive recovery. The ferret developed clinical signs of congestive heart failure 4 months after the surgery, resulting in its death 3 weeks later. Necropsy results attributed the death to cardiac failure due to extensive myocardial mineralization. To the authors' knowledge this is the first published report of surgical report of surgical pacemaker implantation in a ferret.
Collapse
Affiliation(s)
- David Sanchez-Migallon Guzman
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA 01536, USA.
| | | | | | | | | | | | | |
Collapse
|
25
|
Schrope DP, Kelch WJ. Signalment, clinical signs, and prognostic indicators associated with high-grade second- or third-degree atrioventricular block in dogs: 124 cases (January 1, 1997-December 31, 1997). J Am Vet Med Assoc 2006; 228:1710-7. [PMID: 16740072 DOI: 10.2460/javma.228.11.1710] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate signalment, clinical signs, and prognosis associated with high-grade second- or third-degree atrioventricular block (AVB) in dogs. DESIGN Retrospective case series. ANIMALS 124 dogs. PROCEDURES Data were gathered from ECGs, veterinarian questionnaires, echocardiograms, and radiographs submitted for review; compared with data from a large control group; and examined for association between variables and duration of survival. A new classification system for AVB was evaluated. RESULTS Afghan, Catahoula Leopard Dog, Chow Chow, Cocker Spaniel, German Wirehaired Pointer, and Labrador Retriever breeds were predisposed to high-grade second- or third-degree AVB. Heavier, older, and sexually intact female dogs were overrepresented in the study group. Weakness, lethargy, exercise intolerance, and syncope were the most common clinical signs. The presence of clinical signs was not associated with duration of survival. Dogs with high-grade second-degree AVB had a duration of survival similar to that of dogs with third-degree AVB. Dogs with high-grade second- or third-degree AVB were at high risk for sudden death in the first 6 months after diagnosis. High ventricular escape rhythm rate and narrow escape-complex QRS width were negatively associated with duration of survival. Pacemaker implantation had a significant positive association with survival. CONCLUSIONS AND CLINICAL RELEVANCE Pacemaker implantation should be strongly considered in all dogs with high-grade second- or third-degree AVB regardless of whether clinical signs are evident. If medical treatment is warranted, vagolytic medications may be the best choice. A new classification system for AVB may merit further investigation.
Collapse
Affiliation(s)
- Donald P Schrope
- Oradell Animal Hospital, 580 Winters Avenue, Paramus, NJ 07652, USA
| | | |
Collapse
|
26
|
Bulmer BJ, Sisson DD, Oyama MA, Solter PF, Grimm KA, Lamont L. Physiologic VDD versus nonphysiologic VVI pacing in canine 3rd-degree atrioventricular block. J Vet Intern Med 2006; 20:257-71. [PMID: 16594581 DOI: 10.1892/0891-6640(2006)20[257:pvvnvp]2.0.co;2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Historically, ventricular demand, nonphysiologic (VVI) pacing has been the most commonly used modality to treat 3rd-degree atrioventricular (AV) block. The goal of this study was to determine the feasibility of using a commercial, single-lead, physiologic (VDD) pacemaker in dogs with 3rd-degree AV block. Furthermore, we hoped to characterize and identify differences in the radiographic, echocardiographic, neurohormonal, and quality of life consequences of physiologic versus nonphysiologic pacing. We evaluated 10 dogs during a 12-week crossover study. Acutely, rate-matched physiologic pacing reduced pulmonary capillary wedge pressure by 19% compared with nonphysiologic pacing. VDD pacing significantly reduced left atrial size normalized to body weight, left atrial-to-aortic root ratio, and left ventricular end-systolic dimension and increased fractional shortening, aortic Doppler velocity, cardiac output, and stroke volume compared with VVI pacing. Variable rate VDD pacing resulted in a significantly slower heart rate (HR) during echocardiography than fixed-rate (100 bpm) VVI pacing. AV synchronous pacing reduced circulating N-terminal proatrial natriuretic peptide (ANP), norepinephrine (NOR), and epinephrine (EPI) concentrations compared with asynchronous pacing. There were no significant differences in systemic blood pressure, thoracic radiographs, or owner-perceived quality of life. The median percentage of AV synchronous pacing during the VDD modality was 99.8% (range, 1.2 to 99.9%). This study confirms the potential to achieve physiologic pacing with a commercial, single-lead system in dogs. VDD pacing improved hemodynamics and neurohormonal profiles over asynchronous pacing although the long-term clinical benefits of these changes remain to be determined.
Collapse
Affiliation(s)
- Barret J Bulmer
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, USA.
| | | | | | | | | | | |
Collapse
|
27
|
Abstract
Transvenous cardiac pacing is a commonly employed treatment for symptomatic bradyarrhythmias in dogs. Medical management of these conditions has not proven to be successful leaving pacing as the only viable alternative. The technique of pacemaker implantation is not difficult, but successful pacemaker therapy requires an understanding of electrophysiology, cardiac fluoroscopic anatomy, pacemaker instrumentation, and programming. Proper patient selection and identification of the underlying rhythm disturbance is essential to a successful clinical outcome. This article discusses the indications, equipment, techniques, complications, and outcome of permanent transvenous cardiac pacing.
Collapse
|
28
|
Ferasin L, Faena M, Henderson SM, Langford K, Darke PGG. Use of a multi-stage exercise test to assess the responsiveness of rate-adaptive pacemakers in dogs. J Small Anim Pract 2005; 46:115-20. [PMID: 15789806 DOI: 10.1111/j.1748-5827.2005.tb00301.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the ventricular rate response of rate-adaptive (VVIR) pacemakers in dogs using a multi-stage exercise test. METHODS The rate-responsiveness of VVIR pacemakers was assessed in seven dogs with complete atrioventricular (AV) block and implanted with various models of pulse generators (six motion sensors and one automatic dual-sensor rate-response pacemaker). Response activity was assessed with a multi-stage exercise test on a treadmill. Atrial and ventricular rate were analysed retrospectively at the end of the test and the AV ratio was calculated after each minute of exercise. RESULTS During exercise, the mean (sd) AV ratio recorded in all paced dogs was 1.7 (0.5) (expected physiological ratio 1.0), although a variety of individual performances was observed. A poor response (AV ratio 2.8 [0.2]) was obtained with the automatic dual-sensor pacemaker, suggesting that this type of rate-responsive device may not be indicated for implantation in dogs with complete AV block. The overall AV ratio for the six dogs implanted with motion sensors was 1.4 (0.2), showing a better performance of these pacemakers during exercise. CLINICAL SIGNIFICANCE This multi-stage exercise test represents an easy and repeatable method for assessing the accuracy of rate-responsive sensors and offers valuable information for the correct setting of VVIR pacemakers in dogs.
Collapse
Affiliation(s)
- L Ferasin
- University of Bristol, Department of Clinical Veterinary Science, Division of Companion Animals, Langford House, Langford, Bristol BS40 5DU
| | | | | | | | | |
Collapse
|
29
|
|
30
|
Prosek R, Sisson DD, Bulmer BJ, Oyama MA. ECG of the month. Complete AV block, and lack of capture (pacing) of the ventricles by the single-lead atrial-sensing VDD system. J Am Vet Med Assoc 2004; 225:845-6. [PMID: 15485041 DOI: 10.2460/javma.2004.225.845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Robert Prosek
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, USA
| | | | | | | |
Collapse
|
31
|
Abstract
Pacemaker implantation in veterinary practice is still not well known and remains uncommon. However, this technique is the only possible way to cure animals suffering from symptomatic bradycardia whose state does not improve with a medical treatment. In most cases, the use of pacemakers in veterinary medicine leads to the disappearance of the clinical and electrocardiographic signs. This retrospective study concerning the last 30 years draws up an evaluation of the improvements, advantages and drawbacks of this method. Moreover, this study allows the understanding of the evolution of pacemakers' use in veterinary cardiology.
Collapse
Affiliation(s)
- L François
- Unité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | | | | | | | | | | |
Collapse
|
32
|
Prosek R, Sisson DD, Oyama MA. Runaway pacemaker in a dog. J Vet Intern Med 2004; 18:242-4. [PMID: 15058778 DOI: 10.1892/0891-6640(2004)18<242:rpiad>2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Robert Prosek
- University of Illinois, Veterinary Teaching Hospital, Urbana, IL, USA.
| | | | | |
Collapse
|
33
|
Nicolle A, Borenstein N, Tessier Vetzel D, Rouby M, Behr L, Pouchelon JL, Chetboul V. [Exploration of a third degree atrioventricular block by standard echocardiography, tissue Doppler imaging, and treatment with a cardiac pacemaker in a German wire-haired pointer]. SCHWEIZ ARCH TIERH 2004; 146:81-7. [PMID: 14994485 DOI: 10.1024/0036-7281.146.2.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A nine-year-old intact male Drathaar was evaluated for syncope and extreme weakness, and was found to have a third degree atrioventricular (AV) block. As there were no biochemic, serologic, organic (thoracic radiographs, abdominal echography, standard and tissue Doppler echocardiographies) and histologic (interventricular septum biopsy) anomalies, the dog was treated with a permanently implanted cardiac pacemaker.
Collapse
Affiliation(s)
- A Nicolle
- Unité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.
| | | | | | | | | | | | | |
Collapse
|
34
|
Miura N, Fujiki M, Misumi K, Setoyama K, Takegawa K, Takahashi T, Miyahara K, Sakamoto H. Successful use of an acceleration rate response pacemaker with a transvenous steroid-eluting screw-in lead for third-degree atrioventricular block in a labrador retriever. J Vet Med Sci 2003; 65:1101-5. [PMID: 14600348 DOI: 10.1292/jvms.65.1101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Permanent pacemakers are commonly used in veterinary practice and can have a dramatic effect on the treatment of heart block. A Labrador Retriever dog suffering from exercise intolerance secondary to third degree atrioventricular block was treated with a new pacemaker system. A steroid-eluting screw-in type lead that has the advantage of being more fixed to the myocardial wall without increasing the pacing threshold was used. The heart rate was regulated with an acceleration sensing pacemaker generator that included several automatic modulation systems. Nineteen months after implantation, the dog has a normal level of activity. The present case suggests that this pacemaker design may offer important advantages for canine patients.
Collapse
Affiliation(s)
- Naoki Miura
- Department of Veterinary Surgery, Kagoshima University, Japan
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Kobayashi M, Hoshi K, Hirao H, Shimizu M, Shimamura S, Akiyama M, Tanaka R, Maruo K, Yamane Y. Implantation of permanent transvenous endocardial pacemaker in a dog with atrioventricular block. J Vet Med Sci 2003; 65:1131-4. [PMID: 14600355 DOI: 10.1292/jvms.65.1131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 10-year old male mongrel dog was presented to the University Veterinary Teaching Hospital with a two-month history of episodic syncope. Twenty-four hr Holter electrocardiographic (ECG) recording revealed frequent episodes of advanced atrioventriculer block with long periods of ventricular asystole. The cause of syncope was determined to be Adams-Stokes syndrome exhibited bradyarrhythmia. After the animal failed to respond to medical therapy, permanent transvenous pacemaker implantation was performed. Postoperative Holter ECG showed 100 beat per min programmed pacemaker rhythm, which indicated successful capture of the artificial pacing. The dog recovered smoothly from the operation and syncopal episodes completely disappeared. Six months after the surgery, no complications were observed and the dog's quality of life has dramatically improved.
Collapse
Affiliation(s)
- Masayuki Kobayashi
- Department of Veterinary Surgery, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Glaus TM, Unterer S, Tomsa K, Baumgartner C, Geissbühler U, Gardelle O, Reusch C. [Possibilities of minimal invasive cardiac catheter interventions in the dog]. SCHWEIZ ARCH TIERH 2003; 145:407-14. [PMID: 14535040 DOI: 10.1024/0036-7281.145.9.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The therapeutic possibilities in veterinary cardiology have developed rapidly in the past few years. Whereas until recently cardiac intervention in dogs could only be performed by thoracotomy, new minimally invasive techniques are adopted. Procedures like balloondilatation of pulmonic stenosis, coil embolisation of patent ductus arteriosus, pacemaker implantation in symptomatic bradyarrhyhtmia, and palliative balloon pericardiotomy are becoming more and more established. These alternative interventional methods are attractive, because no postsurgical pain and no complications potentially associated with thoracotomy ensue. The knowledge of such new treatment modalities and particularly the indications for an intervention are prerequisites to apply them optimally and broadly.
Collapse
Affiliation(s)
- T M Glaus
- Abteilung für Kardiologie, Departement für Kleintiere, Universität Zürich.
| | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
Temporary cardiac pacing is used in the emergency treatment of life-threatening bradyarrhythmias and for the support of heart rate and blood pressure of patients with sick sinus syndrome or high-grade atrioventricular (AV) block undergoing general anesthesia, typically for permanent pacemaker implantation. We retrospectively evaluated the safety and efficacy of a noninvasive transthoracic external cardiac pacing system in 42 dogs treated for bradyarrhythmias. Optimal placement of the patch electrodes on the skin of the thorax was initially established on 2 anesthetized normal dogs. The optimal electrode placement was determined to be on the right and left hemithoraces, directly over the heart. Afterward, by means of this electrode placement all 42 dogs treated for bradyarrhythmias in this study were successfully paced with the noninvasive transthoracic system. Dogs ranged in age from 1 to 15 years and weighed between 3.2 and 40 kg. Miniature Schnauzers, German Shepherds, and mixed breeds were most common in the study population. Indications for noninvasive transthoracic pacing included emergency treatment of hemodynamically unstable 3rd-degree AV block (2 dogs): support of heart rate during general anesthesia for permanent pacemaker implantation or lead-wire adjustment (38 dogs): and support of heart rate during general anesthesia for ophthalmologic surgery in dogs with sick sinus syndrome (2 dogs). Complications included pain and skeletal muscle stimulation, which required general anesthesia. We conclude that the noninvasive transthoracic pacing system evaluated is satisfactory for clinical veterinary use.
Collapse
Affiliation(s)
- Teresa C DeFrancesco
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
| | | | | | | | | |
Collapse
|
38
|
Buchanan JW. First pacemaker in a dog: a historical note. J Vet Intern Med 2003; 17:713-4. [PMID: 14529140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Affiliation(s)
- James W Buchanan
- Section of Cardiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, 19104, USA.
| |
Collapse
|
39
|
van Loon G, Fonteyne W, Rottiers H, Tavernier R, Deprez P. Implantation of a dual-chamber, rate-adaptive pacemaker in a horse with suspected sick sinus syndrome. Vet Rec 2002; 151:541-5. [PMID: 12448492 DOI: 10.1136/vr.151.18.541] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A five-year-old gelding suffered syncope at the end of a period of exercise. A 24-hour electrocardiogram recording revealed intermittent pauses in the sinus rhythm of up to 10 seconds, indicating sinus node disease; the pauses occurred repeatedly, particularly after exercise. A dual-chamber, rate-adaptive pacemaker was successfully implanted, which prevented excessive postexercise bradycardia and syncope, and allowed the horse to return to work.
Collapse
Affiliation(s)
- G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | | | | | | |
Collapse
|
40
|
Muñana KR, Vitek SM, Tarver WB, Saito M, Skeen TM, Sharp NJH, Olby NJ, Haglund MM. Use of vagal nerve stimulation as a treatment for refractory epilepsy in dogs. J Am Vet Med Assoc 2002; 221:977-83. [PMID: 12369700 DOI: 10.2460/javma.2002.221.977] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate safety and efficacy of vagal nerve stimulation in dogs with refractory epilepsy. DESIGN Placebo-controlled, double-masked, crossover study. ANIMALS 10 dogs with poorly controlled seizures. PROCEDURE A programmable pacemaker-like device designed to deliver intermittent stimulation to the left cervical trunk of the vagus was surgically implanted in each dog. Dogs were assigned randomly to two 13-week test periods, 1 with nerve stimulation and 1 without nerve stimulation. Owners recorded data on seizure frequency, duration, and intensity, as well as adverse effects. RESULTS No significant difference in seizure frequency, duration, or severity was detected between overall 13-week treatment and control periods. During the final 4 weeks of the treatment period, a significant decrease in mean seizure frequency (34.4%) was detected, compared with the control period. Complications included transient bradycardia, asystole, and apnea during intraoperative device testing, and seroma formation, subcutaneous migration of the generator, and transient Horner's syndrome during the 14-day period between surgery and suture removal. No adverse effects of stimulation were detected, and most owners were satisfied with the treatment. CONCLUSIONS AND CLINICAL RELEVANCE Vagal nerve stimulation is a potentially safe approach to seizure control that appears to be efficacious in certain dogs and should be considered a possible treatment option when antiepileptic medications are ineffective.
Collapse
Affiliation(s)
- Karen R Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA
| | | | | | | | | | | | | | | |
Collapse
|
41
|
MacAulay K. Permanent transvenous pacemaker implantation in an Ibizan hound cross with persistent atrial standstill. Can Vet J 2002; 43:789-91. [PMID: 12395764 PMCID: PMC339617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
An Ibizan hound cross was referred with a 1-year history of syncope and exercise intolerance. An electrocardiogram showed bradycardia and no P waves; atrial standstill was diagnosed. A permanent artificial endocardial pacemaker was implanted. The lead dislodged and was reimplanted into the right ventricular apex. Capture was once again achieved.
Collapse
Affiliation(s)
- Kevin MacAulay
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4
| |
Collapse
|
42
|
Abstract
We describe the development and the different features of an experimental model of chronic atrial fibrillation (AF) in equines. In four healthy ponies a dual-chamber pacemaker, with an adapted pacemaker program, was implanted transvenously in the standing animal. This adapted pacemaker induced episodes of AF by delivering a 2s burst of electrical stimuli (42 Hz) as soon as sinus rhythm was detected. Simultaneous with a surface electrocardiogram, the intra-atrial electrogram could be recorded to determine the atrial electrogram morphology. Programmed electrical stimulation (PES) was used to determine the atrial effective refractory period (AERP) and the rate adaptation of the AERP, the sinus node recovery time (SNRT) and the corrected SNRT, AF vulnerability, AF cycle length and AF duration. This experimental AF model can be used to study the pathophysiology of chronic AF in equines.
Collapse
Affiliation(s)
- G Van Loon
- Department of Cardiology, University Hospital, Ghent University, Ghent, Belgium.
| | | | | | | | | | | |
Collapse
|
43
|
Ferasin L, van de Stad M, Rudorf H, Langford K, Hotston MA. Syncope associated with paroxysmal atrioventricular block an ventricular standstill in a cat. J Small Anim Pract 2002; 43:124-8. [PMID: 11916056 DOI: 10.1111/j.1748-5827.2002.tb00042.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A four-and-a-half-year-old neutered male shorthair cat was presented with a three-week history of episodic fainting. Twenty-four hour electrocardiographic (Holter) recording revealed frequent prolonged episodes of complete atrioventricular (AV) block with ventricular standstill. The fainting episodes coincided with the longest periods of ventricular inactivity. A permanent transjugular pacemaker was placed to prevent further life-threatening episodes of syncope. Three months after discharge, the patient was re-presented with sudden onset dyspnoea associated with chylothorax and electrocardiography showed a third degree (complete) AV block. The pacemaker was reprogrammed in view of the third degree AV block and the chylous effusion was successfully treated by repeated thoracocentesis and long-term diuresis. However, the patient's general condition deteriorated progressively and the cat was euthanased five and a half months after implantation of the pacemaker.
Collapse
Affiliation(s)
- L Ferasin
- University of Bristol, Department of Clinical Veterinary Science, Langford House
| | | | | | | | | |
Collapse
|
44
|
Bulmer BJ, Oyama MA, Lamont LA, Sisson DD. Implantation of a single-lead atrioventricular synchronous (VDD) pacemaker in a dog with naturally occurring 3rd-degree atrioventricular block. J Vet Intern Med 2002; 16:197-200. [PMID: 11899038 DOI: 10.1892/0891-6640(2002)016<0197:ioasla>2.3.co;2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Barret J Bulmer
- University of Illinois, College of Veterinary Medicine, Urbana, 61802, USA.
| | | | | | | |
Collapse
|
45
|
van Loon G, Fonteyne W, Rottiers H, Tavernier R, Jordaens L, D'Hont L, Colpaert R, De Clercq T, Deprez P. Dual-chamber pacemaker implantation via the cephalic vein in healthy equids. J Vet Intern Med 2001; 15:564-71. [PMID: 11817062 DOI: 10.1892/0891-6640(2001)015<0564:dpivtc>2.3.co;2] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of the present study was to develop a feasible and safe technique for dual-chamber pacemaker implantation in healthy horses. Implantation was performed in a standing, tranquilized horse and in ponies. Atrial and ventricular leads were transvenously inserted through the cephalic vein, and a subcutaneous pacemaker pocket was created between the lateral pectoral groove and the manubrium sterni in 6 equids. Positioning of each lead was guided by echocardiography and by measuring the electrical characteristics of the lead. The implantation procedure lasted about 4 hours in each animal and was well tolerated. In all animals, dual-chamber pacemaker function was obtained, and these results remained good throughout the follow-up period. At the time of implantation, atrial and ventricular sensing were between 2.1 and 7.2 mV and 7.8 and 16.8 mV, respectively, and atrial and ventricular pacing thresholds at 0.5 millisecond varied from 0.5 to 0.7 V and from 0.3 to 1.0 V, respectively. Six months after the implantation, sensing values varied from 2 to 10 mV for the atrial lead and from 2 to 16 mV for the ventricular lead, while pacing thresholds at 0.5 millisecond varied from less than 0.5 to 2.5 V for the right atrium and from less than 0.5 to 5.0 V for the right ventricle. Atrial lead dislodgment occurred in 2 animals, requiring insertion of a new lead. Ventricular lead dislodgment was not observed.
Collapse
Affiliation(s)
- G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, University of Ghent, Merelbeke, Belgium.
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Moneva-Jordan A, Corcoran BM, French A, Dukes-McEwan J, Martin MW, Luis Fuentes V, Hitchcock LS, Bonagura JD. Sick sinus syndrome in nine West Highland white terriers. Vet Rec 2001; 148:142-7. [PMID: 11271916 DOI: 10.1136/vr.148.5.142] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Sick sinus syndrome is a clinical term used to describe the clinical signs of sinus node dysfunction. This paper describes the clinical data from nine West Highland white terriers, eight females and one male, in which a diagnosis of sick sinus syndrome was made. The most common clinical signs were episodic weakness and presyncope. Electrocardiographic findings included sinus bradycardia, sinus arrest with or without escape complexes, disturbances of atrioventricular conduction, paroxysmal supraventricular tachycardia, or some combination of these dysrhythmias. The main radiographic changes were mild right-sided cardiomegaly in five cases, and a slight increase in bronchial and interstitial markings in four, but there was no evidence of congestive heart failure in any of the dogs. Echocardiography revealed mild to moderate mitral endocardiosis in three cases with no other significant abnormalities. The dogs' responses to parenteral atropine were variable and were not necessarily related to their response to oral anticholinergic agents. Five of the dogs were initially treated with propantheline bromide, but in only two of them were the clinical signs controlled in the long term. Six of the dogs were successfully treated by the implantation of a transvenous pacemaker.
Collapse
Affiliation(s)
- A Moneva-Jordan
- Hospital for Small Animals, Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian
| | | | | | | | | | | | | | | |
Collapse
|
47
|
van Loon G, Tavernier R, Duytschaever M, Fonteyne W, Deprez P, Jordaens L. Pacing induced sustained atrial fibrillation in a pony. Can J Vet Res 2000; 64:254-8. [PMID: 11041507 PMCID: PMC1189629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
A transvenous, screw-in electrode was implanted in the right atrium of a healthy pony and connected with an implantable pulse generator programmed to deliver bursts of electrical stimuli to the atrium. Initially, cessation of burst pacing resulted in short (less than 1 minute), self-terminating episodes of atrial fibrillation. As burst pacing continued, the episodes of induced atrial fibrillation became longer. After 3 weeks of continuous atrial pacing, atrial fibrillation became sustained (56 hours). This model of pacing induced atrial fibrillation can be used to study the mechanisms leading to atrial fibrillation, its perpetuation and therapy. Our preliminary observations support the concept that once atrial fibrillation starts, it sets up changes in the electrical characteristics of the atrium that favor its own perpetuation.
Collapse
Affiliation(s)
- G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, University of Ghent, Merelbeke, Belgium.
| | | | | | | | | | | |
Collapse
|
48
|
Abstract
Transvenous pacing therapy is a life-saving technique for patients with clinically significant bradyarrhythmias. For most symptomatic bradyarrhythmias in small animals, there is no effective substitute for cardiac pacing. The methods employed for pacemaker placement, although potentially time-consuming, are not technically difficult. This article discusses the indications, techniques, clinical decision-making, and potential complications associated with temporary and permanent transvenous cardiac pacing.
Collapse
Affiliation(s)
- E Côté
- Section of Cardiology, Angell Memorial Animal Hospital, Boston, MA 02130, USA
| | | |
Collapse
|
49
|
Flanders JA, Moïse NS, Gelzer AR, Waskiewicz JC, MacGregor JM. Introduction of an endocardial pacing lead through the costocervical vein in six dogs. J Am Vet Med Assoc 1999; 215:46-8, 34. [PMID: 10397064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Lead dislodgement is one of the most common complications of endocardial pacing lead implantation in dogs. Incidence of lead displacement appears to be higher in large-breed, compared with small-breed, dogs, suggesting that excessive neck movements may be a contributing factor. To avoid introducing pacing leads through a vein in the neck, we developed a technique for implantation of endocardial pacing leads through the right costocervical vein. A right second intercostal space thoracotomy was performed to expose the vein, and the pacing generator was placed in the musculature over the lateral aspect of the thorax. The technique was performed in 6 dogs, 5 of which had had an endocardial pacing lead dislodge. None of the dogs had problems with lead dislodgement during follow-up periods of 15 to 20 months. Implantation of endocardial pacing leads through the costocervical vein should not be considered a replacement for implantation through the jugular vein. However, we believe that this technique is indicated for large dogs in which endocardial pacing leads implanted through the jugular vein have dislodged.
Collapse
Affiliation(s)
- J A Flanders
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA
| | | | | | | | | |
Collapse
|
50
|
Estrada AH, Ko JC, Snyder PS, Sobel KE. Anesthesia case of the month. Pacemaker malfunction during anesthesia in a dog. J Am Vet Med Assoc 1998; 213:961-3. [PMID: 9776990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- A H Estrada
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville 32610, USA
| | | | | | | |
Collapse
|