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1.
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.  相似文献   

2.
Artificial pacing (AP) is a treatment for symptomatic bradyarrhythmias unresponsive to medical therapy. This retrospective study was designed to define the practices and outcome of AP in dogs at 7 referral institutions participating in the Companion Animal Pacemaker Registry and Repository (CANPACERS). The indications, implantation techniques, complications, long-term outcome, and owner satisfaction were examined. One hundred fifty-four dogs were identified as undergoing AP from January 1, 1991, to January 1, 1996. Third-degree atrioventricular (AV) block (n = 91; 59%) and sinus node dysfunction (n = 45; 29%) were the most common indications for AP Transvenous endocardial AP systems were implanted in 136 dogs (88%), and epicardial systems were implanted in 18 (12%). Complications associated with AP were reported in 84 dogs (55%). Major complications occurred in 51 dogs (33%), including dislodgement of the pacing lead (n = 15; 10%), generator failure (n = 10; 6%), cardiac arrest during implantation (n = 9; 6%), and infection (n = 7; 5%). Minor complications occurred in 47 dogs (31%), including seroma formation (n = 18; 12%), muscle twitch (n = 17; 11%), and inconsequential arrhythmias (n = 15; 10%). Fourteen dogs (9%) experienced both major and minor complications. Survival analysis revealed 1-, 2-, and 3-year survival rates of 70, 57, and 45%, respectively. Age and presence of preexisting congestive heart failure (CHF) had a negative effect on survival (P = .001). Sixty percent of dogs with preexisting CHF died within 1 year of implantation, whereas 25% of dogs without heart failure died during the same period. Owners rated their satisfaction with the procedure as high in 80% of the dogs.  相似文献   

3.
Permanent Transvenous Pacemaker Implantation in Forty Dogs   总被引：1，自引：0，他引：1  
Permanent transvenous cardiac pacemakers were implanted in 40 dogs. Electrocardiographic diagnoses included persistent atrial standstill (3 dogs), sick sinus syndrome (8 dogs), and high-grade second-degree or third-degree atrioventricular (AV) block (29 dogs). Thirteen dogs were alive and well 4 to 42 months after pacemaker implantation (mean, 16.9 months). The mean and median survival times of the 26 dogs that died or were euthanatized during the study were 17.9 months and 13 months, respectively. Most of these dogs succumbed to problems unrelated to the arrhythmia and pacemaker implant. One dog was lost to follow-up. Complications associated with permanent transvenous pacemaker implantation included lead dislodgement, infection, hematoma formation, skeletal muscle stimulation, ventricular arrhythmia, migration of the pulse generator, and skin erosion. Lead dislodgement was the most common complication, occurring in 7 of 9 dogs paced using untined electrode leads and in 6 of 30 dogs paced using tined leads. Lead dislodgement did not occur in the only dog paced using an actively fixed endocardial lead. It was concluded that permanent transvenous cardiac pacing is a feasible, less traumatic alternative to epimyocardial pacing in dogs, but that successful use of this technique requires careful implantation technique and anticipation of the potential complications.  相似文献   

4.
Background: Pacemaker implantation is the treatment of choice for symptomatic bradyarrhythmias. In dogs, a single chamber system is commonly used. In human patients with high-grade 2nd- or 3rd-degree atrioventricular (AV) block, physiologic pacing is recommended, because it improves cardiac output, blood pressure, exercise tolerance, and quality of life. In dogs, this type of pacing is seldom used.
Hypothesis: The implantation of a dual chamber pacemaker in dogs with AV block is a feasible procedure for restoring AV synchrony.
Animals: Thirty-three privately owned dogs with high-grade 2nd- or 3rd-degree AV block were included.
Methods: Patient data of all dogs with AV block presented for pacemaker implantation between December 1997 and November 2004 were reviewed.
Results: Dual chamber pacemaker implantation with AV synchronous stimulation was successfully performed in 33/33 dogs (100%). In 9/33 (27%) major and in 12/33 (36%) minor complications were observed. Mean survival time for the patients discharged from hospital (n = 32) was 33.6 ± 20.4 months (range, 3.9–83.5 months).
Conclusion and Clinical Importance: Dual chamber pacing is a feasible procedure in dogs with 2nd- or 3rd-degree AV block and is not associated with a higher complication rate compared with single chamber pacemaker systems. A major advantage over ventricular demand pacemaker systems is the restoration of AV synchrony for a substantial period of time.  相似文献   

5.
The case reported herein describes the placement of a permanent transvenous pacemaker in an older dog with a previously undiagnosed persistent left cranial vena cava (PLCVC) and recent onset symptomatic third-degree atrioventricular (AV) block. On presentation the dog was found to have atrial flutter and third-degree AV block and echocardiography demonstrated evidence of chronic valvular disease and pulmonary arterial hypertension. The persistent left cranial vena cava was discovered via angiography when difficulties were encountered with pacemaker placement. Successful right ventricular pacing necessitated passage of the lead through the coronary sinus. The attendant complications in pacemaker placement in the presence of a PLCVC are well-described in man but, to the authors' knowledge, have not been described in companion animals.  相似文献   

6.
Objective: To describe successful treatment of third-degree atrioventricular (AV) block using temporary noninvasive transthoracic pacing and placement of a permanent transvenous pacemaker in a case of suspected lily-of-the-valley ( Convallaria majalis ) intoxication in a dog.
Case summary: A 2-year-old neutered male Beagle weighing 17.8 kg was presented to the emergency service for treatment of bradycardia, vomiting, and lethargy. An electrocardiogram revealed third-degree AV block that was nonresponsive to atropine. Ten hours after admission, the dog became obtunded. Treatment initially consisted of temporary noninvasive transthoracic pacing and eventually placement of a permanent transvenous pacemaker. The initial history did not suggest that the dog had access to any known cardiotoxins. However, C. majalis , which contains cardiac glycosides, was identified within the dog's environment and the dog's serum did contain digoxin or an immunologically cross-reactive compound.
New or unique information provided: This is the first reported successful management of C. majalis toxicosis in a dog. Temporary noninvasive transthoracic pacing was used in the management of this case as a safe and effective bridge to permanent pacemaker implantation.  相似文献   

7.
Two cats with bradycardia and syncope were treated by permanent pacemaker implantation. Cat 1 had multiple episodes of syncope intermittently over a 10-month period and then multiple episodes within 24 hours; cat 2 had episodes of collapse over a 3-month period. Clinical signs included disorientation, vocalization, and collapse. High-grade second-degree AV block was recorded in both cats, with left and right bundle branch block in cat 1 and right bundle branch block in cat 2. Neither responded to pharmacologic therapy. In cat 1, an epimyocardial electrode was implanted into the left ventricular apex by a ventral abdominal transdiaphragmatic surgical approach. Cat 2 had a permanent smooth endocardial pacing lead introduced into the fight external jugular vein and directed into the right ventricular apex. Both cats were clinically normal within three days after implantation. Complications in cat 2 included failure of pacemaker capture, endocardial lead dislodgement, and pulse generator pocket seroma. Cats with symptomatic bradycardia caused by second-degree and third-degree AV block can be effectively treated by pacemaker implantation by surgical endomyocardial or perivenous endocardial lead placement.  相似文献   

8.
Objectives : English springer spaniels (ESS) are one of the most frequently presented breeds for pacemaker implantation in the UK and may do so at an early age. In comparison to dogs of other breeds (non-ESS) presenting for pacemaker implantation, cardiac troponin I (cTnI), the outcome and survival of ESS were investigated. Methods : Case records of dogs receiving pacemaker implantation were retrospectively reviewed. Results : Between September 2004 and October 2008, 58 dogs were presented to the Small Animal Teaching Hospital, University of Liverpool for pacemaker implantation. ESS (n=10) was the second most commonly presented breed. ESS were significantly younger than non-ESS (P=0·022). cTnI values were elevated on presentation and a significant reduction was present after pacemaker implantation (P=0·008) in all dogs. No significant difference in initial cTnI was identified comparing ESS and non-ESS (P=0·45) and median survival times were similar (P=0·37). Clinical Significance : ESS may be predisposed to bradyarrhythmias requiring pacemaker implantation. They present at a significantly younger age than non-ESS. Survival times between ESS and non-ESS were similar, despite ESS being paced at a younger age. However, pacemaker implantation is recommended in ESS as median survival times of 30 months with a good quality of life were achieved.  相似文献   

9.
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.  相似文献   

10.
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.  相似文献   

11.
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.  相似文献   

12.
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.  相似文献   

13.
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.  相似文献   

14.
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.  相似文献   

15.
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.  相似文献   

16.
Third degree atrioventricular (AV) block in dogs is thought to be most frequently characterized by non-specific fibrotic changes in the AV node. However, it may occur secondary to an undiagnosed inflammatory process. We report a case of third degree AV block in a dog, secondary to acute lymphocytic-plasmacytic myocarditis that resulted in sudden death. This dog had cardiac troponin I levels of 44.65 ng/mL (normal <0.11 ng/mL). The serum cardiac troponin I level was five times higher than any other AV block patient measured in our laboratory, and was also substantially higher than in dogs with chronic valve disease or dilated cardiomyopathy. The severe myocardial necrosis observed at necropsy correlated with the degree of cardiac troponin I elevation. This report suggests that measurement of cardiac troponin I may be an indicated test before pacemaker implantation in dogs with third degree AV block.  相似文献   

17.

Background

An important consideration for the treatment of sick sinus syndrome (SSS) lies in the function of the atrioventricular (AV) node because most patients with SSS retain the ability to conduct atrial impulses.

Hypothesis/Objectives

This retrospective study examined the feasibility of atrial pacing (AAI) in dogs with sinus node dysfunction (SND).

Animals

Sixteen dogs with SND and AAI pacing were identified.

Methods

Retrospective review of medical records.

Results

Follow‐up time ranged from 45 to 1,227 days (mean: 292 days). Only 1 dog developed AV block 3 days postoperatively. Complete lead dislodgment occurred in 3/16 dogs 1, 19, and 27 days postoperatively. Lead perforation into the pericardial space occurred in 2/16 dogs. Rising thresholds for pacing with possible lead microdislodgment or fibrosis were suspected in another 3/16 dogs 57, 192, and 1,016 days after implantation. None of these dogs had complete loss of capture but all required higher thresholds for pacing.

Conclusions and Clinical Importance

Based on this small group of dogs, clinically important AV block does not appear to occur in the long‐term for dogs with SND. Risks of lead perforation, complete dislodgment, and rising thresholds for pacing, possibly because of microdislodgment, may be related to the initial skill level of the operator or the leads that were used. Use of leads with reduced torque at the lead tip, higher flexibility, increased lead‐tip surface of contact with the endocardium or, more likely, use of alternate locations for pacing in the small right atrium of dogs with SND may decrease the frequency of these complications.  相似文献   

18.

Background

Increased cardiac troponin I (cTnI) concentration has been reported in dogs with atrioventricular (AV) block before and shortly following pacemaker implantation. The role of AV dyssynchrony, age, or concurrent cardiac disease on cTnI concentration remains unknown.

Objectives

To investigate change in cTnI concentration following dual-chamber pacemaker implantation on short- and long-term follow-up and to compare cTnI values to a case-matched control group.

Animals

Thirty-eight client-owned dogs with permanent AV block and 38 matched control dogs.

Methods

Retrospective review of medical records. Pacemaker group consisted of dogs with AV block and dual-chamber pacing. Control group matched the study population in age and cardiac disease. cTnI was compared between pacemaker and control group on short- and long-term follow-up. Different lead types and influence of arrhythmia on cTnI were tested.

Results

cTnI was high at presentation (median 0.66 ng/ml; range 0.03–18.6) and showed a significant reduction over time after pacemaker implantation (p < 0.0001). Median cTnI values were significantly different between pacemaker and control group on short-term (p = 0.0004; 0.11 ng/ml, range 0.03–1.36 versus 0.06 ng/ml, range 0.03–0.46), but not on long-term follow-up (p = 0.0547; 0.14 ng/ml, range 0.03–0.73 versus 0.07 ng/ml, range 0.03–0.46). Lead type and severity of arrhythmia did not show a significant correlation to cTnI concentration.

Conclusions

On long-term follow-up, cTnI remained mildly elevated in some of the pacemaker dogs but was not significantly different to the matched control group.  相似文献   

19.
Background: Surgical and interventional therapy for occlusion of a patent ductus arteriosus (PDA) in small dogs is challenging. Interventional closure of a PDA is rarely described in small dogs. Hypothesis: Transvenous single‐coil occlusion of a PDA in small (≤3.0 kg) dogs is possible and safe. Animals: Twenty‐one client‐owned dogs with a left‐to‐right shunting PDA. Methods: Prospective clinical study. Inclusion criteria were a left‐to‐right shunting PDA and a body weight ≤3.0 kg. Dogs with additional congenital cardiac diseases were excluded. Without arterial access, a single detachable coil was implanted by a transvenous approach with a 4 Fr catheter. Results: Twenty‐one dogs were the study population with Chihuahua and Yorkshire Terrier being the commonest breeds (n = 6 and n = 5, respectively). There were 14 female and 7 male dogs. The age range was 1.9–83.5 months (median, 7.7 months), and the body weight was 1.0–2.9 kg (1.87 ± 0.45). By angiography, the minimal ductal diameter measured 1.2–2.4 mm (median, 1.8 mm) and the PDA ampulla diameter was 2.4–5.9 mm (median, 4.6 mm). Coil implantation was successful in all dogs. After detachment of the coil from the delivery cable, repositioning of the pulmonary loop of the coil became necessary in 1 dog. The prevalence of immediate closure was 76%. The prevalence of cumulative closure was 90%. Conclusion: For an experienced cardiologist, transvenous occlusion of a PDA in small dogs is possible with a 4 Fr catheter and a commercial single detachable coil. Arterial access is not essential. The procedure is safe and successful in experienced hands.  相似文献   

20.
Complete atrioventricular (AV) block was produced in 32 chloralose-anesthetized autonomically intact dogs to determine the effects of halothane, enflurane, and isoflurane on supraventricular and ventricular rate. Halothane (n = 17), enflurane (n = 6), and isoflurane (n = 9) were administered in three separate experiments in sequential minimum alveolar concentration (MAC) multiples of 0.5, 1.0, 1.5, 2.0, 1.5, and 1.0. Supraventricular rate, ventricular rate, and mean arterial blood pressure (MAP) were measured and recorded at baseline and after a 20-minute equilibration period of each inhalation anesthetic at each MAC multiple. Increasing concentrations of enflurane and isoflurane significantly decreased supraventricular rate ( P < .05). Ventricular rate was not significantly changed by sequential MAC multiples of halothane, enflurane, and isoflurane. Increasing concentrations of halothane, enflurane, and isoflurane significantly decreased MAP with enflurane producing the most significant decrease ( P < .05). Ventricular arrhythmias occurred in 5 of 17 dogs anesthetized with halothane and 1 of 9 dogs anesthetized with isoflurane. Inhalation anesthesia can significantly decrease supraventricular rate and MAP, does not alter ventricular rate, and can produce ventricular arrhythmias in dogs with complete AV block.  相似文献   

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