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1.
OBJECTIVE: To determine the clinical usefulness of cardiac event recording in evaluating dogs and cats with unexplained syncope, episodic collapse, or intermittent weakness. DESIGN: Retrospective study. ANIMALS: 58 dogs and 2 cats. PROCEDURE: Medical records and electrocardiographic rhythm strips obtained by cardiac event recordings were reviewed. Cardiac rhythm data from the event recordings were classified as diagnostic or nondiagnostic. Diagnostic yield was calculated by dividing the number of animals for which cardiac event recording was diagnostic by the total number of animals undergoing cardiac event recording. RESULTS: For 51 animals, cardiac event recording was classified as diagnostic; therefore, overall diagnostic yield was 85%. Diagnostic yield was lower for animals without underlying structural heart disease (75.5%) than for animals with structural heart disease (95.6%). A specific arrhythmia was identified as the cause of clinical signs in 18 of the 51 (35%) animals for which cardiac event recording was diagnostic. Cardiac arrhythmia was definitively excluded as the cause of clinical signs in the remaining 33 (65%) animals in which cardiac event recording was diagnostic. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicate that cardiac event recording had a high diagnostic yield in dogs and cats examined because of unexplained syncope, episodic collapse, or transient weakness and ataxia, regardless of whether animals did or did not have an underlying structural heart disease. Diagnostic yield of cardiac event recording was higher than that reported previously for Holter monitoring.  相似文献   

2.

Background

Atrial fibrillation (AF) usually is associated with a rapid ventricular rate. The optimal heart rate (HR) during AF is unknown.

Hypothesis/Objectives

Heart rate affects survival in dogs with chronic AF.

Animals

Forty‐six dogs with AF and 24‐hour ambulatory recordings were evaluated.

Methods

Retrospective study. Holter‐derived HR variables were analyzed as follows: mean HR (meanHR, 24‐hour average), minimum HR (minHR, 1‐minute average), maximum HR (maxHR, 1‐minute average). Survival times were recorded from the time of presumed adequate rate control. The primary endpoint was all‐cause mortality. Cox proportional hazards analysis identified variables independently associated with survival; Kaplan‐Meier survival analysis estimated the median survival time of dogs with meanHR <125 bpm versus ≥125 bpm.

Results

All 46 dogs had structural heart disease; 31 of 46 had congestive heart failure (CHF), 44 of 46 received antiarrhythmic drugs. Of 15 dogs with cardiac death, 14 had CHF. Median time to all‐cause death was 524 days (Interquartile range (IQR), 76–1,037 days). MeanHR was 125 bpm (range, 62–203 bpm), minHR was 82 bpm (range, 37–163 bpm), maxHR was 217 bpm (range, 126–307 bpm). These were significantly correlated with all‐cause and cardiac‐related mortality. For every 10 bpm increase in meanHR, the risk of all‐cause mortality increased by 35% (hazard ratio, 1.35; 95% CI, 1.17–1.55; P < 0.001). Median survival time of dogs with meanHR<125 bpm (n = 23) was significantly longer (1,037 days; range, 524‐open) than meanHR ≥125 bpm (n = 23; 105 days; range, 67–267 days; P = 0.0012). Mean HR was independently associated with all‐cause and cardiovascular mortality (P < 0.003).

Conclusions and Clinical Importance

Holter‐derived meanHR affects survival in dogs with AF. Dogs with meanHR <125 bpm lived longer than those with meanHR ≥ 125 bpm.  相似文献   

3.
Background: Atrial fibrillation (AF) with excessively high ventricular rates (VR) occurs in dogs with advanced heart disease. Rate control improves clinical signs in these patients. Optimal drug therapy and target VR remain poorly defined.
Hypothesis: Digoxin-diltiazem combination therapy reduces VR more than either drug alone in dogs with high VR AF.
Animals: Eighteen client-owned dogs (>15 kg) with advanced heart disease, AF, and average VR on 24-hour Holter > 140 beats per minute (bpm).
Methods: After baseline Holter recording, dogs were randomized to digoxin or diltiazem monotherapy, or combination therapy. Repeat Holter evaluation was obtained after 2 weeks; dogs were then crossed over to the other arm (monotherapy or combination therapy) for 2 weeks and a third Holter was acquired. Twenty-four hour average VR, absolute and relative VR changes from baseline, and percent time spent within prespecified VR ranges (>140, 100–140, and <100 bpm) were compared. Correlations between serum drug concentrations and VR were examined.
Results: Digoxin (median, 164 bpm) and diltiazem (median, 158 bpm) decreased VR from baseline (median, 194 bpm) less than the digoxin-diltiazem combination (median, 126 bpm) ( P < .008 for each comparison). With digoxin-diltiazem, VR remained <140 bpm for 85% of the recording period, but remained >140 bpm for 88% of the recording period with either monotherapy. Serum drug concentrations did not correlate with VR.
Conclusions and Clinical Importance: At the dosages used in this study, digoxin-diltiazem combination therapy provided a greater rate control than either drug alone in dogs with AF.  相似文献   

4.
Background: Few reported studies describe normal values from 24‐hour ECG (Holter) recordings of small breed dogs. Objectives: To investigate influence of breed, age, sex, body weight, degree of recording artifact, and mitral valve prolapse (MVP) on Holter recordings of 3 breeds of small dogs that have differing predispositions for myxomatous mitral valve disease. The study also assessed if heart rate (HR) at clinical examination (HRex) was associated with HR during Holter monitoring and evaluated the reproducibility of Holter variables. Animals: Fifty clinically healthy, privately owned dogs of the breeds Cavalier King Charles Spaniel (CKCS), Wire‐haired Dachshund (wD), or Cairn Terrier (CT). Methods: Prospective, longitudinal observational study. Dogs were recruited for clinical examination, echocardiography, and Holter monitoring. In 8 CKCS, Holter recordings were performed twice with a 7‐day interval. Arrhythmia and heart rate variability (HRV) analysis (time and frequency domain analysis) were performed on Holter recordings. Results: Fifteen out of 27 Holter derived variables were significantly associated with breed (P < .03), but not with age (P > .7), sex (P > .2), body weight (P > .7), degree of recording artifact (P > .4), or MVP (P > .6). During Holter recording, minimum (P= .0001) and mean HR (P= .0001) were higher in CKCS compared with wD. CKCS had significantly lower values than wD, CT, or both in 10 out of 13 HRV variables (P < .03). Minimum and mean HR during Holter recording were correlated with HRex (r= 0.55, P= .0003). HR and time domain variables had a coefficient of variation <10%. Conclusions and Clinical Importance: There is an influence of breed on Holter‐derived variables in 3 breeds of small dogs. Arrhythmia and HRV analysis can be performed on 24‐hour ambulatory ECG (Holter) recordings. Arrhythmia analysis includes HR measurements and identification of arrhythmias.  相似文献   

5.
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   

6.
Ambulatory electrocardiogram (ECG) has been recorded in dogs wearing a jacket to protect a Holter recording system, but the jacket was often damaged by dogs. We compared ECG recorded by a Holter recording system and spontaneous activity measured by an accelerometer in Beagle dogs with or without an Elizabethan collar. There were few significant differences in mean values (per hr) of the heart rate and the amount of spontaneous activity between dogs with or without the Elizabethan collar. Mean values (per 23 hr) of them had no significant difference between them. We concluded that the Elizabethan collar did not have any effect on ambulatory ECG and canine movements and was effective to protect the recording apparatus.  相似文献   

7.
Objective Describe the presence of arrhythmias in dogs with myxomatous mitral valve disease (MMVD) and the potential association with class of heart failure and left atrial enlargement. Compare the standard electrocardiogram (ECG) with Holter monitoring for assessing heart rate (HR). Experimental procedure The study group of 36 dogs weighing less than 20 kg was divided into MMVD and no clinical signs (preclinical) or MMVD and clinical signs (clinical). A standard echocardiogram, ECG and 24-h Holter recording were obtained in all dogs. Results Minimum and mean Holter HRs were higher in the clinical group than in the preclinical group. Clinical dogs had more ventricular arrhythmias than preclinical dogs. An enlarged left atrium was associated with the presence of more supraventricular arrhythmias. Conclusions Arrhythmias are a common finding in dogs with MMVD and Holter monitoring is a reliable tool for both HR monitoring and diagnosis.  相似文献   

8.
OBJECTIVE: To identify, by means of 24-hour ambulatory electrocardiography, electrocardiographic abnormalities in overtly healthy Doberman Pinschers in which results of echocardiography were abnormal. DESIGN: Clinical case series. ANIMALS: 56 (35 male, 21 female) overtly healthy Doberman Pinschers with echocardiographic evidence of cardiomyopathy on initial examination that subsequently died of cardiomyopathy. PROCEDURE: Twenty-four-hour ambulatory electrocardiographic (Holter) recordings obtained at the time of initial examination were reviewed. For all dogs, scan quality was > 90%. RESULTS: Initial Holter recordings of all 56 dogs contained ventricular premature contractions (VPC). Thirty-six (65%) dogs had > 1,000 VPC/24 h, 17 (31%) had > 5,000 VPC/24 h, and 11 (19%) had > 10,000 VPC/24 h. Fifty-four (96%) dogs had couplets of VPC, 37 (66%) had triplets of VPC, and 36 (64%) had episodes of nonsustained (< 30 seconds) ventricular tachycardia. Number of VPC/24 h during the initial Holter recordings was positively correlated with numbers of couplets and triplets of VPC and number of ventricular escape beats and negatively correlated with left ventricular fractional shortening. Twenty-eight dogs died suddenly prior to the putative onset of congestive heart failure. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that along with echocardiography, 24-hour ambulatory electrocardiography can be used to help identify overtly healthy Doberman Pinschers with cardiomyopathy.  相似文献   

9.
OBJECTIVE: To characterize ambulatory electrocardiographic results of overtly healthy Doberman Pinschers and determine associations between those results and development of dilated cardiomyopathy. DESIGN: Cohort study. ANIMALS: 114 (58 male, 56 female) overtly healthy Doberman Pinschers without echocardiographic evidence of cardiac disease on initial examination. PROCEDURE: Echocardiograms and 24-hour ambulatory electrocardiograms (Holter recordings) were obtained initially and at variable intervals. The status (live vs dead) of all dogs was known at least 2 years and as long as 10 years after initial examination (mean [+/- SD] follow-up time, 4.33 +/- 1.84 years). Associations between development of dilated cardiomyopathy and number of ventricular premature contractions (VPC), age, and sex were determined. RESULTS: 55 dogs (48%) did not have VPC on initial Holter recordings, and only 8 dogs had > 50 VPC/24 hours. The likelihood that a dog would have VPC was associated with increasing age and being male. At least 1 VPC/24 hours, and in particular, > 50 VPC/24 hours or > or = 1 couplet or triplet of VPC/24 hours, were predictive of subsequent development of dilated cardiomyopathy. Fifty-four dogs (47%) developed dilated cardiomyopathy; 12 were still alive at the end of the study, and 42 had died. Twenty-five of these 42 dogs died after the onset of congestive heart failure (CHF), 15 died suddenly before the onset of overt CHF, and 2 died of noncardiac causes. More males developed dilated cardiomyopathy than females, and dogs that died suddenly were approximately 1 year younger than those that developed CHF. CONCLUSIONS AND CLINICAL RELEVANCE: Results of high-quality Holter recordings may be used to identify overtly healthy Doberman Pinschers that are at a high risk for dilated cardiomyopathy.  相似文献   

10.
Motor vehicle-related injury is the most common form of trauma incurred by dogs, and cardiac arrhythmias are a well-recognized complication. Although posttraumatic arrhythmias are often observed, little is known regarding their frequency. This study utilized continuous ambulatory electrocardiography (i.e., Holter monitoring) to describe the cardiac rhythm disturbances in 30 dogs sustaining trauma in motor vehicle accidents. Ventricular ectopy was identified by Holter monitoring in 29 of 30 dogs, although the initial electrocardiogram (EKG) only documented ventricular ectopic complexes (VECs) in four dogs. Ventricular ectopy was infrequent in most dogs (i.e., 62% of the dogs had less than 100 VECs per day for the entire study), but 16% developed frequent arrhythmias (greater than 4,000 VECs per day). In all cases, the VECs were observed within 24 hours of injury. Forty-three percent of dogs had at least one episode of ventricular tachycardia, including several dogs that had an overall infrequent rate of VECs (i.e., less than 100 or 100 to 1,000 VECs per day). Although baseline EKGs are useful in identifying arrhythmias in most dogs, the length of the recording should be increased to improve the likelihood of observing an abnormal EKG event. Most importantly, additional EKGs should be obtained or continuous EKG monitoring should be performed in dogs that display clinical signs that could be attributed to ventricular arrhythmias.  相似文献   

11.
Pregnancy and lactation involve great demands on the cardiovascular system. The purpose of this study was to investigate how the heart rate and diurnal heart rate pattern change when dogs become pregnant or lactate. Five clinically healthy female beagle dogs were mated, and delivered three to seven healthy puppies. The heart rate was investigated with 24-h ECG (Holter) once during anoestrus, at 3, 5, 7 and 9 weeks of pregnancy, and at week 4 postpartum (lactation). However, at 9 weeks, the ECG could not be recorded for the fully 24 h in 4 of 5 dogs, because labour started and the dogs then appeared disturbed by the recordings. The results at this date are not included in the statistical comparison. The heart rate increased progressively during pregnancy and was still elevated at 4 weeks of lactation. During late pregnancy the difference in heart rates between daytime and nighttime became smaller, but the heart rate was significantly higher in daytime in all periods. In conclusion, the increased heart rates during pregnancy and lactation reflect increased demands on the cardiovascular system and may be important to consider in clinical practice.  相似文献   

12.
OBJECTIVE: To determine results of ambulatory electrocardiography in and outcome of overtly healthy Doberman Pinschers with equivocal echocardiographic evidence of dilated cardiomyopathy. DESIGN: Case series. ANIMALS: 44 overtly healthy (25 male, 19 female) Doberman Pinschers. PROCEDURE: 24-hour ambulatory electrocardiographic (Holter) recordings with > 90% scan quality obtained the same day that echocardiography was performed were reviewed. RESULTS: Holter recordings from 42 of 44 (95%) dogs contained ventricular premature complexes (VPC). Fifteen of 44 (34%) dogs had > 100 VPC, 9 (20%) had > 500 VPC, and 5 (11%) had > 1,000 VPC. Nonsustained (< 30 seconds) ventricular tachycardia was detected in 4 dogs. Eighteen of 27 (67%) dogs with > 100 VPC, any couplets or triplets of VPC, or ventricular tachycardia developed dilated cardiomyopathy within 1 year, compared with 8 of 17 (47%) dogs with < 100 VPC, no couplets or triplets of VPC, and no ventricular tachycardia. Of the 18 dogs that did not develop dilated cardiomyopathy within 1 year, 11 (61%) did so within 3 years. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a high percentage of Doberman Pinschers with equivocal echocardiographic evidence of dilated cardiomyopathy will be found to have VPC during 24-hour ambulatory electrocardiography and that most will develop echocardiographic abnormalities indicative of cardiomyopathy.  相似文献   

13.
A 6-year-old castrated male Golden Retriever was diagnosed with severe subaortic stenosis with severe left atrial enlargement and high heart rate due to atrial fibrillation. Treatment with digoxin and diltiazem to control ventricular response rate was initiated. Ambulatory electrocardiographic monitoring (Holter monitoring) was performed at the beginning of treatment and was repeated to evaluate the patient's response to drug therapy. Drug dose adjustments were made based on response to therapy as assessed by Holter monitoring. The dog experienced sudden death at home 19 days after beginning treatment while wearing the Holter monitor. Analysis of the Holter recording revealed marked increase in number and complexity of ventricular arrhythmias. A ventricular premature complex occurring on a T wave (R on T) was noted preceding the polymorphic ventricular tachycardia. This arrhythmia immediately degenerated into ventricular fibrillation followed by asystole. This case report describes the arrhythmia that preceded cardiac arrest and reviews the risk factors that could have potentiated the fatal arrhythmia in this dog.  相似文献   

14.
OBJECTIVE: To determine correlations between time-domain and frequency-domain variables of heart rate variability (HRV) derived from 24-hour recordings obtained by use of an ambulatory electrocardiographic recorder (Holter monitor). ANIMALS: 59 overtly healthy Doberman Pinschers (41 without echocardiographic evidence of cardiomyopathy and 18 with precongestive heart failure attributable to cardiomyopathy). PROCEDURE: The HRV was analyzed from 24-hour recordings. Variables were calculated from the entire 24-hour recording as well as 4 user-selected time epochs. Comparisons were made for total power to SD of normal beat-to-normal-beat (NN) intervals (SDNN), ultra-low frequency power to SD of the means of NN intervals, low-frequency power and very-low-frequency power to mean of the SD of NN intervals, and high-frequency (HF) power to the root mean square successive difference of NN intervals (RMSSD) and percentage of NN intervals that varied from the previous NN interval by > 50 milliseconds (PNN50). RESULTS: 58 of 66 (88%) comparisons revealed significant values, indicating that relationships between variables were not random (r > 0.7 in 41 of 66 [62%)) comparisons). Strong correlations (r > 0.8) were found between the square root of total power and SDNN and between HF power and RMSSD. CONCLUSIONS AND CLINICAL RELEVANCE: Time-domain surrogates for variables of frequency-domain analysis variables that correlated in the dogs reported here are the same ones that reportedly correlate in humans. When 24-hour recordings obtained by use of a Holter monitor are used to calculate HRV, SDNN and total power as well as RMSSD and HF power are interchangeable.  相似文献   

15.
Objective: The purpose of this study was to examine a population of miniature schnauzers exhibiting syncope as their primary presenting complaint and to correlate their electrocardiographic (ECG) findings with the criteria for the diagnosis of sick sinus syndrome (SSS) reported in the human and veterinary literature. Design: Retrospective study. Patients: Case records of 31 miniature schnauzers with syncope during the period 1996–2000 were reviewed. Measurements and results: This study supported two previous studies finding that females were more predisposed to ECG abnormalities associated with SSS than males. It was also noted that females were slightly older (10.1 years) when compared to males (8.9 years) at the time of diagnosis. A heart murmur was present in 61% of the dogs and this was most likely secondary to mitral valve endocardiosis and regurgitation. The primary rhythm disturbance seen was sinus arrest/sinoatrial block in 48.5% of the cases; sinus bradycardia was the second most common arrhythmia noted. Conclusion: In miniature schnauzers with syncope, SSS should be considered as a primary etiology if abnormal ECG findings are noted.  相似文献   

16.
Objective – To characterize the signalment, clinical findings, and prognosis of dogs with supraventricular tachycardia (SVT). Design – Retrospective study. Setting – North Carolina State University Veterinary Teaching Hospital. Animals, Intervention, and Measurements – Case selection included all patients at the veterinary teaching hospital with SVT during years 1990–2007. Medical records from dogs with at least 1 recorded episode of SVT were extracted. The signalment, history, electrocardiographic, radiographic, and echocardiographic findings, therapy, and response to therapy were reviewed and summarized. Follow‐up was conducted to determine the date and cause of death. Kaplan‐Meier survival curves were constructed and analyzed. The relationships between patient characteristics and responses to therapy and prognosis were evaluated. Main Results – Sixty‐five records documented a diagnosis of SVT. Sixty‐two percent were males. Labrador Retrievers and Boxers were overrepresented compared with the general hospital population. Median age at presentation was 9 years (range 0.5–15.5 y). The median heart rate during SVT was 270/minute (range 187–375/min). The most common presenting complaint was syncope (30%), 23% were asymptomatic at the time of diagnosis. Most dogs had structural heart disease (65%). Median survival was 472 days (<1–2007 d). Identification of sustained SVT (>30 s) did not affect survival (P=0.50), nor did the presence of congestive heart failure (P=0.70). Conclusions – The majority of dogs with SVT had structural heart disease or a severe concurrent illness at the time of SVT diagnosis. SVT, though often a persistent and occasionally sustained arrhythmia, does not appear to be a primary factor in mortality.  相似文献   

17.
A 9-year-old male neutered Devon Rex cat was presented for continued investigations following a 7-year history of recurrent syncope. Previous diagnostic tests, including 24h (Holter) electrocardiographic monitoring, had failed to identify the aetiology of such episodes, and former empirical treatment with atenolol had not provided satisfactory control of the clinical signs. A conclusive diagnosis was eventually achieved using an implantable loop recorder (Reveal), which identified paroxysmal supraventricular tachycardia (SVT) associated with a syncopal episode. Treatment with oral sotalol was instituted and, 18 months after initiation of anti-arrhythmic therapy, no further syncopal episodes have been observed by the cat's owners.  相似文献   

18.
OBJECTIVE: To determine whether heart rate variability (HRV) is reduced in Doberman Pinschers with dilated cardiomyopathy. DESIGN: Case series. ANIMALS: 62 overtly healthy Doberman pinschers. PROCEDURE: Heart rate variability was analyzed in time and frequency domains from data obtained during 24-hour ambulatory electrocardiographic Holter recordings in 41 overtly healthy Doberman pinschers with normal echocardiograms and 21 overtly healthy Doberman pinschers with abnormal echocardiograms. RESULTS: Heart rate variability usually was greater during night versus day, and 2 dogs with the most severe myocardial failure had reduced HRV. CONCLUSIONS AND CLINICAL RELEVANCE: Reduced HRV was detected only in Doberman Pinschers with the most severe myocardial failure. Thus, HRV in less severely affected dogs is not reduced, or the normal sinus arrhythmia of dogs renders HRV relatively insensitive. Analysis of HRV did not provide additional information relative to the severity of left ventricular dysfunction or risk of sudden death from that which could be derived from echocardiography, analysis of Holter recordings, and signal-averaged electrocardiography.  相似文献   

19.
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20.
Heart rate variability (HRV) is considered to be a measure of autonomic regulation of cardiac activity for assessing stress and welfare in animals. Polar® human heart rate monitors are frequently used in animal studies to measure HRV and have been validated for this use in cows, pigs, and horses. Although Polar® monitors have been used in canine research to measure cardiac activity, we know of no studies that have tested its validity in dogs. Our objectives were as follows: (1) to collect interbeat interval (IBI) data while simultaneously using a Polar® heart rate monitor and an electrocardiogram (ECG) monitor in awake healthy dogs under stationary conditions; (2) to compare Polar® data with ECG data and examine whether any errors occurred in the Polar® data; and (3) to assess the validity of these Polar® data for recording time- and frequency-domain HRV data in dogs. IBI data from the Polar® RS800CX monitor and a telemetric ECG monitor, the Televet 100, were recorded simultaneously for 5 continuous minutes in 10 adult beagles. The Polar® data were compared with the ECG data to identify possible interbeat anomalies, such as those previously identified in pigs and horses. Statistical comparisons for a variety of time and frequency domain parameters (i.e., mean heart rate [ms], mean IBI [ms], R-R max [ms], R-R min [ms], standard deviation, total variance [ms2], and root mean square of successive differences) were performed. Time and frequency domain parameters from the Polar® data were not significantly different from ECG data. The mean heart rate from the Polar® data was 123.98 bpm (range: 101.57-138.35 bpm) and from ECG data was 123.33 bpm (range: 101.57-135.08 bpm). Bland–Altman analysis was used to measure the level of agreement between the 2 data sets. The mean difference between ECG and Polar® data was 0.42 ms (limits of agreement: ?126.76 to 127.60 ms); more than 95% of the differences fell between these limits. We conclude that the Polar® RS800CX digital R-R heart rate monitor is a promising instrument to reliably measure HRV in dogs under stationary conditions.  相似文献   

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