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1.
The objective of this study was to evaluate retrospectively the clinical utility of ambulatory (Holter) electrocardiographic monitoring in syncopal dogs and to compare the Holter recording with the clinic electrocardiogram (ECG) in these animals. Fifty Holter reports and 44 medical records from 44 dogs were evaluated. A syncopcal episode occurred during monitoring in 24% of the recordings. No obvious relationship was found between the frequency of syncope occurring before Holter recording and the likelihood of a dog having an episode during recording. Holter recordings were helpful in establishing a diagnosis 42% of the time, but no relationship was detected between the frequency of episodes occurring before Holter recording and the likelihood of a diagnostically useful Holter. An arrhythmia was ruled out as the cause of syncope in 12% of the recordings and was implicated as the cause of syncope in 30% of recordings. Of these, 20% were ventricular tachyarrhythmias and 10% were bradyarrhythmias including pacemaker failure. Ambulatory electrocardiographic recordings led to a therapeutic change in 38% of cases. A comparison of the Holter recordings and clinic ECGs documented the expected increased sensitivity for Holter detection of arrhythmias. The average clinic ECG heart rate consistently exceeded the average Holter heart rate with a mean difference between the average heart rates recorded by the two techniques of 31 bpm (range -8-87 bpm).  相似文献   

2.
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   

3.
This case report describes transient atrioventricular block as the etiology for syncopal events in a 6-year-old male German shepherd dog with atrial fibrillation and dilated cardiomyopathy. The arrhythmia diagnosis was obtained via Holter monitoring. Medical treatment with a sustained-release preparation of theophylline, as an additive to the standard congestive heart failure treatment (benazepril, furosemide and pimobendan) may have contributed to temporary remission of the syncopal events. However, the congestive heart failure progressed and the dog was euthanized. Veterinarians should be aware of the possibility of transient atrioventricular block causing syncope in dogs with DCM and AF and should be careful in empirically lowering the ventricular response rate if these dogs present with syncopal episodes.  相似文献   

4.
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   

5.
A 10-year-old female neutered boxer was presented with a five-week history of episodic collapse and melaena. Twenty-four-hour electrocardiograph (Holter) analysis revealed the collapsing episodes to coincide with episodes of paroxysmal ventricular tachycardia. Investigation of the dog's melaena revealed a gastric ulcer which was treated medically and an ileocaecal mass which was surgically excised. Histopathological examination of the mass was consistent with a neuroendocrine (carcinoid) tumour. The patient's recovery after surgery was unremarkable. At six-week follow-up, there had been no further episodes of melaena or collapse and repeat Holter analysis did not show any significant abnormalities. In this dog the gastric ulceration and paroxysmal ventricular tachycardia could be attributed to a paraneoplastic syndrome as a result of circulating vasoactive substances released by the tumour; this is supported by the evidence that all clinical signs resolved after surgical excision of the mass and the dog was clinically well 18 months after surgery.  相似文献   

6.
OBJECTIVE: To evaluate the use of in-hospital electrocardiography (ECG) for detection of ventricular premature complexes (VPC), compared with 24-hour ambulatory ECG. DESIGN: Original study. ANIMALS: 188 Boxers > 9 months old; 31 had a history of syncope, and 157 were healthy (no history of syncope). PROCEDURE: In-hospital ECG was performed on all Boxers for at least 2 minutes. Within 7 days after the in-hospital ECG was completed, 24-hour ambulatory ECG was performed. RESULTS: The specificity of in-hospital ECG was 100% for the detection of at least 50 VPC in a 24-hour period in dogs with syncope and 93% in healthy dogs. In-hospital ECG had poor sensitivity, although sensitivity increased as the number of VPC per 24 hours increased. CONCLUSIONS AND CLINICAL RELEVANCE: Use of in-hospital ECG is highly specific for detection of at least 50 VPC during a 24-hour period. However, in-hospital ECG is insensitive, and a lack of VPC does not suggest that the dog does not have a substantial number of VPC during that same period. The use of in-hospital ECG appears to be inadequate for screening purposes and therapeutic evaluations in mature Boxers with ventricular arrhythmic disease.  相似文献   

7.
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.  相似文献   

8.
A 3 year old Boxer dog was presented with a history of syncope and an irregular heart heat. An arrhythmia characterised by ventricular premature contractions was detected and was thought to cause the syncopal episodes. On the basis of the age, breed and the characteristic electrocardiographic findings, a diagnosis of Boxer Cardiomyopathy was made. The dog was treated with procainamide 500 mg every 8 hours to control the arrythmia and there were no further syncopal episodes in the subsequent 13 months.  相似文献   

9.
A 3 year old Boxer dog was presented with a history of syncope and an irregular heart heat. An arrhythmia characterised by ventricular premature contractions was detected and was thought to cause the syncopal episodes. On the basis of the age, breed and the characteristic electrocardiographic findings, a diagnosis of Boxer Cardiomyopathy was made. The dog was treated with procainamide 500 mg every 8 hours to control the arrythmia and there were no further syncopal episodes in the subsequent 13 months.  相似文献   

10.
CASE DESCRIPTION: A 12-year-old Miniature Dachshund with a history of permanent endocardial pacemaker implantation performed 7 weeks previously was admitted for routine dental prophylaxis. CLINICAL FINDINGS: Preanesthetic ECG revealed normal ventricular capture. Thoracic radiographic findings included caudomedial displacement of the endocardial pacemaker lead. Echocardiography revealed moderate chronic degenerative valve disease with moderate left atrial and ventricular dilation. After induction of anesthesia, loss of ventricular capture was detected. The dog recovered from anesthesia and had improved ventricular capture. The following day, surgical exposure of the cardiac apex revealed perforation of the right ventricular apex by the passive-fixation pacemaker lead. TREATMENT AND OUTCOME: A permanent epicardial pacemaker was implanted through a transxiphoid approach. Appropriate ventricular capture and sensing were achieved. The dog recovered without complications. Approximately 2 months later, the dog developed sudden respiratory distress at home and was euthanized. CLINICAL RELEVANCE: In dogs with permanent pacemakers and loss of ventricular capture, differential diagnoses should include cardiac perforation. If evidence of perforation of the pacemaker lead is found, replacement of the endocardial pacemaker lead with an epicardial pacemaker lead is warranted.  相似文献   

11.
A 10-year-old male cairn terrier cross was presented with a history of myxomatous mitral valve disease diagnosed six months previously and with a four-week history of intermittent collapse. On 24 hour electrocardiograph (Holter) analysis, periods of no discernable electrical cardiac activity, which coincided with three collapsing episodes, were identified. Unfortunately, on re-presentation for removal of the Holter monitor, the dog collapsed and died. A post-mortem examination was conducted, and histology of the right and left atrium showed evidence of myocarditis. This is the first reported case, to our knowledge, of collapse because of electrical asystole in a dog with atrial myocarditis.  相似文献   

12.
Background: Ventricular premature contractions (VPCs) are common in the occult stage of cardiomyopathy in Doberman Pinschers. Although the gold standard for detecting arrhythmia is the 24‐hour ambulatory electrocardiography (ECG) (Holter), this method is more expensive, time‐consuming and often not as readily available as common ECG. Objectives: Comparison of 5‐minute ECGs with Holter examinations. Animals: Eight hundred and seventy‐five 5‐minute ECGs and Holter examinations of 431 Doberman Pinschers. Methods: Each examination included a 5‐minute ECG and Holter examination. A cut‐off value of >100 VPCs/24 hours using Holter was considered diagnostic for the presence of cardiomyopathy. Statistical evaluation included calculation of sensitivity, specificity, positive predictive value, and negative predictive value. Results: Holter examinations revealed >100 VPCs/24 hours in 204/875 examinations. At least 1 VPC during a 5‐minute ECG was detected in 131 (64.2%) of these 204 examinations. No VPCs were found in the 5‐minute ECG in 73 (35.8%) examinations of affected Doberman Pinschers. A 5‐minute ECG with at least 1 VPC as cut‐off had a sensitivity of 64.2%, a specificity of 96.7%, a positive predictive value of 85.6% and a negative predictive value of 89.9% for the presence of >100 VPCs/24 hours. Conclusions and Clinical Importance: A 5‐minute ECG is a rather insensitive method for detecting arrhythmias in Doberman Pinschers. However, the occurrence of at least 1 VPC in 5 minutes strongly warrants further examination of the dog, because specificity (96.7%) and positive predictive value (85.6%) are high and could suggest occult cardiomyopathy.  相似文献   

13.
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.  相似文献   

14.
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   

15.
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   

16.
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.  相似文献   

17.
Objectives : To describe the electrocardiographic characteristics of ventricular tachycardia arising from the right ventricular outflow tract and the particular association between this arrhythmia and the presence of localised right ventricular outflow tract enlargement in English bulldogs. Methods : Five English bulldogs were referred with a history of syncope or cardiogenic shock. In all dogs, 12‐lead surface ECG, thoracic radiograph and echocardiography were collected. In all but one dog 24‐hours Holter monitoring and signal‐averaged ECGs was examined and in one dog electrophysiological study and radiofrequency catheter ablation of the VT substrate was performed. Results : Documented arrhythmias included a single sustained monomorphic wide QRS tachycardia in four dogs, and an alternans of two different monomorphic forms in one dog. Mean QRS duration during tachy‐cardia was 91·6 ±9·83 milliseconds. QRS complexes manifested a left bundle branch block morphology and an inferior axis (81 ±13·73°). R wave notching was present in the caudal (inferior) leads in three tachy‐cardias. Lead I was negative in 3 of 6, positive in 1 of 6 and isodiphasic in 2 of 6. Lead aVL was negative in 5 of 6 and positive in 1 of 6. Signal‐averaged electrocardiograms revealed late potentials in three dogs. Echocardiography showed a localised right ventricular outflow tract enlargement in all dogs. Cardiac map‐ping established two sites of origin of ventricular tachycardia within the right ventricular outflow tract in one dog: caudal free‐wall and cranial‐septal. Clinical Significance : The presence of a localised right ventricular outflow tract enlargement and ventricular tachycardia with left bundle branch block morphology could suggest segmental arrhythmogenic right ven‐tricular cardiomyopathy in the English bulldog.  相似文献   

18.
An adult female mixed breed dog presented for recurrent collapsing episodes over several weeks. Holter evaluation revealed periods of sinus arrest and echocardiography identified a soft tissue mass with subsequent severe dynamic obstruction of the left ventricular outflow tract. The patient was euthanized five days after presentation for severe dyspnea. Necropsy revealed an irregular mass circumferentially lining the left ventricular outflow tract as well as multiple myocardial metastases. The final diagnosis was an undifferentiated pleomorphic endocardial sarcoma.  相似文献   

19.
Carotid body tumours were diagnosed in two British Bulldogs that each had a history of syncopal episodes induced by eating, drinking or pulling on the leash. In both dogs, a cervical mass was identified using computed tomography (CT) or magnetic resonance imaging, with carotid body tumour (CBT) being the histopathological diagnosis. A heart base mass was also identified in one dog by both CT and echocardiography. Swallowing syncope has been reported in the human literature in association with cervical mass lesions, but this is the first report in dogs. The present cases emphasise the value of advanced imaging of the head and neck in dogs presenting with clinical signs of syncope associated with swallowing and the importance of careful manipulation of the neck in patients with CBTs.  相似文献   

20.
Objective: To describe a case of atrioventricular block and syncope secondary to systemic hypertension in a dog with malignant pheochromocytoma. Case Summary: A 13‐year‐old spayed female mixed‐breed dog presented following an acute onset of collapse. The dog was hypertensive and had paradoxical high‐grade second‐degree atrioventricular block with concurrent syncope. Initial emergent therapy included a nitroprusside infusion for the systemic hypertension and vagolytic therapy for the bradyarrhythmia. A left adrenal mass was seen on abdominal ultrasound and was further characterized by MRI. Following medical stabilization with phenoxybenzamine and propantheline, a left adrenalectomy was performed. Histological diagnosis was consistent with a malignant pheochromocytoma. Following tumor removal there has been no further hypertension, atrioventricular block or syncope. Unique information provided: This is the first documented case of a malignant pheochromocytoma presenting as syncope secondary to hypertension induced atrioventricular block.  相似文献   

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