Three-dimensional electroanatomic mapping and radiofrequency catheter ablation of ventricular arrhythmia in a dog without structural heart disease |
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| Institution: | 1. Cardiac Electrophysiology Section, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA;2. Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3800 Spruce St, Philadelphia, PA 19104, USA;1. Small Animal Teaching Hospital, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire, CH64 7TE, UK;2. Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire, CH64 7TE, UK;1. Anicura Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy;2. Department of Veterinary Sciences, University of Pisa, Via Livornese lato monte, 56122 San Piero a Grado, Pisa, Italy;3. Anicura Clinica Veterinaria CMV Varese, Viale Padre P.G. Aguggiari 162, 21100 Varese, Italy;4. Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, 10095 Grugliasco, Turin, Italy;1. Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, 060-0818, Japan;2. Laboratory of Veterinary Internal Medicine, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-nishi, Miyazaki, 889-2192, Japan;1. Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E., Guelph, Ontario, N1G 2W1, Canada;2. Department of Pathobiology, Ontario Veterinary College, University of Guelph, 419 Gordon St., Guelph, Ontario, N1G 2W1, Canada;3. Mississauga Oakville Veterinary Emergency and Specialty Hospital, 2285 Bristol Circle, Oakville, Ontario, L6H 6P8, Canada;1. Anicura Albano Animal Hospital, Rinkebyvägen 21, Danderyd, Sweden;2. Department of Clinical Sciences Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden |
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| Abstract: | A 1.5-year-old, female-spayed mix-breed dog was presented with recurrent episodes of shaking and excessive panting attributed to drug-refractory ventricular arrhythmia (VA) characterized predominantly by incessant periods of ventricular bigeminy. The VA had a narrow QRS morphology, suggestive of an origin near the His bundle or fascicular system. Diagnostic evaluation found no structural heart disease or underlying etiology. Three-dimensional electroanatomic mapping and radiofrequency catheter ablation were pursued. Voltage mapping demonstrated normal bi-ventricular voltage (≥1.5 mV) without any fractionated or multicomponent electrograms, indicating the absence of ventricular myocardial scar. Pace mapping identified an endocardial origin of the VA at the basal anterior septum of the left ventricle, distal to the His bundle and near the left bundle branch. Two ablation lesions were delivered to this site, and a left bundle branch block was temporarily induced. The dog recovered uneventfully. One month later, the owners reported a remarkable improvement in clinical signs, and follow-up 48-h Holter monitor found complete resolution of VA. |
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| Keywords: | Veterinary Electrophysiology Premature complex Tachycardia Bundle branch block |
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