A retrospective review of 146 active and passive fixation bradycardia lead implantations in 74 dogs undergoing pacemaker implantation in a research setting of short term duration

Abstract

BackgroundCanine veterinary patients increasingly benefit from implantation of transvenous pacemakers for bradyarrhythmias. No published data exist examining procedural outcomes of pacemaker implantation performed in the preclinical laboratory. The purpose was to review short term complication, infection, dislodgement, penetration rates, plus overall morbidity following pacemaker implantation in the research setting. A retrospective review of 74 Class A purpose-bred mongrels implanted with active (n = 89) and passive fixation (n = 57) intracardiac leads for dual (n = 72) or single (n = 2) chamber pacing was performed.ResultsAll leads were implanted successfully, meeting electrical implant criteria. Follow-ups typically occurred every 7 days (first month), then at 30 day intervals. Seroma formation was 1.4% and 10.8% at the venotomy and pulse generator site respectively. Overall infection rate was 1.4%. Overall dislodgement rate was 2.1%, (2 passive atrial leads, 1 passive ventricular lead). Overall fractures and insulation defects were zero. Two helix penetrations were noted incidentally post mortem, one at the right atrial appendage and one at the right ventricle (64 dogs, 128 leads evaluated), a 1.6% event rate. Major in-life adverse events were 5.4% (4 of 74 dogs), including 1 infection and 3 lead dislodgements.ConclusionsThis review demonstrates a low complication rate with bradycardia lead implants in the short term (up to 180 days), in a high volume research setting. Lead type, implant technique, surgeon experience, healthy patient population, patient size and follow-up care play a role. This review also suggests active fixation leads in the right atrial appendage of dogs are safe and reliable.Electronic supplementary materialThe online version of this article (10.1186/s12917-018-1431-2) contains supplementary material, which is available to authorized users.

Single-Chamber Cardiac Pacemaker Implantation in a Donkey with Complete AV Block: A Long-Term Follow-Up

“…Although the transvenous implantation of a cardiac pacemaker is a relatively safe and simple procedure, there could be complications associated with it. Lead displacement is one of the most common major complications in both dogs and humans [ 7 , 11 , 13 , 18 , 19 , 20 ]. In our patient, lead dislodgement occurred in the early postoperative period and required correction of the lead position because of loss of capture.…”

“…The Staphylococcus species from the skin may contaminate the wound, most likely during pocket formation, which later causes pocket infection [ 13 ]. The reported rate of infection in dogs varies from 1% to 5% [ 7 , 18 , 19 , 20 , 22 ], and Staphylococcus spp. is also the most commonly cultured isolate [ 20 , 22 ].…”

“…The reported rate of infection in dogs varies from 1% to 5% [ 7 , 18 , 19 , 20 , 22 ], and Staphylococcus spp. is also the most commonly cultured isolate [ 20 , 22 ]. Treatment of the pacemaker pocket infection in our patient included complete system removal and prolonged antibiotic therapy.…”

2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1‐ Defining populations at risk

“…. 331–364 Most were case series or single case reports (LOE 5), and 1240 dogs were described, of which 60 had suspected or confirmed thrombosis (5%). Two studies were experimental (LOE 3) but of poor quality 336,361 .…”

An experimental study on a piezoelectric vibration energy harvester for self-powered cardiac pacemakers

“…At present, implanted medical devices such as pacemakers are used to maintain normal vital signs in millions of patients worldwide (4). With the wide application of pacemakers, many complications related to batteries and implanted devices of pacemakers can also arise (5,6). Furthermore, routine battery replacement to ensure adequate power supply is inavoidable, but this greatly increases the health risks for patients.…”