Anatomic distribution and electrophysiologic properties of accessory atrioventricular pathways in dogs

Santilli, Roberto A.; Spadacini, G.; Moretti, Paolo; Perego, M.; Perini, A.; Crosara, S.; Tarducci, Alberto

doi:10.2460/javma.231.3.393

Cited by 30 publications

(37 citation statements)

References 36 publications

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“…Cardiac arrhythmias were not frequently reported in our dogs. Neither ventricular pre-excitation nor the SVT typical of a macro re-entrant circuit was identified, despite an association between EM and WolffParkinson-White syndrome in people (Misaki et al, 1995), and the predisposition of Labradors to orthodromic atrioventricular reciprocating tachycardia (OAVRT) (Santilli et al, 2007). The only case in this study with SVT was a border collie, a breed not considered to be of increased risk for OAVRT.…”

Section: Discussionmentioning

confidence: 62%

Tricuspid valve dysplasia: A retrospective study of clinical features and outcome in dogs in the UK

Navarro-Cubas¹,

Palermo

French³

et al. 2017

Open Vet J.

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The objective of this study was to determine the demographic, clinical and survival characteristics and to identify risk factors for mortality due to tricuspid valve dysplasia in UK dogs. Records of client-owned dogs diagnosed with tricuspid valve dysplasia at a referral centre were retrospectively reviewed. Only dogs diagnosed with tricuspid valve dysplasia based on the presence of a right-sided heart murmur identified prior to one year of age, and confirmed with Doppler echocardiography, were included. Dogs with concomitant cardiac diseases, pulmonary hypertension and/or trivial tricuspid regurgitation were excluded. Analysed data included signalment, reason for presentation, clinical signs, electrocardiographic and echocardiographic features, survival status and cause of death. Survival times and risk factors for mortality were evaluated using Kaplan-Meier curves and Cox regression. Eighteen dogs met inclusion criteria. Border collies were over-represented (p= 0.014). Dogs were most frequently referred for investigation of heart murmur. The most common arrhythmia was atrial fibrillation (n=3). Median survival time from diagnosis of tricuspid valve dysplasia was 2775 days (range 1-3696 days; 95% CI 1542.41-4007.59) and from onset of right-sided congestive heart failure was 181 days (range 1-2130 days; 95% CI 0-455.59). Syncope was the sole risk factor for cardiac death. In this population of UK dogs, tricuspid valve dysplasia was uncommon but, when severe, frequently led to rightsided congestive heart failure. Prognosis was favourable for mild and moderate tricuspid dysplasia. Survival time was reduced with right-sided congestive heart failure but varied widely. Risk of cardiac death was significantly increased if syncope had occurred.

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Section: Discussionmentioning

confidence: 62%

Tricuspid valve dysplasia: A retrospective study of clinical features and outcome in dogs in the UK

Navarro-Cubas¹,

Palermo

French³

et al. 2017

Open Vet J.

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“…The mid-septal and anteroseptal and the left-sided APs, might be more difficult to be treated by radiofrequency catheter ablation, due to their proximity to the His bundle in the first two cases, and the need to perform an interatrial septal puncture in the left-sided bands. 9,10 An anatomical RBBB was detected in addition to an AP. Persistent RBBB can be present both in normal and diseased hearts, and if not associated with heart failure, it usually doesn't cause hemodynamic problems.…”

Section: Discussionmentioning

confidence: 96%

“…In a study performed on 15 dogs with APs, the most frequent anatomical localization of the anomalous bands was the right free wall, followed by the postero-septal position, while only 3 of the 15 studied APs were located in the mid-septum. 9 Moreover, in contrast to human beings, bidirectional decremental conduction is an infrequent finding in dogs. In the case described here, bidirectional conduction along the AP was diagnosed before the EP study, because of evidence of pre-excitation on the surface ECG.…”

Section: Discussionmentioning

confidence: 99%

Orthodromic atrioventricular reciprocating tachycardia conducted with intraventricular conduction disturbance mimicking ventricular tachycardia in an English Bulldog

Santilli¹,

Diana

Toaldo

2012

Journal of Veterinary Cardiology

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“…[9][10][11][12] In contrast to humans, the abnormal atrioventricular connection in dogs is most frequently located in the right free wall (40%) or in the posteroseptal area (27%). 13 Humans affected by an Ebstein anomaly may have multiple APs that are typically located in the right free wall or in the posterior part of the septum, locations that are more frequently described in dogs. 14,15 Most dogs that have APs are Labrador Retrievers and Boxers, suggesting a possible predisposition of these breeds to develop anomalous atrioventricular bundle connections.…”

Section: Discussionmentioning

confidence: 98%

“…Moreover, the conduction can be decremental or nondecremental with variable durations of refractory periods. 10,12,13 In people, the classification of APs is as follows: left free wall APs, 44% to 70%; right free wall APs, 5% to 20%; posteroseptal APs, 10% to 35%; midseptal APs, 2% to 11%; and anteroseptal APs, 4% to 10%. [9][10][11][12] In contrast to humans, the abnormal atrioventricular connection in dogs is most frequently located in the right free wall (40%) or in the posteroseptal area (27%).…”

Section: Discussionmentioning

confidence: 99%

ECG of the Month

Ra¹,

Critelli²,

Toaldo³

2010

javma

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A 2-year-old 30-kg (66-lb) sexually intact male Golden Retriever was referred to the Clinica Veterinaria Malpensa because of exercise intolerance and episodic weakness of 1 month' s duration. During 1 episode of weakness, an ECG examination performed by the primary veterinarian revealed a narrow-QRS complex tachycardia with a cycle length of 200 milliseconds. The patient was treated with sotalol a (2 mg/kg [0.9 mg/lb], PO, q 12 h) to control episodic supraventricular tachycardia and to reduce clinical signs.At the initial evaluation, a physical examination revealed no abnormalities. Findings of survey thoracic radiography and transthoracic echocardiography were considered normal. An initial 12-lead ECG revealed short PQ intervals, slurring of the onset of the QRS complexes (delta wave), and alteration of the QRS-ST segment morphology. These findings were consistent with ventricular pre-excitation.The presence of an accessory pathway (AP)-mediated tachycardia was strongly suspected, and an electrophysiological assessment was performed. Sotalol administration was discontinued for 24 hours (ie, a period equivalent to 5 half-lives of the drug) before the procedure. The patient was anesthetized and placed in dorsal recumbency during the entire interventional procedure. Multiple access sites on jugular and femoral veins were used to allow introduction of endocardial catheters by use of the Seldinger technique. The electrophysiological assessment was conducted in accordance with standard techniques. 1,2 A decapolar catheter b was introduced at the level of the coronary sinus and positioned in contact with the epicardal surface, and a quadripolar catheter c was inserted near the bundle of His. An ablation catheter d was used to perform programmed atrial and ven- Figure 1-Surface ECG tracings (6 leads of a 12-lead ECG) obtained during electrophysiological assessment of a dog that was evaluated because of exercise intolerance and episodic weakness of 1 month's duration. On the basis of initial ECG findings, an accessory pathway (AP) was suspected. The electrophysiological examination revealed the presence of an AP that was subsequently ablated by use of a radiofrequency catheter. During the procedure and before the ablation, the dog developed a paroxysm of sustained atrial fibrillation (AF). The first 6 beats of the ECG tracings have features typical of AF with orthodromic conduction through the His-Purkinje system, including absence of the P wave, narrow QRS complex (duration, 60 milliseconds; reference range, < 70 milliseconds), and irregular R-R intervals. From the seventh beat onward, antegrade activation of the AP with signs of ventricular pre-excitation is evident. Wide QRS complexes (duration, 100 milliseconds), the presence of a delta wave preceding each R wave, and persistence of irregular R-R intervals are indicative of the occurrence of pre-excited AF. Paper speed = 50 mm/s; 1 cm = 1 mV.

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Anatomic distribution and electrophysiologic properties of accessory atrioventricular pathways in dogs

Abstract: Results suggested that in dogs, most APs are right-sided, had unidirectional retrograde conduction, and are associated with various arrhythmias, including orthodromic atrioventricular reciprocating tachycardia and atrial fibrillation without evidence of pre-excitation.

Cited by 30 publications

References 36 publications

Tricuspid valve dysplasia: A retrospective study of clinical features and outcome in dogs in the UK

Tricuspid valve dysplasia: A retrospective study of clinical features and outcome in dogs in the UK

Orthodromic atrioventricular reciprocating tachycardia conducted with intraventricular conduction disturbance mimicking ventricular tachycardia in an English Bulldog

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