Atrial‐Based Pacing for Sinus Node Dysfunction in Dogs: Initial Results

Estrada, Amara H.; Pariaut, Romain; Hemsley, Shari A.; Gatson, B.H.; Moı̈se, N. Sydney

doi:10.1111/j.1939-1676.2012.00928.x

Cited by 11 publications

(6 citation statements)

References 37 publications

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“…These findings support the routine use of dual-paced, dual-sensed, dual mode of response rate modulation, rather than AAIR, pacing in patients with SSS [67]. Also, in human medicine, in patients with sinus standstill, dualchamber pacing is considered the pacing mode of choice [67], whereas AAIR is not considered for routine use [130]. Unnecessary right ventricular pacing should be systematically avoided in patients with sinus standstill by programming the PM with a long AV interval [135,136].…”

Section: Indications For Pacing and Choice Of Pacing Modementioning

confidence: 54%

Indications for permanent pacing in dogs and cats

Santilli

Giacomazzi²,

Vázquez³

et al. 2019

Journal of Veterinary Cardiology

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Pacemaker implantation is considered as a standard procedure for treatment of symptomatic bradycardia in both dogs and cats. Advanced second-degree and third-degree atrioventricular blocks, sick sinus syndrome, persistent atrial standstill, and vasovagal syncope are the most common rhythm disturbances that require pacing to either alleviate clinical signs or prolong survival. Most pacemakers are implanted transvenously, using endocardial leads, but rarely epicardial leads may be necessary. To decide whether a patient is a candidate for pacing, as well as which pacing modality should be used, the clinician must have a clear understanding of the etiology, the pathophysiology, and the natural history of the most common bradyarrhythmias, as well as what result can be achieved by pacing patients with different rhythm disturbances. The goal of this review was, therefore, to describe the indications for pacing by evaluating the available evidence in both human and veterinary medicine. We described the etiology of bradyarrhythmias, clinical signs and electrocardiographic abnormalities, and the choice of pacing modality, taking into account how different choices may have different physiological consequences to selected patients. It is expected that this review will assist veterinarians in recognizing arrhythmias that may require permanent pacing and the risk-benefit of each pacing modality and its impact on outcome. ª

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Section: Indications For Pacing and Choice Of Pacing Modementioning

confidence: 54%

Indications for permanent pacing in dogs and cats

Santilli

Giacomazzi²,

Vázquez³

et al. 2019

Journal of Veterinary Cardiology

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“…SSS has been described in various dog breeds, such as pugs, dachshunds, cocker spaniels and West Highland white terriers, but femaleminiature schnauzers seem to be the most affected [7,11]; syncope is a clinical sign commonly present in patients with sinus node dysfunction [12,18,20]. Episodes of syncope were reported by the owner of the female schnauzer referred to in the present report, and throughout the patient's care, syncope was present.…”

Section: Discussionmentioning

confidence: 46%

“…A subcutaneous pocket was created at the ventral aspect of the thoracic incision to accommodate a generator, which was connected to the pacemaker lead. The pacemaker was made by Boston Scientific and was an Advantio model (K082) 7 [basic frequency 60-60 (BOL-ERI-ppm], magnetic frequency 100-85 (BOL-ERI-ppm), connector size IS-1 (mm), polarity UNI/BI, leads, and titanium battery). After the surgical procedure, the patient remained under observation for 24 h. At the time of writing, the clinical signs have ceased.…”

Section: Casementioning

confidence: 99%

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Pacemaker Implant in a Dog with Sick Sinus Syndrome

Aleixo

Alfonso

Kichise

et al. 2017

Acta Scientiae. Vet.

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Background: Sick sinus syndrome is characterized by the presence of arrhythmias, including persistent sinus bradycardia, sinus arrest and paroxysmal atrial tachyarrhythmia. It commonly occurs in elderly dogs, especially miniature schnauzers; however, it is also detected in dachshunds and pugs. Reports of clinical signs by animal owners are not always clear and precise, which may result in erroneous interpretations by veterinarians; consequently, the use of inappropriate therapies. The present work aims to describe clinical aspects and findings from tests related to sick sinus syndrome (SSS) and presents the case of a female schnauzer with SSS.Case: A 10-year-old female dog (schnauzer, 8.6 kg) attended the Veterinary Hospital of the FMVZ-UNESP - Botucatu. The owner mentioned convulsive episodes, but a thorough medical history and patient assessment revealed that the dog exhibited episodes of syncope. During the physical examination, cardiac auscultation revealed the heart rate to be 56 beats per minute (bpm), and there was a presence of pauses. Also during cardiac auscultation, a holosystolic heart murmur was verified, with a focus on the mitral and tricuspid valves. The electrocardiogram showed the presence of sinus arrest with escape rhythms, pauses of 10 s and the presence of bradycardia-tachycardia syndrome. A Holter monitor was used to establish the diagnosis of SSS. The patient presented with significant episodes of syncope during outpatient care, and based on the clinical manifestation, drug therapy was initiated. The prescribed medications were aminophylline 20 mg/ kg TID, enalapril maleate 0.5 mg/kg BID, spironolactone 1 mg/kg SID and furosemide 2 mg/kg BID. After the start of treatment, there was a reduction in the frequency of episodes of syncope. Three weeks after diagnosis, a pacemaker device was implanted. Currently, clinical signs are absent.Discussion: Sinus node dysfunction is one of the main reasons for pacemaker implantation. It is usually diagnosed based on clinical signs and the presence of sinus bradycardia and sinus pauses in electrocardiograms or Holter monitoring. The diagnosis of SSS is limited to cases in which the patient does not present with abnormalities in an electrocardiogram. Syncope is a clinical sign commonly present in patients with dysfunction of the sinus node, and episodes of syncope were reported by the owner of the dog referred to in the present report. A thorough medical history and physical examination must be performed to diagnose SSS because erroneous diagnosis and incorrect interpretations of clinical signs can lead to the misuse of medications. The treatment of choice for SSS is an implantable pacemaker device; however, because the method is not widely used in Brazil, a second option is drug treatment. In the present report, after implantation of a pacemaker, clinical signs ceased, and the patient was in good general health and could return to her normal activities. Sick sinus syndrome is a disease commonly found in schnauzers. There is a need for detailed histories and complementary exams because the clinical signs do not always correlate with electrocardiographic findings. The implantation of a pacemaker is the treatment of choice and is effective for the condition, but its use is not uniformly accessible throughout the country.

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“…This review also suggests that an active fixation lead implanted into the RA appendage (44 implants in this review) by experienced operators using appropriate techniques is safe in the short term and effective (in terms of lead electrical performance). Such an approach has not been fully utilized clinically, due to the perception that an optimal lead design for veterinary patients does not yet exist, that the thin walled RA appendage will not necessarily allow for proper fixation into the tissue, the presumption that there is a greater risk of perforation, and recognition of the need to develop optimized techniques to make atrial pacing more reliable [ 5 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

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

2018

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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.

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Atrial‐Based Pacing for Sinus Node Dysfunction in Dogs: Initial Results

Cited by 11 publications

References 37 publications

Indications for permanent pacing in dogs and cats

Indications for permanent pacing in dogs and cats

Pacemaker Implant in a Dog with Sick Sinus Syndrome

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

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