Paroxysmal atrial fibrillation in seven dogs with presumed neurally-mediated syncope

Vázquez, D.M. Porteiro; Perego, M.; Santos, Luis Felipe Neves Dos; Gerou-Ferriani, Magda; Martin, Mike W.; Santilli, Roberto A.

doi:10.1016/j.jvc.2015.10.010

Cited by 16 publications

(8 citation statements)

References 23 publications

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“…In the present case, the surgery‐induced substrate also represents the trigger for AF as it was initiated immediately after the clamping of the left auricle and the ligation of the PVs, similar to the other case previously reported 21 . High vagal tone is a known facilitating factor for the development and maintenance of paroxysmal AF which frequently originates from specialised cells located near the sites where PVs enter the left atrium 24,25 . Although the underlying mechanism is unclear, we hypothesise that the surgical manipulation induced a direct trauma to the cardiac autonomic nerves, thereby increasing vagal tone, and caused ectopic depolarisations in the atrial, ultimately becoming the cause and the maintenance factor for this arrhythmia.…”

Section: Discussionsupporting

confidence: 84%

Transient atrial fibrillation following total pneumonectomy for the treatment of a primary pulmonary chondrosarcoma, managed with one‐lung ventilation in a dog

Szewczyk¹,

Merlin²,

Norgate

2021

Vet Record Case Reports

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An 8-year and 2-month-old 37.2 kg crossbreed dog was presented with a persistent cough. Thoracic computed tomography was performed and identified a large lobar mass sitting within the left main stem bronchus. The mass was deemed operable, but considering the unique technical challenges associated with the surgery (need for specific ventilation strategies and risk of major haemorrhage) a guarded prognosis was given. A total left-sided pneumonectomy via a lateral thoracotomy was performed. One-lung ventilation was required in order to allow surgical access. During the surgery, the dog suddenly developed atrial fibrillation, which converted back to a normal sinus rhythm (SR) during the recovery period. The dog recovered uneventfully following the return to SR and was discharged 72 hours after the surgery. Histopathological results of the lung mass concluded to a primary pulmonary chondrosarcoma.

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Section: Discussionsupporting

confidence: 84%

Transient atrial fibrillation following total pneumonectomy for the treatment of a primary pulmonary chondrosarcoma, managed with one‐lung ventilation in a dog

Szewczyk¹,

Merlin²,

Norgate

2021

Vet Record Case Reports

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“…Porteiro Vázquez et al . () described seven dogs, three of which were boxers, with atrial fibrillation following an episode of neurally‐mediated collapse detected on their AECG. Whilst both sympathetic and parasympathetic stimulation can shorten the refractory period of atrial myocytes, vagal stimulation also increases the dispersion of the refractory period, creating conditions suitable for the maintenance of multiple re‐entrant wavelets.…”

Section: Discussionmentioning

confidence: 99%

Heart rhythm during episodes of collapse in boxers with frequent or complex ventricular ectopy

Domingues¹,

Brookes

Oliveira³

et al. 2020

J of Small Animal Practice

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Objectives: To describe heart rhythm during collapse events in boxer dogs using ambulatory electrocardiogram and determine the predictive value of frequent or complex ventricular ectopy for collapse associated with ventricular tachycardia. Materials and MethOds:A total of 659 ambulatory electrocardiogram recordings from 429 boxer dogs were identified from a database in the UK. Summary statistics described the frequency and complexity of ventricular ectopy during all recordings, recordings in which collapse occurred and associated boxer demographics. Positive predictive values were calculated to investigate whether frequent ventricular ectopy was useful to predict heart rhythm during episodes of collapse.results: Of the 659 ambulatory electrocardiogram recordings, 250 recordings showed <50 single ventricular beats (Group 1), and frequent (≥50) or complex ventricular ectopy were observed in 409 recordings (Group 2). A total of 90 collapse events were observed in 72 ambulatory electrocardiograms from 68 dogs, comprising 30 dogs in Group 1 and 38 dogs in Group 2. In both groups, sinus rhythm was the most frequent collapse rhythm, followed by neurally mediated collapse and then ventricular tachycardia. The proportion of dogs that displayed ventricular tachycardia-associated episodic collapse given that they had frequent (≥50) or complex ventricular ectopy in the study population was 0.11 [95% confidence interval = 0.01 to 0.21].clinical significance: These results challenge the preconception that UK boxer dogs with collapse will have ventricular tachycardia and, consequently, the authors recommend definitive diagnosis of the cause of episodic collapse to guide selection of therapeutic drugs.

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“…In the present case, lidocaine successfully converted AFL, which has not been reported before. It could be argued that termination of AFL could have also occurred coincidentally because of simultaneous decreased vagal stimulation 22. However, this is unlikely as it occurred soon after lidocaine administration.…”

Section: Discussionmentioning

confidence: 99%

Cardioversion of suspected vagally mediated atrial flutter using lidocaine in an anaesthetised dog

Cornacchini

Pedro

Martin

et al. 2018

Vet Record Case Reports

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A 10-year-old male neutered English bull terrier was referred for investigation of sneezing and stertorous breathing. Upper airway assessment under general anaesthesia was scheduled, along with a CT scan, bronchoscopy and bronchoalveolar lavage. The anaesthetic protocol consisted of acepromazine and butorphanol for premedication, propofol for induction, and isoflurane for maintenance of anaesthesia. Laryngoscopy during induction of anaesthesia revealed paradoxical collapse of both arytenoid cartilages with complete closure of the rima glottidis during inspiration. During bronchoscopy an electrocardiogram was attached which revealed atrial flutter. Atrial flutter was converted using lidocaine into a marked respiratory sinus arrhythmia. Six days later the dog was readmitted for unilateral cricoarytenoid lateralisation. No intraoperative or postoperative complications were encountered. It was speculated that atrial flutter was vagally mediated and occurred acutely during laryngoscopy. If atrial flutter is considered to be vagally mediated, lidocaine may serve as a useful treatment.

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Paroxysmal atrial fibrillation in seven dogs with presumed neurally-mediated syncope

Cited by 16 publications

References 23 publications

Transient atrial fibrillation following total pneumonectomy for the treatment of a primary pulmonary chondrosarcoma, managed with one‐lung ventilation in a dog

Transient atrial fibrillation following total pneumonectomy for the treatment of a primary pulmonary chondrosarcoma, managed with one‐lung ventilation in a dog

Heart rhythm during episodes of collapse in boxers with frequent or complex ventricular ectopy

Cardioversion of suspected vagally mediated atrial flutter using lidocaine in an anaesthetised dog

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