Temporary Cardiac Pacing

DeFrancesco, Teresa C.

doi:10.1016/b978-1-4557-0306-7.00203-8

Cited by 1 publication

(6 citation statements)

References 22 publications

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“…Identification of the RV apex as the optimal lead position is consistent with reports in other species 1,5,7,9,39,40 . However, despite multiple attempts, the RV apical position was not achieved in some horses because of difficulties manipulating lead direction.…”

Section: Discussionsupporting

confidence: 83%

“…Lead dislodgement and loss of capture also presents an issue with both TV‐TP and permanent pacing leads in human and canine patients 6,10,12,41 . Management includes movement restriction and constant telemetric ECG monitoring 6,39,40 . Larger cardiac size is hypothesized to be associated with lead dislodgement in large breed dogs and therefore may also be a factor in the horse 14 .…”

Section: Discussionmentioning

confidence: 99%

“…10,12,41 Reported complications include failure of capture, infection, myocardial puncture, cardiac perforation/hemopericardium, life-threatening arrhythmias, air embolism, arterial puncture, significant hemorrhage, diaphragmatic pacing, and venous thrombosis. 2,3,40,42,[47][48][49] Short duration, self-limiting ventricular ectopy occurred during lead placement, as in other species where it rarely requires intervention. 3,8,10,42 However, significant ventricular arrhythmias do rarely occur 41 so telemetric monitoring and antiarrhythmic preparedness are indicated.…”

Section: Discussionmentioning

confidence: 99%

“…Identification of the RV apex as the optimal lead position is consistent with reports in other species. 1,5,7,9,39,40 However, despite multiple attempts, the RV apical position was not achieved in some horses because of difficulties manipulating lead direction. The use of more rigid, steerable pacing leads and/or longer, flexible introducer sheaths may improve the ability to achieve a desired position in the caudal RV apex.…”

Section: Discussionmentioning

confidence: 99%

“…6,10,12,41 Management includes movement restriction and constant telemetric ECG monitoring. 6,39,40 Larger cardiac size is hypothesized to be associated with lead dislodgement in large breed dogs and therefore may also be a factor in the horse. 14 Operator inexperience is also associated with lead dislodgement.…”

Section: Discussionmentioning

confidence: 99%

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Twenty‐four hour continuous transvenous temporary right ventricular pacing in healthy horses

Avison,

Gelzer,

Reef

et al. 2024

Veterinary Internal Medicne

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BackgroundThe ability to perform transvenous temporary cardiac pacing (TV‐TP) is critical to stabilize horses with symptomatic bradyarrhythmias. Reports of successful TV‐TP in horses are limited, and only briefly describe short‐term pacing.ObjectiveTo describe temporary, medium‐term (24 h) transvenous right ventricular pacing in awake horses using a bipolar torque‐directed pacing catheter.AnimalsSix healthy adult institutional teaching horses.MethodsProspective experimental study with 2 immediately successive TV‐TP lead placements in each horse with a target location of the RV apex. One placement was performed primarily with echocardiographic guidance and 1 primarily with fluoroscopic guidance. In all placements, corresponding images were obtained with both imaging modalities. Horses were then paced for 24 h, unrestricted in a stall with continuous telemetric ECG monitoring. Echocardiographically determined lead position, episodes of pacing failure in the preceding 6 h, and pacing thresholds were recorded every 6 h. Pacing failure was defined as a period of loss of capture longer than 20 s.ResultsPacing leads were placed with both guidance methods and maintained for 24 h with no complications. Two horses with leads angled caudally in the right ventricular apex had no pacing failure, the remaining 4 horses had varying degrees of loss of capture. Leads located in the right ventricular apex had longer time to pacing failure and lower capture thresholds P < 0.05.Conclusions and Clinical ImportanceMedium‐term TV‐TP is feasible and has potential for stabilization of horses with symptomatic bradyarrhythmias. Lead position in the right ventricular apex appears optimal. Continuous ECG monitoring is recommended to detect pacing failure.

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Section: Discussionsupporting

confidence: 83%