Schrope Donald P, Kelch William J
Oradell Animal Hospital, 580 Winters Avenue, Paramus, NJ 07652, USA.
J Am Vet Med Assoc. 2006 Jun 1;228(11):1710-7. doi: 10.2460/javma.228.11.1710.
To evaluate signalment, clinical signs, and prognosis associated with high-grade second- or third-degree atrioventricular block (AVB) in dogs.
Retrospective case series.
124 dogs.
Data were gathered from ECGs, veterinarian questionnaires, echocardiograms, and radiographs submitted for review; compared with data from a large control group; and examined for association between variables and duration of survival. A new classification system for AVB was evaluated.
Afghan, Catahoula Leopard Dog, Chow Chow, Cocker Spaniel, German Wirehaired Pointer, and Labrador Retriever breeds were predisposed to high-grade second- or third-degree AVB. Heavier, older, and sexually intact female dogs were overrepresented in the study group. Weakness, lethargy, exercise intolerance, and syncope were the most common clinical signs. The presence of clinical signs was not associated with duration of survival. Dogs with high-grade second-degree AVB had a duration of survival similar to that of dogs with third-degree AVB. Dogs with high-grade second- or third-degree AVB were at high risk for sudden death in the first 6 months after diagnosis. High ventricular escape rhythm rate and narrow escape-complex QRS width were negatively associated with duration of survival. Pacemaker implantation had a significant positive association with survival.
Pacemaker implantation should be strongly considered in all dogs with high-grade second- or third-degree AVB regardless of whether clinical signs are evident. If medical treatment is warranted, vagolytic medications may be the best choice. A new classification system for AVB may merit further investigation.
评估犬高度二度或三度房室传导阻滞(AVB)的信号、临床症状及预后。
回顾性病例系列研究。
124只犬。
收集提交审查的心电图、兽医调查问卷、超声心动图和X光片数据;与一个大型对照组的数据进行比较;并检查变量与生存时间之间的关联。对一种新的AVB分类系统进行评估。
阿富汗犬、卡塔胡拉豹犬、松狮犬、可卡犬、德国刚毛指示犬和拉布拉多寻回犬品种易患高度二度或三度AVB。体重较重、年龄较大且未绝育的雌性犬在研究组中占比过高。虚弱、嗜睡、运动不耐受和晕厥是最常见的临床症状。临床症状的出现与生存时间无关。高度二度AVB犬的生存时间与三度AVB犬相似。高度二度或三度AVB犬在诊断后的前6个月有猝死的高风险。高心室逸搏心律率和窄QRS波宽度与生存时间呈负相关。起搏器植入与生存有显著正相关。
对于所有高度二度或三度AVB犬,无论临床症状是否明显,均应强烈考虑植入起搏器。如果需要药物治疗,抗迷走神经药物可能是最佳选择。一种新的AVB分类系统可能值得进一步研究。