Section of Cardiology, Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126, USA.
J Vet Intern Med. 2012 May-Jun;26(3):558-64. doi: 10.1111/j.1939-1676.2012.00928.x. Epub 2012 Apr 10.
An important consideration for the treatment of sick sinus syndrome (SSS) lies in the function of the atrioventricular (AV) node because most patients with SSS retain the ability to conduct atrial impulses.
HYPOTHESIS/OBJECTIVES: This retrospective study examined the feasibility of atrial pacing (AAI) in dogs with sinus node dysfunction (SND).
Sixteen dogs with SND and AAI pacing were identified.
Retrospective review of medical records.
Follow-up time ranged from 45 to 1,227 days (mean: 292 days). Only 1 dog developed AV block 3 days postoperatively. Complete lead dislodgment occurred in 3/16 dogs 1, 19, and 27 days postoperatively. Lead perforation into the pericardial space occurred in 2/16 dogs. Rising thresholds for pacing with possible lead microdislodgment or fibrosis were suspected in another 3/16 dogs 57, 192, and 1,016 days after implantation. None of these dogs had complete loss of capture but all required higher thresholds for pacing.
Based on this small group of dogs, clinically important AV block does not appear to occur in the long-term for dogs with SND. Risks of lead perforation, complete dislodgment, and rising thresholds for pacing, possibly because of microdislodgment, may be related to the initial skill level of the operator or the leads that were used. Use of leads with reduced torque at the lead tip, higher flexibility, increased lead-tip surface of contact with the endocardium or, more likely, use of alternate locations for pacing in the small right atrium of dogs with SND may decrease the frequency of these complications.
在治疗病态窦房结综合征（SSS）时，房室（AV）结的功能是一个重要的考虑因素，因为大多数 SSS 患者仍有传导心房冲动的能力。
假设/目的：本回顾性研究探讨了窦房结功能障碍（SND）犬行心房起搏（AAI）的可行性。
确定了 16 只患有 SND 和 AAI 起搏的狗。
回顾性病历审查。
随访时间为 45 至 1227 天（平均：292 天）。仅 1 只狗术后 3 天发生 AV 阻滞。16 只狗中有 3 只（1、19 和 27 天）完全导联脱位。2 只狗的导联穿透至心包腔。另外 3 只狗（植入后 57、192 和 1016 天）怀疑起搏阈值升高，可能与导联微脱位或纤维化有关。这些狗均未完全失夺获，但均需要更高的起搏阈值。
基于这一小组狗，患有 SND 的狗在长期随访中似乎不会出现临床重要的 AV 阻滞。导联穿孔、完全脱位和起搏阈值升高的风险，可能是由于微脱位引起的，可能与操作人员的初始技能水平或使用的导联有关。使用尖端扭矩降低、柔韧性更高、与心内膜接触的导联尖端表面积增加的导联，或者更有可能在 SND 犬的小右心房中使用替代起搏部位，可能会降低这些并发症的发生频率。
