Santilli R A, Porteiro Vázquez D M, Vezzosi T, Perego M
Clinica Veterinaria Malpensa, Samarate, Varese, Italy.
Ospedale Didattico Veterinario "Mario Modenato", Dipartimento di Scienze Veterinarie, Università di Pisa, San Piero a Grado (Pisa), Italy.
J Vet Intern Med. 2016 Jan-Feb;30(1):58-62. doi: 10.1111/jvim.13661. Epub 2015 Nov 17.
Atrioventricular block (AVB) is a conduction abnormality along the atrioventricular node that, depending on etiology, may lead to different outcomes.
To evaluate variations of intrinsic rhythm (IR) in dogs that underwent pacemaker implantation (PMI).
Medical records of 92 dogs affected by 3rd degree atrioventricular block (3AVB), advanced 2nd degree AVB (2AVB), paroxysmal 3AVB, 2:1 2AVB, or 3AVB with atrial fibrillation (AF) were retrospectively reviewed.
The patient IR was documented with telemetry on the day of 1--(95% CI, 1-2), 33--(95% CI, 28-35), 105--(95%CI, 98-156), and 275 days (95%CI, 221-380) after PMI. According to AVB grade at different examinations, AVB was defined as progressed, regressed, or unchanged.
In 48 dogs, 3AVB remained unchanged, whereas in 7 it regressed. Eight cases of 2AVB progressed, 3 regressed and 2 remained unchanged. Eight cases of paroxysmal 3AVB progressed and 3 remained unchanged. Four dogs affected by 2:1 2AVB progressed, 2 regressed, and 1 remained unchanged. All cases with 3AVB with AF remained unchanged. Regression occurred within 30 days after PMI, whereas progression was documented at any time. Variations in IR were associated with type of AVB (P < .03) and time of follow-up (P < .0001).
The degree of AVB assessed at the time of PMI should not be considered definitive because more than one-third of the cases in this study either progressed or regressed. Additional studies would be necessary to elucidate possible causes for transient AVB in dogs.
房室传导阻滞(AVB)是一种沿房室结的传导异常,根据病因不同,可能导致不同的结果。
评估接受起搏器植入(PMI)的犬只固有心律(IR)的变化。
回顾性分析了92只患有三度房室传导阻滞(3AVB)、高度二度房室传导阻滞(2AVB)、阵发性3AVB、2∶1 2AVB或伴有心房颤动(AF)的3AVB犬只的病历。
在PMI后1天(95%可信区间,1 - 2)、33天(95%可信区间,28 - 35)、105天(95%可信区间,98 - 156)和275天(95%可信区间,221 - 380)通过遥测记录患犬的IR。根据不同检查时的AVB分级,将AVB定义为进展、消退或未改变。
48只犬的3AVB未改变,7只犬的3AVB消退。8例2AVB进展,3例消退,2例未改变。8例阵发性3AVB进展,3例未改变。4只患有2∶1 2AVB的犬进展,2只消退,1只未改变。所有伴有AF的3AVB病例均未改变。消退发生在PMI后30天内,而进展可在任何时间记录。IR的变化与AVB类型(P < .03)和随访时间(P < .0001)相关。
PMI时评估的AVB程度不应被视为决定性的,因为本研究中超过三分之一的病例出现了进展或消退。需要进一步研究以阐明犬只短暂性AVB的可能原因。