Ward J L, DeFrancesco T C, Tou S P, Atkins C E, Griffith E H, Keene B W
North Carolina State University Veterinary Hospital, 1052 William Moore Dr, Raleigh, NC 27607, USA.
North Carolina State University Veterinary Hospital, 1052 William Moore Dr, Raleigh, NC 27607, USA.
J Vet Cardiol. 2016 Sep;18(3):199-212. doi: 10.1016/j.jvc.2016.04.004. Epub 2016 Jun 7.
To evaluate the clinical presentation, diagnosis, treatment, and outcomes of a group of dogs with sinoatrial node abnormalities.
Ninety-three client-owned dogs at a referral institution.
Medical records were reviewed for clinical history, diagnostic testing, and medical or permanent artificial pacemaker (PAP) treatment. Owners or veterinarians were contacted for long-term follow-up.
Sixty-one dogs were symptomatic for their bradyarrhythmia and were diagnosed with sick sinus syndrome (SSS). Thirty-two dogs were asymptomatic for their bradyarrhythmia and were diagnosed with sinus node dysfunction (SND). Miniature Schnauzers, West Highland White terriers, Cocker spaniels, and female dogs were overrepresented. Medical management with positive chronotropic drugs successfully controlled syncope long-term in 54% of SSS dogs, and acted as a bridge to PAP in 20%. Positive atropine response predicted medical treatment success. Forty-six percent of SSS dogs eventually underwent PAP implantation. Median survival time was approximately 18 months in SND and SSS dogs regardless of treatment strategy. Congestive heart failure (CHF) associated with progressive valvular heart disease occurred commonly in all groups, particularly in dogs with bradycardia-tachycardia syndrome.
Sinus node dysfunction and SSS represent a spectrum of sinoatrial node disease, which for some dogs may also involve a component of autonomic dysfunction. Dogs with SND do not require treatment. Dogs with SSS often require treatment to reduce the frequency of syncope; medical management is often useful, particularly in atropine responsive dogs. Prognosis of SSS with treatment is good, though development of CHF does not appear to be mitigated by treatment.
评估一组患有窦房结异常的犬的临床表现、诊断、治疗及预后。
一家转诊机构的93只客户拥有的犬。
回顾病历以获取临床病史、诊断检测及药物或永久性人工起搏器（PAP）治疗情况。联系主人或兽医进行长期随访。
61只犬因心动过缓出现症状，被诊断为病态窦房结综合征（SSS）。32只犬心动过缓但无症状，被诊断为窦房结功能障碍（SND）。迷你雪纳瑞犬、西部高地白梗犬、可卡犬及母犬占比过高。使用正性变时药物进行药物治疗成功长期控制了54%的SSS犬的晕厥症状，20%的犬作为PAP植入的过渡治疗。阿托品阳性反应预示药物治疗成功。46%的SSS犬最终接受了PAP植入。无论治疗策略如何，SND和SSS犬的中位生存时间约为18个月。所有组中，尤其是患有心动过缓-心动过速综合征的犬，常发生与进行性瓣膜性心脏病相关的充血性心力衰竭（CHF）。
窦房结功能障碍和SSS代表了一系列窦房结疾病，对一些犬来说，可能还涉及自主神经功能障碍的成分。患有SND的犬无需治疗。患有SSS的犬通常需要治疗以减少晕厥频率；药物治疗通常有效，特别是对阿托品有反应的犬。SSS经治疗后的预后良好，尽管治疗似乎并未减轻CHF的发生。
