Vestberg Anna Rave, Tidholm Anna, Ljungvall Ingrid
Anicura Regional Animal Hospital, Ljusnevägen 17, 12848, Bagarmossen, Sweden.
Anicura Albano Animal Hospital, Rinkebyvägen 21a, 18236, Danderyd, Sweden.
Acta Vet Scand. 2017 May 3;59(1):28. doi: 10.1186/s13028-017-0296-x.
Vipera berus has a worldwide distribution and causes high morbidity in dogs annually. A complication to envenomation may be cardiac arrhythmias. The purpose of this study was to investigate the prevalence, types, and timing of arrhythmias, using 24-h ambulatory electrocardiography (24-AECG), in dogs bitten by V. berus in the first 24-32 h after envenomation. In addition, this study aimed to investigate if there were differences in selected clinical and hematological- and biochemical variables (including cardiac troponin I) at admission between V. berus-envenomed dogs with and without detected pathologic arrhythmias. Seventeen prospectively recruited client-owned dogs acutely envenomed by V. berus, were therefore examined clinically and echocardiographically, sampled for blood, hospitalized, and monitored by 24-AECG.
Clinically significant pathologic arrhythmias in this study were of ventricular origin, such as frequent single ventricular premature contractions (VPCs) and couplets of VPCs, episodes of ventricular tachycardia and idioventricular rhythm, and "R-on-T phenomenon". Variations of these arrhythmias were detected by 24-AECG in eight (47%) of included dogs. No arrhythmias were detected by cardiac auscultation. Twenty-four hours following envenomation, four out of eight dogs experienced decreases (all P < 0.039), and three out of eight dogs experienced increases (all P < 0.034), in arrhythmic episodes. All four dogs bitten on a limb developed pathologic arrhythmias. Otherwise, no significant differences in clinical, hematological or biochemical variables were seen between dogs with pathologic arrhythmias and those without.
Forty-seven percent of dogs bitten by V. berus included in this study experienced pathologic arrhythmias of abnormal ventricular depolarization. During the first 24-32 h from the snakebite, some dogs experienced a decrease in arrhythmic episodes and others an increase in arrhythmic episodes. These findings indicate a potential value of repeated or prolonged electrocardiography monitoring of envenomed dogs for identification of which dogs that might benefit the most from prolonged hospitalization for optimal monitoring and treatment of cardiac abnormalities. In the present study, dogs that developed arrhythmias could not be differentiated from dogs that did not based on clinical findings or hematological or biochemical variables obtained at admission.
极北蝰分布于全球，每年都会导致犬类出现高发病率。蛇毒中毒的一个并发症可能是心律失常。本研究的目的是使用24小时动态心电图（24 - AECG）来调查极北蝰咬伤犬类后24至32小时内心律失常的发生率、类型和发生时间。此外，本研究旨在调查在入院时，被极北蝰咬伤且检测到病理性心律失常的犬类与未检测到病理性心律失常的犬类在选定的临床、血液学和生化变量（包括心肌肌钙蛋白I）方面是否存在差异。因此，对17只前瞻性招募的被极北蝰急性咬伤的客户自养犬进行了临床和超声心动图检查、采血、住院，并通过24 - AECG进行监测。
本研究中具有临床意义的病理性心律失常起源于心室，例如频繁的单发性室性早搏（VPC）和室性早搏成对出现、室性心动过速发作和心室自主节律，以及“R波落在T波上现象”。通过24 - AECG在八只（47%）纳入研究的犬类中检测到了这些心律失常的变化。通过心脏听诊未检测到心律失常。蛇毒中毒24小时后，八只犬中有四只的心律失常发作次数减少（所有P < 0.039），八只犬中有三只的心律失常发作次数增加（所有P < 0.034）。所有四只肢体被咬伤的犬类都出现了病理性心律失常。否则，在有病理性心律失常的犬类和没有病理性心律失常的犬类之间，在临床、血液学或生化变量方面未观察到显著差异。
本研究中被极北蝰咬伤的犬类中有47%经历了异常心室去极化的病理性心律失常。在被蛇咬伤后的最初24至32小时内，一些犬类的心律失常发作次数减少，而另一些犬类的心律失常发作次数增加。这些发现表明，对被蛇毒中毒的犬类进行重复或延长的心电图监测对于识别哪些犬类可能从延长住院时间以进行最佳心脏异常监测和治疗中获益最大具有潜在价值。在本研究中，根据入院时的临床发现或血液学或生化变量，无法区分出现心律失常的犬类和未出现心律失常的犬类。
