Gunasekaran T, Sanders R A
Bluepearl Veterinary Partners, 4126 Packard Road, Ann Arbor, MI 48187, USA.
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan Sate University, East Lansing, MI 48824, USA.
J Vet Cardiol. 2017 Oct;19(5):455-461. doi: 10.1016/j.jvc.2017.08.003. Epub 2017 Sep 19.
A 6-year-old castrated male Golden Retriever was diagnosed with severe subaortic stenosis with severe left atrial enlargement and high heart rate due to atrial fibrillation. Treatment with digoxin and diltiazem to control ventricular response rate was initiated. Ambulatory electrocardiographic monitoring (Holter monitoring) was performed at the beginning of treatment and was repeated to evaluate the patient's response to drug therapy. Drug dose adjustments were made based on response to therapy as assessed by Holter monitoring. The dog experienced sudden death at home 19 days after beginning treatment while wearing the Holter monitor. Analysis of the Holter recording revealed marked increase in number and complexity of ventricular arrhythmias. A ventricular premature complex occurring on a T wave (R on T) was noted preceding the polymorphic ventricular tachycardia. This arrhythmia immediately degenerated into ventricular fibrillation followed by asystole. This case report describes the arrhythmia that preceded cardiac arrest and reviews the risk factors that could have potentiated the fatal arrhythmia in this dog.
一只6岁去势雄性金毛猎犬被诊断为严重的主动脉瓣下狭窄，伴有严重的左心房扩大和因心房颤动导致的高心率。开始使用地高辛和地尔硫䓬治疗以控制心室反应率。在治疗开始时进行了动态心电图监测（Holter监测），并重复进行以评估患者对药物治疗的反应。根据Holter监测评估的治疗反应进行药物剂量调整。这只狗在开始治疗19天后在家中佩戴Holter监测仪时突然死亡。对Holter记录的分析显示室性心律失常的数量和复杂性显著增加。在多形性室性心动过速之前，注意到一个室性早搏落在T波上（R on T）。这种心律失常立即恶化为心室颤动，随后是心脏停搏。本病例报告描述了心脏骤停前的心律失常，并回顾了可能加剧这只狗致命心律失常的危险因素。
