Berlin Noa, Ohad Dan G, Maiorkis Igal, Kelmer Efrat
Department of Small Animal Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
Department of Small Animal Cardiology, The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
J Vet Emerg Crit Care (San Antonio). 2020 Jul;30(4):474-480. doi: 10.1111/vec.12960. Epub 2020 May 13.
To describe the successful management of ventricular fibrillation (VF) and ventricular tachycardia (VT) using cardiopulmonary resuscitation, including defibrillation, followed by continuous rate infusion of IV amiodarone, in a cat with cardiac arrest secondary to tachyarrhythmia.
A 12-year-old previously healthy neutered male Scottish Fold cat presented following an acute episode of collapse. Initial physical examination revealed severe tachycardia and cardiovascular collapse. Within a few minutes after arrival, the cat experienced cardiopulmonary arrest. Electrocardiographic assessment was suggestive of VF, and CPR was initiated, including 2 rounds of defibrillation (2 joule/kg each), resulting in return of spontaneous circulation with sustained VT. After procainamide and lidocaine failed to result in conversion to normal sinus rhythm (NSR), continuous IV amiodarone therapy was initiated, and NSR was achieved. Echocardiography demonstrated severe systolic dysfunction, and tachycardia-induced cardiomyopathy (TICM) secondary to chronic VT was suspected; however, dilated cardiomyopathy (DCM) or end-stage hypertrophic cardiomyopathy could not be ruled out. The patient was discharged the following day with oral amiodarone and pimobendan. During a recheck examination performed 7 months later the cat was in NSR, with no direct evidence of long-term amiodarone adverse effects. The cat died acutely at home 8 months after discharge.
This report is the first to describe the successful use of IV amiodarone in a cat to manage sustained VT following CPR.
描述对一只因快速心律失常继发心脏骤停的猫，使用包括除颤在内的心肺复苏术成功处理心室颤动（VF）和室性心动过速（VT），随后持续静脉输注胺碘酮的情况。
一只12岁、既往健康的已绝育雄性苏格兰折耳猫，在一次急性虚脱发作后就诊。初始体格检查发现严重心动过速和心血管虚脱。到达后几分钟内，该猫发生心肺骤停。心电图评估提示VF，遂开始进行心肺复苏，包括2轮除颤（每次2焦耳/千克），结果恢复自主循环并伴有持续性VT。在普鲁卡因胺和利多卡因未能使心律转为正常窦性心律（NSR）后，开始持续静脉给予胺碘酮治疗，并实现了NSR。超声心动图显示严重收缩功能障碍，怀疑为慢性VT继发的心动过速性心肌病（TICM）；然而，不能排除扩张型心肌病（DCM）或终末期肥厚型心肌病。患者次日出院，带口服胺碘酮和匹莫苯丹。在7个月后进行的复查中，该猫处于NSR，没有胺碘酮长期不良反应的直接证据。该猫在出院8个月后在家中急性死亡。
本报告首次描述了在猫中成功使用静脉胺碘酮处理心肺复苏术后的持续性VT。
