Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4.
Can Vet J. 2021 Jan;62(1):32-36.
A 12-year-old spayed female German shorthaired pointer dog sustained extensive bite wounds around the neck. At presentation, atrial fibrillation was identified with a rapid ventricular response rate of 300 beats per minute (bpm). The ventricular response rate rapidly decreased to 130 bpm following administration of hydromorphone and oxygen. Based on the rate, antiarrhythmic therapy was not initiated. The heart rhythm converted back to sinus rhythm by the time of the first recheck evaluation 2 days later, and the dog remained in sinus rhythm at all subsequent evaluations. With the resolution of the arrhythmia, paroxysmal atrial fibrillation was suspected. The underlying etiology of the arrhythmia was not determined; however, imbalances in autonomic tone associated with trauma and/or direct trauma to the heart were hypothesized. Key clinical message: This report indicates a possible role of imbalances in autonomic tone due to trauma in the development of paroxysmal atrial fibrillation and suggests that it should be a differential diagnostic consideration in patients with atrial fibrillation following trauma. Primary treatment of atrial fibrillation may not be needed in these cases if the ventricular response rate is not rapid, or if there is spontaneous conversion to sinus rhythm.
一只 12 岁已绝育的雌性德国短毛指示猎犬的颈部周围有广泛的咬伤。就诊时,发现其存在心房颤动,心室率快速为 300 次/分钟。给予氢吗啡酮和氧气后,心室率迅速降至 130 次/分钟。由于心室率,未开始抗心律失常治疗。两天后,在第一次复查评估时,心律恢复为窦性心律,此后所有后续评估均为窦性心律。随着心律失常的缓解,怀疑为阵发性心房颤动。心律失常的潜在病因尚未确定;然而,假设与创伤和/或心脏直接创伤相关的自主神经平衡失调可能是导致心律失常的原因。关键临床信息:本报告表明,由于创伤导致的自主神经平衡失调可能在阵发性心房颤动的发展中起作用,并表明在创伤后发生心房颤动的患者中,这应作为鉴别诊断的考虑因素。如果心室率不快速,或者如果自行转为窦性心律,则这些情况下可能不需要对心房颤动进行主要治疗。