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犬心源性猝死中心律特征分析。

Heart rhythm characterization during sudden cardiac death in dogs.

机构信息

Clinica Veterinaria Malpensa, AniCura, Via G. Marconi 27, Samarate, Varese, 21017, Italy; Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, NY, 14853, USA.

Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), Ecole Nationale Vétérinaire d'Alfort, 7 avenue du Général de Gaulle, Maisons-Alfort, F-94700, France.

出版信息

J Vet Cardiol. 2021 Dec;38:18-30. doi: 10.1016/j.jvc.2021.09.005. Epub 2021 Oct 1.

Abstract

INTRODUCTION/OBJECTIVES: Inherited or acquired arrhythmic disorders and cardiac disease have been associated with sudden cardiac death (SCD) in dogs. The electrical mechanism related to death in most of these cases is unknown. This retrospective study aimed to describe arrhythmic events in dogs that experienced SCD during Holter monitoring.

ANIMALS, MATERIALS AND METHODS: Nineteen client-owned dogs that experienced SCD during Holter examination were included. Clinical records from a Holter service database were reviewed, and both the rhythm preceding death and the dominant rhythm causing SCD were analysed. Clinical data, Holter diaries and echocardiographic diagnosis were also evaluated.

RESULTS

Structural heart disease was identified in 12/19 dogs (dilated cardiomyopathy in five dogs, arrhythmogenic right ventricular cardiomyopathy in four dogs, myxomatous mitral valve disease in two dogs, and suspected myocarditis in one dog), five of which had concurrent congestive heart failure. Sudden cardiac death was related to ventricular premature complexes or monomorphic ventricular tachycardia degenerating into ventricular fibrillation in 42% of dogs, polymorphic ventricular tachycardia, or torsade de pointes-like inducing ventricular fibrillation in 21%, and asystole or presumptive agonal pulseless electrical activity triggered by malignant bradyarrhythmias in 37%.

CONCLUSIONS

The most common rhythm associated with SCD in our population of dogs was ventricular tachycardia leading to ventricular fibrillation, although bradyarrhythmia-related SCD, possibly related to inappropriate vagal reflexes, was also a notable cause.

摘要

引言/目的:遗传性或获得性心律失常和心脏病与犬的心脏性猝死(SCD)有关。在大多数这些情况下,与死亡相关的电生理机制尚不清楚。本回顾性研究旨在描述在 Holter 监测中经历 SCD 的犬的心律失常事件。

动物、材料和方法:纳入了 19 只在 Holter 检查中经历 SCD 的患犬。回顾了 Holter 服务数据库中的临床记录,并分析了死亡前的节律和导致 SCD 的主导节律。还评估了临床数据、Holter 日记和超声心动图诊断。

结果

在 12/19 只犬中发现了结构性心脏病(五只犬扩张型心肌病、四只犬致心律失常性右室心肌病、两只犬黏液瘤性二尖瓣疾病和一只犬疑似心肌炎),其中五只犬伴有充血性心力衰竭。42%的犬的 SCD 与室性期前收缩或单相性室性心动过速发展为心室颤动有关,21%与多形性室性心动过速或尖端扭转性室性心动过速引起的心室颤动有关,37%与恶性缓慢性心律失常引起的心动过缓和/或假定濒死性无脉电活动有关。

结论

在我们的犬群中,与 SCD 最相关的节律是导致心室颤动的室性心动过速,尽管与缓慢性心律失常相关的 SCD 可能与不适当的迷走反射有关,也是一个显著的原因。

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