Langford Vets Small Animal Referral Hospital, University of Bristol, Langford House, Langford, Bristol, BS40 5DU, United Kingdom.
Small Animal Teaching Hospital, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Wirral, CH64 7TE, United Kingdom.
J Vet Cardiol. 2023 Oct;49:9-28. doi: 10.1016/j.jvc.2023.06.004. Epub 2023 Jun 28.
Pacemaker implantation is the treatment of choice for clinically relevant bradyarrhythmias. Pacemaker-lead-associated thrombosis (PLAT) occurs in 23.0-45.0% of people with permanent transvenous pacemakers. Serious thromboembolic complications are reported in 0.6-3.5%. The incidence of PLAT in dogs is unknown.
ANIMALS, MATERIALS AND METHODS: multicenter retrospective study of seven centers with 606 client-owned dogs undergoing permanent pacemaker implantation between 2012 and 2019. 260 dogs with a transvenous pacemaker with echocardiographic follow-up, 268 dogs with a transvenous pacemaker without echocardiographic follow-up and 78 dogs with an epicardial pacemaker.
10.4% (27/260) of dogs with transvenous pacemakers and echocardiographic follow-up had PLAT identified. The median time to diagnosis was 175 days (6-1853 days). Pacemaker-lead-associated thrombosis was an incidental finding in 15/27 (55.6%) dogs. Of dogs with a urine protein:creatinine ratio measured at pacemaker implantation, dogs with PLAT were more likely to have proteinuria at pacemaker implantation vs. dogs without PLAT (6/6 (100.0%) vs. 21/52 (40.4%), P=0.007). Urine protein:creatinine ratio was measured in 12/27 (44.4%) dogs at PLAT diagnosis, with proteinuria identified in 10/12 (83.3%) dogs. Anti-thrombotic drugs were used following the identification of PLAT in 22/27 (81.5%) dogs. The thrombus resolved in 9/15 (60.0%) dogs in which follow-up echocardiography was performed. Dogs with PLAT had shorter survival times from implantation compared to those without PLAT (677 days [9-1988 days] vs. 1105 days [1-2661 days], P=0.003).
Pacemaker-lead-associated thrombosis is identified in 10.4% (27/260) of dogs following transvenous pacing, is associated with proteinuria, can cause significant morbidity, and is associated with reduced survival times.
心脏起搏器植入是治疗临床相关缓慢性心律失常的首选方法。在永久性经静脉心脏起搏器患者中，起搏器导线相关血栓形成（PLAT）的发生率为 23.0-45.0%。据报道，严重的血栓栓塞并发症发生率为 0.6-3.5%。狗的 PLAT 发生率尚不清楚。
动物、材料和方法：对 2012 年至 2019 年间在 7 个中心接受永久性心脏起搏器植入的 606 只患犬进行多中心回顾性研究。260 只植入经静脉起搏器并进行超声心动图随访，268 只植入经静脉起搏器但未进行超声心动图随访，78 只植入心外膜起搏器。
260 只接受经静脉起搏器并进行超声心动图随访的犬中有 10.4%（27/260）发现有 PLAT。中位诊断时间为 175 天（6-1853 天）。15/27（55.6%）只狗的起搏器导线相关血栓形成是偶然发现的。在植入起搏器时测量尿蛋白/肌酐比值的狗中，与无 PLAT 的狗相比，有 PLAT 的狗在植入起搏器时更有可能出现蛋白尿（6/6（100.0%）与 21/52（40.4%），P=0.007）。在 27 只狗中有 12 只（44.4%）在 PLAT 诊断时测量了尿蛋白/肌酐比值，其中 10 只（83.3%）狗存在蛋白尿。在 27 只狗中有 22 只（81.5%）在发现 PLAT 后使用了抗血栓药物。在进行了后续超声心动图检查的 15 只狗中有 9 只（60.0%）的血栓溶解。与无 PLAT 的狗相比，有 PLAT 的狗的植入后存活时间更短（677 天[9-1988 天]与 1105 天[1-2661 天]，P=0.003）。
在接受经静脉起搏的狗中，有 10.4%（27/260）发现起搏器导线相关血栓形成，与蛋白尿有关，可导致严重的发病率，并与存活时间缩短有关。
