1Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK.
2Langford Vets Small Animal Referral Hospital, University of Bristol, Bristol, UK.
J Am Vet Med Assoc. 2024 Jun 19;262(10):1-10. doi: 10.2460/javma.24.04.0232. Print 2024 Oct 1.
To describe complications and outcomes in dogs undergoing epicardial pacemaker (EP) implantation, identify factors associated with survival, and investigate improvement in clinical signs and health-related quality of life (HRQoL) following surgery.
52 client-owned dogs that underwent EP placement.
Medical records of 4 UK-based referral hospitals were searched and data reviewed retrospectively between July 2010 and December 2022. Factors contributing to outcomes after EP placement were assessed.
The primary reasons for referral included collapsing/syncopal episodes (n = 36), exercise intolerance (15), and significant bradycardia (46). Third-degree atrioventricular block (39/52 [75%]) was the predominant indication for pacemaker placement, and common reasons for EP placement included previous transvenous pacemaker dislodgment/loss of capture (n = 12) and small body size (10). Intra- and postoperative complications were documented in 11% and 23% of dogs, respectively. Overall, 96% of dogs survived to discharge, and median follow-up time was 462 days (range, 31 to 3,139 days). Presence of coexistent myocardial or valvular disease at the time of EP implantation was associated with a reduced survival. Owners reported decreased clinical signs, increased activity levels, and improved HRQoL.
Epicardial pacemaker implantation is a valuable option for dogs requiring artificial cardiac pacing. Complications were common but did not impact the overall outcome. Dogs with a coexisting cardiac pathology had a shorter life expectancy after EP placement, but their HRQoL appeared to be good, with an improvement in clinical signs and increased activity levels.
描述行心外膜起搏器（EP）植入术的犬只的并发症和转归，确定与存活率相关的因素，并研究手术对临床症状和健康相关生活质量（HRQoL）的改善情况。
52 只接受 EP 植入术的患犬。
检索了 4 家英国转诊医院的病历记录，并于 2010 年 7 月至 2022 年 12 月间进行了回顾性数据分析。评估了 EP 植入术后结局的相关因素。
转诊的主要原因包括晕厥/晕厥发作（n = 36）、运动不耐受（15）和显著心动过缓（46）。三度房室传导阻滞（39/52 [75%]）是起搏器放置的主要指征，EP 放置的常见原因包括先前经静脉起搏器脱位/失夺获（n = 12）和体型小（n = 10）。分别有 11%和 23%的犬在围术期出现了术中及术后并发症。总体而言，96%的犬存活至出院，中位随访时间为 462 天（范围：31~3139 天）。EP 植入时存在共存的心肌或瓣膜疾病与存活率降低相关。主人报告临床症状减少、活动水平增加和 HRQoL 改善。
心外膜起搏器植入术是需要人工心脏起搏的犬的一种有价值的选择。并发症常见，但对整体结局无影响。EP 植入后存在共存心脏疾病的犬的预期寿命较短，但它们的 HRQoL 似乎良好，临床症状改善，活动水平增加。
