Heart rate distribution in dogs with third degree atrioventricular block and rate responsive pacemakers |
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| Institution: | 1. Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada;2. Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, 550 University Ave, Charlottetown, Prince Edward Island, C1A 4P3, Canada;1. Equine Sports Medicine Practice, Avenue Beau Séjour 83, 1410 Waterloo, Belgium;2. New Bolton Center, University of Pennsylvania, 382 W Street Road, 19348 PA, Kennett Square, USA;1. Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 28 College Ave W, Guelph, Ontario, N1G 2W1, Canada;2. Hospital Veterinario UCV y Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria y Ciencias Experimentales, Universidad Catolica de Valencia San Vicente Martir, Valencia, Spain;3. Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, 550 University Ave, Charlottetown, PE, C1A 4P3, Canada;1. Friendship Hospital for Animals, 4105 Brandywine St NW, Washington, DC 20016, USA;2. VCA West Los Angeles Animal Hospital, 1900 S Sepulveda Blvd, Los Angeles, CA 90025, USA;3. Oradell Animal Hospital, 580 Winters Ave, Paramus NJ 07652, USA;4. ACCESS-Los Angeles, 9599 Jefferson Blvd, Culver City, CA 90232, USA;5. Veterinary Specialty and Emergency Center Thousand Oaks, 2967 North Moorpark Road, Thousand Oaks, CA 91360, USA;6. ACCESS-South Bay, 2551 W 190th St. Torrance, CA 90504, USA;7. VCA Veterinary Specialists of the Valley, 22123 Ventura Blvd, Woodland Hills, CA 91364, USA;1. Department of Veterinary Clinical Sciences, Purdue University, College of Veterinary Medicine 625 Harrison Street, West Lafayette, IN 47906, USA;2. CVCA, Cardiac Care for Pets, 13160 Magisterial Drive, Louisville, KY 40223, USA;1. Cardiac Electrophysiology Section, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA;2. Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3800 Spruce St, Philadelphia, PA, 19104 USA;1. Department of Veterinary Medical Sciences, Alma Mater Studiorum – University of Bologna, via Tolara di Sopra 50, 40064 Ozzano dell''Emilia, Italy;2. Clinica Veterinaria San Sebastiano, via Boari 22, 04026 Minturno, Italy |
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| Abstract: | IntroductionIn dogs, single lead ventricular pacing, ventricular sensing, inhibition response, rate adaptive (VVIR) pacemakers are routinely used to treat third degree atrioventricular block. The objectives of this study were to investigate the heart rate distribution in dogs with VVIR pacemakers, and report changes when activity settings were adjusted.AnimalsEighteen client-owned dogs with VVIR pacemakers for third degree atrioventricular block.Materials and methodsThis observational study consisted of a review of medical records of dogs with VVIR pacemakers. For dogs with >50% of paced beats at the lower pacing rate, the activity daily living (ADL) and exertion responses were increased. Re-evaluations were performed after 6–12 months.ResultsHeart rate distribution similar to healthy dogs was absent for all dogs. In nine dogs, the ADL and exertion responses were increased to the highest level. Of these, three dogs showed no improvement in heart rate distribution; for two dogs, one with an epicardial pacemaker, several activity settings were adjusted and pacing at higher heart rates was observed at re-evaluation. Four dogs died or were lost to follow-up. Clinical signs had resolved for all dogs after pacemaker implantation.ConclusionDefault activity settings of VVIR pacemakers do not result in heart rate distribution equivalent to healthy dogs. Increasing the ADL and exertion response settings to the highest levels did not improve the pacemaker rate response. Further investigations into the role of dog size, generator positioning, pacemaker settings, and whether rate responsiveness is required for dogs' quality and quantity of life are warranted. |
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| Keywords: | Bradyarrhythmia Canine Exercise Pacemaker programming VVIR |
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