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Santilli R.A.,Clinica Veterinaria Malpensa | Diana A.,University of Bologna | Baron Toaldo M.,University of Bologna
Journal of Veterinary Cardiology | Year: 2012

Electrocardiographic tracings of an English Bulldog referred for cardiogenic shock due to an orthodromic atrioventricular reciprocating tachycardia conducted with intraventricular conduction disturbance and mimicking ventricular tachycardia (VT) are presented. At admission the surface ECG showed a wide QRS complex tachycardia (WCT) that was converted to sinus rhythm using manual cardioversion (chest thump). This change revealed pre-existing right bundle branch block, and a final diagnosis of supraventricular tachycardia (SVT) with intraventricular conduction disturbance was made. Electrophysiologic study defined the SVT mechanism as an atrioventricular macroreentrant tachycardia mediated by a single mid-septal accessory pathway. The differentiation between various types of WCT is essential when antiarrhythmic therapy is considered. The surface ECG should be systematically evaluated in order to recognize the characteristic features of SVT and VT. Moreover chest thump procedure can be very helpful in the attempt to convert the rhythm to sinus rhythm and to correctly recognize the underlying arrhythmia. © 2012 Elsevier Ltd. All rights reserved.

Borgarelli M.,Virginia Polytechnic Institute and State University | Abbott J.,Virginia Polytechnic Institute and State University | Braz-Ruivo L.,Dogs and Cats Veterinary Referral and ER | Chiavegato D.,Clinica Veterinaria Arcella | And 6 more authors.
Journal of Veterinary Internal Medicine | Year: 2015

Background: Pulmonary hypertension (PH) is common in dogs with myxomatous mitral valve disease (MMVD) but its effect on clinical outcome has not been investigated. Hypothesis/objectives: The presence of PH worsens the outcome in dogs with MMVD. To compare survival times of dogs with MMVD and PH to those without PH. Animals: Two hundred and twelve client-owned dogs. Methods: Case review study. Medical records of dogs diagnosed with ACVIM stage B2 and C MMVD between January 2010 and December 2011 were retrospectively reviewed. Long-term outcome was determined by telephone interview or from the medical record. End of the observation period was March 2013. PH was identified if tricuspid regurgitation peak velocity was >3 m/s. Results: Two hundred and twelve were identified. Eighty-three dogs (39%) had PH. PH was more commonly identified in stage C compared to B2 (P < .0001). One hundred and five (49.5%) dogs died during the observation period. Median survival time for the entire study population was 567 days (95% CI 512-743). Stage C (P = .003), the presence of PH (P = .009), left atrial to aortic root ratio (LA/Ao) >1.7 (P = .0002), normalized left-ventricular end-diastolic diameter (LVEDn) >1.73 (P = .048), and tricuspid regurgitation pressure gradient (TRPG) >55 mmHg (P = .009) were associated with worse outcomes in the univariate analyses. The presence of TRPG >55 mmHg (HR 1.8 95% CI 1-2.9; P = .05) and LA/Ao > 1.7 (HR 2 95% CI 1.2-3.4; P = .01) remained significant predictors of worse outcome in the multivariate analysis. Conclusions and Clinical Importance: In dogs with MMVD, moderate to severe PH worsens outcome. © 2015 The Authors.

Porteiro Vazquez D.M.,Clinica Veterinaria Malpensa | Perego M.,Clinica Veterinaria Malpensa | Santos L.,Federal University of Sao Paulo | Gerou-Ferriani M.,Clinica Veterinaria Malpensa | And 2 more authors.
Journal of Veterinary Cardiology | Year: 2016

Objectives: To document the electrocardiographic findings of vagally-induced paroxysmal atrial fibrillation following a presumed reflex syncopal episode in the dog. Animals: Seven dogs with a syncopal episode followed by a paroxysm of atrial fibrillation recorded on a 24-hour Holter. Methods: Twenty-four hour Holter monitors were retrospectively reviewed, analysing the cardiac rhythm associated with syncopal events. Each recording was analysed from 10 min before the syncopal episode to until 10 min after a normal sinus rhythm had returned. Results: Nine episodes were recorded in seven dogs, with one patient experiencing three events during one Holter recording. Five of the seven dogs presented with underlying structural heart disease. In two the syncopal episodes occurred following exercise, two associated with coughing and three were during a period of rest. All dogs had documented on the Holter recording a rhythm abnormality during syncope. The most common finding leading up to the syncopal event was development of a progressive sinus bradycardia, followed by sinus arrest interrupted by a ventricular escape rhythm and then ventricular arrest. This was then followed by an atrial fibrillation. The atrial fibrillation was paroxysmal in seven recordings and persistent in two. In two dogs, the atrial fibrillation reorganised into self-limiting runs of atypical atrial flutter. Conclusions: This combination of electrocardiographic arrhythmias are probably caused by an inappropriate parasympathetic stimulation initiating a reflex or neurally-mediated syncope, with abnormal automaticity of the sinus node and of the subsidiary pacemaker cells and changes in the electrophysiological properties of the atrial muscle, which promoted the paroxysmal atrial fibrillation. © 2015 Elsevier B.V.

Santilli R.A.,Clinica Veterinaria Malpensa | Santos L.F.N.,Federal University of Sao Paulo | Perego M.,Clinica Veterinaria Malpensa
Journal of Veterinary Cardiology | Year: 2013

A 5-year-old male English Bulldog was presented with a 1-year history of paroxysmal supraventricular tachycardia (SVT) partially responsive to amiodarone. At admission the surface ECG showed sustained runs of a narrow QRS complex tachycardia, with a ventricular cycle length (R-R interval) of 260 ms, alternating with periods of sinus rhythm. Endocardial mapping identified the electrogenic mechanism of the SVT as a circus movement tachycardia with retrograde and decremental conduction along a concealed postero-septal atrioventricular pathway (AP) and anterograde conduction along the atrioventricular node. These characteristics were indicative of a permanent junctional reciprocating tachycardia (PJRT). Radiofrequency catheter ablation of the AP successfully terminated the PJRT, with no recurrence of tachycardia on Holter monitoring at 12 months follow-up. © 2013 Elsevier B.V. All rights reserved.

Santilli R.A.,Clinica Veterinaria Malpensa | Perego M.,Clinica Veterinaria Malpensa | Perini A.,Clinica Veterinaria Malpensa | Carli A.,Centro Veterinario Pisani | And 2 more authors.
Journal of Veterinary Cardiology | Year: 2010

Two dogs were presented for episodic weakness caused by a very rapid supraventricular tachycardia with a ventricular rate of 360 bpm and 300 bpm, respectively. Electrocardiography showed narrow QRS complex tachycardia in both subjects, the first one with a fixed 2:1 atrioventricular block, and the second with variable degrees of atrioventricular block from 6:1 to 2:1. The electrophysiological studies revealed bidirectional and typical cavo-tricuspid isthmus-dependent atrial flutter, respectively. Radiofrequency catheter ablation was performed in both dogs and a bidirectional cavo-tricuspid isthmus block was successfully achieved. On follow-up, Holter monitoring confirmed resolution of the arrhythmias in both dogs. © 2010 Elsevier B.V. All rights reserved.

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