Insulation break of the ventricular lead in a dog with a pacemaker

IF 1.5 2区 农林科学 Q2 VETERINARY SCIENCES Journal of Veterinary Cardiology Pub Date : 2023-10-05 DOI:10.1016/j.jvc.2023.09.005
H.W. Jeong DVM, G. Menciotti DVM, PhD
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Abstract

A 10-year-old female spayed mixed breed dog that had a transvenous pacemaker implanted four years prior was presented for the evaluation of episodes of transient loss of consciousness without any history of trauma that were unresponsive to anticonvulsant therapies. Intermittent failure to capture coupled with low impedance and high capture threshold were noted upon interrogation of the pacemaker. Radiography and fluoroscopy demonstrated a possible break in the insulation of the lead. After the placement of another transvenous pacemaker, the dog had no additional syncopal episodes, and anticonvulsants were tapered off. The dog developed an implant infection from the newly placed pacemaker, which prompted the removal of the infected pacemaker and the implantation of an epicardial pacemaker. However, the epicardial lead dislodged seven days after placement, and the dog was euthanized. During necropsy, the first transvenous lead was removed, and the insulation break was visually confirmed. Although an insulation break is a rare delayed complication of pacemaker implantation, this report shows how the diagnosis, suspected by typical interrogation findings, can be aided by radiographic and fluoroscopic investigations.

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带起搏器的狗心室导线绝缘断裂。
一只10岁的雌性绝育杂交犬,四年前植入了经静脉起搏器,用于评估对抗惊厥治疗无反应的短暂意识丧失发作。询问起搏器时发现间歇性捕获失败,同时伴有低阻抗和高捕获阈值。射线照相和荧光透视显示导线绝缘层可能断裂。在放置另一个经静脉起搏器后,这只狗没有出现额外的同步性发作,抗惊厥药物逐渐减少。这只狗因新放置的起搏器而感染了植入物,这促使移除受感染的起搏器并植入心外膜起搏器。然而,放置后7天,心外膜导线移位,狗被实施了安乐死。在尸检过程中,第一根经静脉导线被移除,绝缘层断裂被目视确认。尽管绝缘层断裂是起搏器植入的罕见延迟并发症,但本报告显示了如何通过放射学和荧光镜检查来辅助诊断,这是典型的询问结果所怀疑的。
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来源期刊
Journal of Veterinary Cardiology
Journal of Veterinary Cardiology VETERINARY SCIENCES-
CiteScore
2.50
自引率
25.00%
发文量
66
审稿时长
154 days
期刊介绍: The mission of the Journal of Veterinary Cardiology is to publish peer-reviewed reports of the highest quality that promote greater understanding of cardiovascular disease, and enhance the health and well being of animals and humans. The Journal of Veterinary Cardiology publishes original contributions involving research and clinical practice that include prospective and retrospective studies, clinical trials, epidemiology, observational studies, and advances in applied and basic research. The Journal invites submission of original manuscripts. Specific content areas of interest include heart failure, arrhythmias, congenital heart disease, cardiovascular medicine, surgery, hypertension, health outcomes research, diagnostic imaging, interventional techniques, genetics, molecular cardiology, and cardiovascular pathology, pharmacology, and toxicology.
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