Treatment of a Paroxysmal Atrioventricular Block by Implantation of a Bipolar, Single-Chamber Cardiac Pacemaker in a Donkey.
Abstract: A two-year-old donkey presented with recurrent syncope. Electrocardiography revealed periods without any atrioventricular conduction and without any ventricular escape rhythm with a duration of up to one minute. Finally, atrioventricular conduction resumed spontaneously with a preceding ventricular escape beat. Laboratory tests and echocardiography identified no reversible cause. The diagnosis of a paroxysmal atrioventricular block (PAVB) was made. Therefore, a single-chamber cardiac pacemaker was implanted under general anesthesia. The device was programmed in the VVI mode to prevent further syncope. The therapy was considered successful as the donkey revealed no further syncope during the follow-up period of 17 months. Conclusions: Clinically relevant bradycardia is rare in equids. This is the first report to our knowledge to describe a PAVB, a term commonly used in human medicine, in a donkey. Detailed information about the diagnosis and the successful therapy is included, with a special focus on the implantation and programming of the permanent pacemaker.
Publication Date: 2023-08-27 PubMed ID: 37684988PubMed Central: PMC10486563DOI: 10.3390/ani13172724Google Scholar: Lookup
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Summary
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The research article discusses the successful treatment of a two-year-old donkey suffering from a rare cardiac condition called Paroxysmal Atrioventricular Block (PAVB) by implanting a single-chamber cardiac pacemaker.
Background and Diagnosis
- The case covers a two-year-old donkey that was experiencing recurrent fainting episodes, medically termed as syncope.
- On investigation via electrocardiography, it was found that there were periods of absence of heart rhythm and atrioventricular conduction (which relates to the electrical signals between the upper and lower chambers of the heart). These moments without a ventricular escape rhythm could last up to one minute.
- Eventually, the heart rhythm would spontaneously resume, preceded by a ventricular escape beat (an independent beat originating from the lower heart chambers).
- Further laboratory tests and echocardiography (a sonography of the heart) were unable to identify any reversible or treatable cause.
- Based on these observations, a diagnosis of a paroxysmal atrioventricular block (PAVB), a condition wherein the heart rhythm irregularly stops and starts, was made.
Treatment and Outcome
- The condition was treated by implanting a single-chamber cardiac pacemaker under general anesthesia. This device helps in regulating the heart rhythm.
- To prevent further syncope, the device was programmed in the VVI mode, which allows it to sense the heart’s electrical activity and fire when needed.
- The treatment was considered successful as no further episodes of the fainting spells were observed during the follow-up period of seventeen months.
Conclusion
- Bradycardia, a significantly slower than normal heartbeat, is rare in equids (the horse family). This is reported to be the first instance of successfully treating a case of PAVB, a term commonly used in human medicine, in a donkey.
- The article provides detailed insights into the diagnosis and the successful therapy of PAVB, especially focusing on the implantation and programming of the permanent pacemaker.
Cite This Article
APA
Heun F, Niebuhr T, Gutierrez Bautista A, Wiedmann F, Verhaar N, Kästner S, Feige K, Schmidt C.
(2023).
Treatment of a Paroxysmal Atrioventricular Block by Implantation of a Bipolar, Single-Chamber Cardiac Pacemaker in a Donkey.
Animals (Basel), 13(17).
https://doi.org/10.3390/ani13172724 Publication
Researcher Affiliations
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
- Department of Internal Medicine III, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
- Department of Internal Medicine III, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
Conflict of Interest Statement
The authors declare no conflict of interest.
References
This article includes 11 references
- Schwarzwald C.C.. Disorders of the cardiovascular system.. In: Reed S.M., Bayly W.M., Sellon D.C., editors. Equine Internal Medicine. 4th ed. Elsevier; St. Louis, MO, USA: 2018.
- Keen J.A.. Pathological bradyarrhythmia in horses.. Vet. J. 2020;259:105463.
- Issa Z., Miller J.M., Zipes D.P.. Atrioventricular Conduction Abnormalities.. In: Issa Z., Miller J.M., Zipes D.P., editors. Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald’s Heart Disease. 3rd ed. Elsevier; Philadelphia, PA, USA: 2018.
- van Loon G., Rottiers H., Deprez P., Fonteyne W., Tavernier R.. Implantation of a dual-chamber, rate-adaptive pacemaker in a horse with suspected sick sinus syndrome.. Vet. Rec. 2002;151:541–545.
- Sedlinská M., Kabeš R., Novák M., Kološ F., Melková P.. Single-Chamber Cardiac Pacemaker Implantation in a Donkey with Complete AV Block: A Long-Term Follow-Up.. Animals 2021;11:746.
- Pibarot P., Vrins A., Salmon Y., DiFruscia R.. Implantation of a Programmable Atrioventricular Pacemaker in a Donkey with Complete Atrioventricular-Block and Syncope.. Equine Vet. J. 1993;25:248–251.
- De Lange L., Van Steenkiste G., Vernemmen I., Vera L., Cromheeke K.M., Walser U., Meert H., Decloedt A., van Loon G.. Successful application of closed loop stimulation pacemakers with remote monitoring in 3 miniature donkeys with syncope.. J. Vet. Intern. Med. 2021;35:2920–2925.
- van Loon G., Fonteyne W., Rottiers H., Tavernier R., Jordaens L., D’Hont L., Colpaert R., de Clercq T., Deprez P.. Dual-chamber pacemaker implantation via the cephalic vein in healthy equids.. J Vet Intern Med 2001;15:564–571.
- d’Anselme O., Robel M., Schwarzwald C., Ringer S.K.. Anaesthesia management of transvenous implantation of a single-chamber, rate-adaptive pacemaker in a donkey with high-grade second and third degree atrioventricular block.. Vet. Rec. Case Rep. 2022;10:e363.
- Hesselkilde E.M., Isaksen J.L., Petersen B.V., Carstensen H., Jespersen T., Pehrson S., Kanters J.K., Buhl R.. A novel approach for obtaining 12-lead electrocardiograms in horses.. J. Vet. Intern. Med. 2021;35:521–531.
- Aste M., Brignole M.. Syncope and paroxysmal atrioventricular block.. J. Arrhythmia. 2017;33:562–567.
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