Peer-reviewed veterinary case report
High-septal pacing lowers heart rhythm risks in dogs with AV block
By Winckels, Stephan K G et al.·Published in Journal of the American College of Cardiology·2007·Department of Medical Physiology, Netherlands·View original on PubMed →
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Original publication title: High-septal pacing reduces ventricular electrical remodeling and proarrhythmia in chronic atrioventricular block dogs.
- Species:
- dog
Plain-English summary
A group of dogs with chronic atrioventricular (AV) block, which can cause slow heart rates (bradycardia), were studied to see if a specific pacing technique could help. Some dogs were paced from a high spot in the heart (high-septal pacing), while others were not paced at all. After four weeks, the dogs that received high-septal pacing showed less electrical remodeling of the heart and fewer dangerous heart rhythms compared to those that weren't paced. This suggests that pacing can help protect the heart in dogs with AV block.
People also search for: dog heart problems · AV block in dogs · high-septal pacing for dogs · bradycardia treatment in dogs
Abstract
OBJECTIVES: This study was designed to analyze the relevance of ventricular activation patterns for ventricular electrical remodeling after atrioventricular (AV) block in dogs. BACKGROUND: Bradycardia is thought to be the main contributor to ventricular electrical remodeling after complete AV block. However, an altered ventricular activation pattern or AV dyssynchrony may also contribute. METHODS: For 4 weeks, AV block dogs were either paced from the high-ventricular septum near the His bundle at lowest captured rate (n = 9, high-septal pacing [HSP]) or kept at idioventricular rate without controlled activation (n = 14, chronic AV block [CAVB]). Multiple electrocardiographic and electrophysiological parameters were measured under anesthesia at 0 and 4 weeks. Proarrhythmia was tested at 4 weeks by I(Kr) block (25 mug/kg dofetilide intravenous). RESULTS: At 0 weeks, the 2 groups were comparable, whereas after 4 weeks of similar bradycardia, QT duration at unpaced conditions had increased from 300 +/- 5 to 395 +/- 18 ms in CAVB (+32 +/- 6%) and from 307 +/- 8 ms to 357 +/- 11 ms in HSP (+17 +/- 4%; p < 0.05). Frequency dependency of repolarization was less steep in HSP compared to CAVB dogs after 4 weeks remodeling. Beat-to-beat variability of repolarization, a proarrhythmic parameter, increased only in CAVB from 0 to 4 weeks. Torsades de pointes arrhythmias were induced at 4 weeks in 44% HSP versus 78% CAVB dogs (p = 0.17). Cumulative duration of arrhythmias per inducible dog was 87 +/- 36 s in CAVB and 30 +/- 21 s in HSP (p < 0.05). CONCLUSIONS: High-septal pacing reduces the magnitude of ventricular electrical remodeling and proarrhythmia in AV block dogs, suggesting a larger role for altered ventricular activation pattern in the generation of ventricular electrical remodeling than previously assumed.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/17719479/