Peer-reviewed veterinary case report
Cat with pacemaker having fainting episodes one year after surgery
By Ferasin, L et al.·Published in Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology·2024·The Ralph Veterinary Referral Centre, United Kingdom·View original on PubMed →
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Original publication title: Pacemaker-twiddler's syndrome in a seven-year-old male domestic shorthaired cat.
- Species:
- cat
Plain-English summary
A 7-year-old male domestic shorthaired cat had a pacemaker implanted to treat seizure-like episodes caused by heart block. About a year later, he started having near-fainting spells, prompting further investigation. Tests revealed that the pacemaker lead had twisted and become entangled, a condition known as "twiddler syndrome," which is rare in cats. The cat's pacemaker was unable to function properly due to this issue. This case highlights the importance of monitoring pacemaker function in pets after surgery.
People also search for: cat seizure-like episodes · cat pacemaker problems · twiddler syndrome in cats · cat heart block treatment
Abstract
A seven-year-old male neutered domestic shorthaired cat underwent surgical placement of a permanent epicardial pacemaker following diagnosis of intermittent second and third degree atrioventricular block, which was responsible for 'seizure-like' episodes. Although the pacemaker implant was successful, the cat started experiencing near-syncopal episodes approximately one year after surgery. Ambulatory Holter recording showed periods of loss of capture. Therefore, the pacemaker was interrogated using incremental energy output, which did not evoke any capture, even at the highest possible pulse voltage and duration. Thoracic radiographs showed that the pulse generator had rotated compared to the original radiographic assessment and the lead appeared entangled and shortened, resembling the findings described as 'twiddler syndrome' in humans and dogs, which is characterised by twisting of the lead caused by rotation of the pulse generator around its long axis and subsequent lead migration. To the best of the authors' knowledge, this is the first report of twiddler syndrome in a cat.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/39004068/