Bradyarrhythmias and Pacemaker Therapy in Dogs with Chagas Disease

Journal of Veterinary Internal Medicine

A.B. Saunders²  S.G. Gordon²  M.H. Rector²  A. DeMaster²  N. Jackson¹  F.J. Clubb¹  G.T. Fosgate³ 

[1] Department of Veterinary Pathobiology, College Station, TX;Department of Small Animal Clinical Sciences and, Michael E. DeBakey Institute for Comparative Cardiovascular Sciences and Biomedical Devices, College Station, TX;College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX

关键词: Arrhythmias;    Atrioventricular block;    Canine;    Myocarditis;   

DOI  :  10.1111/jvim.12098

来源: Wiley

【 摘 要 】

Abstract

Background

Chagas disease (Trypanosomiasis) is a cause of myocarditis in the southern United States causing cardiac conduction abnormalities, arrhythmias, and heart failure.

Objectives

To report clinical findings and outcome in Chagas positive (CP) dogs requiring pacemaker implantation for bradyarrhythmias.

Animals

One hundred and forty-four client-owned dogs requiring pacemaker implantation.

Methods

Retrospective case series. Information regarding history, physical exam, laboratory and diagnostic imaging findings, treatment, and survival were obtained from medical records, with additional follow-up information obtained by contacting referring veterinarians and owners.

Results

Of the 144 dogs requiring pacemaker implantation from January 2001 to May 2010, 83 (57.6%) had a Chagas titer performed and 9 (10%) were CP. Concurrent ventricular arrhythmias (odds ratio 1.61, P = .005) or atrioventricular (AV) block (odds ratio 4.18, P < .001) increased the likelihood that a Chagas titer was submitted. Median age for CP dogs was 6.2 years (range, 0.3–10); 7 were male. Bradyarrhythmias included high-grade 2nd or 3rd degree AV block (n = 8) and sinus bradycardia with 1st degree AV block (n = 1); 5 had concurrent ventricular arrhythmias. A positive Chagas titer had a negative impact on survival (hazard ratio 4.04; 95% CI 1.36–12.1, P = .012) with a reported median survival time of 365 days (interquartile range, 84–973 days).

Conclusions and Clinical Importance

Bradyarrhythmias can result in clinical signs requiring pacemaker implantation in CP dogs, and although the diagnosis negatively impacts survival, pacemaker therapy is a viable treatment option.

【 授权许可】

Unknown   
Copyright © 2013 by the American College of Veterinary Internal Medicine