TY - JOUR
T1 - Acquired tricuspid valve stenosis due to intentionally redundant transvenous lead placement for VDD pacing in two small dogs
AU - Gunther-Harrington, Catherine
AU - Michel, Adam O.
AU - Stern, Joshua A
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Placement of an endocardial VDD pacing lead in small dogs (<12 kg) may necessitate a redundant lead remaining looped in the right atrium for appropriate sensing and pacing. This report documented acquired tricuspid valve stenosis in two small dogs between 8 months and 4 years after VDD pacemaker placement for third-degree atrioventricular block. Echocardiography and Doppler echocardiography identified elevated transtricuspid flow velocities, prolonged pressure half-times, decreased valve leaflet excursions, and tricuspid regurgitation in both cases. Both cases were euthanized secondary to this pacing complication. Necropsy was performed in one case and confirmed adherence between the redundant lead loop, atrial and valve tissue. While VDD pacing in dogs has proven hemodynamic benefits, these benefits have not been demonstrated in terms of survival benefit or clinical signs. The requirement of redundant lead placement in small dogs for appropriate VDD lead function creates potential deleterious effects that should be weighed against the possible clinical value of VDD pacing in these patients.
AB - Placement of an endocardial VDD pacing lead in small dogs (<12 kg) may necessitate a redundant lead remaining looped in the right atrium for appropriate sensing and pacing. This report documented acquired tricuspid valve stenosis in two small dogs between 8 months and 4 years after VDD pacemaker placement for third-degree atrioventricular block. Echocardiography and Doppler echocardiography identified elevated transtricuspid flow velocities, prolonged pressure half-times, decreased valve leaflet excursions, and tricuspid regurgitation in both cases. Both cases were euthanized secondary to this pacing complication. Necropsy was performed in one case and confirmed adherence between the redundant lead loop, atrial and valve tissue. While VDD pacing in dogs has proven hemodynamic benefits, these benefits have not been demonstrated in terms of survival benefit or clinical signs. The requirement of redundant lead placement in small dogs for appropriate VDD lead function creates potential deleterious effects that should be weighed against the possible clinical value of VDD pacing in these patients.
KW - Complete heart block
KW - Complications
KW - Pacemaker
KW - Third-degree atrioventricular block
UR - http://www.scopus.com/inward/record.url?scp=84959377088&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959377088&partnerID=8YFLogxK
U2 - 10.1016/j.jvc.2015.04.004
DO - 10.1016/j.jvc.2015.04.004
M3 - Article
C2 - 26463216
AN - SCOPUS:84959377088
VL - 17
SP - 298
EP - 303
JO - Journal of Veterinary Cardiology
JF - Journal of Veterinary Cardiology
SN - 1760-2734
IS - 4
ER -