Atrioventricular accessory pathways in 89 dogs

Clinical features and outcome after radiofrequency catheter ablation

Kathy N. Wright, Chad E. Connor, Holly M. Irvin, Timothy K. Knilans, Dawn Webber, Philip H Kass

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Atrioventricular accessory pathways (APs) in dogs have been reported rarely. Data regarding clinical presentation and long-term outcome after radiofrequency catheter ablation (RFCA) are limited. Hypothesis/Objectives: To study clinical features, electrophysiologic characteristics, and outcome of RFCA in dogs with APs. Animals: Eighty-nine dogs presented consecutively for RFCA of APs. Methods: Case series. Results: Labrador retrievers (47.2% of dogs) and male dogs (67.4% of dogs) were most commonly affected. Labrador retrievers were more likely to be male than non-Labrador breeds (P =.043). Clinical signs were nonspecific and most commonly included lethargy and gastrointestinal signs. Concealed APs were more prevalent in Labrador retrievers than other breeds (P =.001). Right-sided APs (91.7%) predominated over left-sided (8.3%). Tachycardia-induced cardiomyopathy (TICM) occurred in 46.1% of dogs, with complete resolution or substantial improvement noted on one-month postablation echocardiograms. Radiofrequency catheter ablation successfully eliminated AP conduction long term in 98.8% of dogs in which it was performed. Complications occurred in 5/89 dogs. Recurrence in 3 dogs was eliminated long term with a second procedure. Clinical Importance/Conclusions: Accessory pathways are challenging to recognize in dogs because of nonspecific clinical signs, frequency of concealed APs that show no evidence of their presence during sinus rhythm, and intermittent occurrence of tachyarrhythmias resulting from APs. Tachycardia-induced cardiomyopathy commonly occurs with AP-mediated tachycardias and should be considered in any dog presenting with a dilated cardiomyopathic phenotype because of its good long-term prognosis with rhythm control. Radiofrequency catheter ablation is a highly effective method for eliminating AP conduction and providing long-term resolution.

Original languageEnglish (US)
Pages (from-to)1517-1529
Number of pages13
JournalJournal of Veterinary Internal Medicine
Volume32
Issue number5
DOIs
StatePublished - Sep 1 2018

Fingerprint

Accessory Atrioventricular Bundle
Catheter Ablation
catheters
Dogs
dogs
Newfoundland and Labrador
Tachycardia
Labrador Retriever
cardiomyopathy
Cardiomyopathies
breeds
Lethargy
sinuses
prognosis

Keywords

  • accessory pathway
  • congestive heart failure
  • orthodromic atrioventricular reciprocating tachycardia
  • tachycardia
  • tachycardia-induced cardiomyopathy
  • ventricular preexcitation

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Atrioventricular accessory pathways in 89 dogs : Clinical features and outcome after radiofrequency catheter ablation. / Wright, Kathy N.; Connor, Chad E.; Irvin, Holly M.; Knilans, Timothy K.; Webber, Dawn; Kass, Philip H.

In: Journal of Veterinary Internal Medicine, Vol. 32, No. 5, 01.09.2018, p. 1517-1529.

Research output: Contribution to journalArticle

Wright, Kathy N. ; Connor, Chad E. ; Irvin, Holly M. ; Knilans, Timothy K. ; Webber, Dawn ; Kass, Philip H. / Atrioventricular accessory pathways in 89 dogs : Clinical features and outcome after radiofrequency catheter ablation. In: Journal of Veterinary Internal Medicine. 2018 ; Vol. 32, No. 5. pp. 1517-1529.
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abstract = "Background: Atrioventricular accessory pathways (APs) in dogs have been reported rarely. Data regarding clinical presentation and long-term outcome after radiofrequency catheter ablation (RFCA) are limited. Hypothesis/Objectives: To study clinical features, electrophysiologic characteristics, and outcome of RFCA in dogs with APs. Animals: Eighty-nine dogs presented consecutively for RFCA of APs. Methods: Case series. Results: Labrador retrievers (47.2{\%} of dogs) and male dogs (67.4{\%} of dogs) were most commonly affected. Labrador retrievers were more likely to be male than non-Labrador breeds (P =.043). Clinical signs were nonspecific and most commonly included lethargy and gastrointestinal signs. Concealed APs were more prevalent in Labrador retrievers than other breeds (P =.001). Right-sided APs (91.7{\%}) predominated over left-sided (8.3{\%}). Tachycardia-induced cardiomyopathy (TICM) occurred in 46.1{\%} of dogs, with complete resolution or substantial improvement noted on one-month postablation echocardiograms. Radiofrequency catheter ablation successfully eliminated AP conduction long term in 98.8{\%} of dogs in which it was performed. Complications occurred in 5/89 dogs. Recurrence in 3 dogs was eliminated long term with a second procedure. Clinical Importance/Conclusions: Accessory pathways are challenging to recognize in dogs because of nonspecific clinical signs, frequency of concealed APs that show no evidence of their presence during sinus rhythm, and intermittent occurrence of tachyarrhythmias resulting from APs. Tachycardia-induced cardiomyopathy commonly occurs with AP-mediated tachycardias and should be considered in any dog presenting with a dilated cardiomyopathic phenotype because of its good long-term prognosis with rhythm control. Radiofrequency catheter ablation is a highly effective method for eliminating AP conduction and providing long-term resolution.",
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AU - Webber, Dawn

AU - Kass, Philip H

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AB - Background: Atrioventricular accessory pathways (APs) in dogs have been reported rarely. Data regarding clinical presentation and long-term outcome after radiofrequency catheter ablation (RFCA) are limited. Hypothesis/Objectives: To study clinical features, electrophysiologic characteristics, and outcome of RFCA in dogs with APs. Animals: Eighty-nine dogs presented consecutively for RFCA of APs. Methods: Case series. Results: Labrador retrievers (47.2% of dogs) and male dogs (67.4% of dogs) were most commonly affected. Labrador retrievers were more likely to be male than non-Labrador breeds (P =.043). Clinical signs were nonspecific and most commonly included lethargy and gastrointestinal signs. Concealed APs were more prevalent in Labrador retrievers than other breeds (P =.001). Right-sided APs (91.7%) predominated over left-sided (8.3%). Tachycardia-induced cardiomyopathy (TICM) occurred in 46.1% of dogs, with complete resolution or substantial improvement noted on one-month postablation echocardiograms. Radiofrequency catheter ablation successfully eliminated AP conduction long term in 98.8% of dogs in which it was performed. Complications occurred in 5/89 dogs. Recurrence in 3 dogs was eliminated long term with a second procedure. Clinical Importance/Conclusions: Accessory pathways are challenging to recognize in dogs because of nonspecific clinical signs, frequency of concealed APs that show no evidence of their presence during sinus rhythm, and intermittent occurrence of tachyarrhythmias resulting from APs. Tachycardia-induced cardiomyopathy commonly occurs with AP-mediated tachycardias and should be considered in any dog presenting with a dilated cardiomyopathic phenotype because of its good long-term prognosis with rhythm control. Radiofrequency catheter ablation is a highly effective method for eliminating AP conduction and providing long-term resolution.

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KW - congestive heart failure

KW - orthodromic atrioventricular reciprocating tachycardia

KW - tachycardia

KW - tachycardia-induced cardiomyopathy

KW - ventricular preexcitation

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