Double trouble: First degree-atrioventricular block and concealed ventricular preexcitation
DOI:
https://doi.org/10.33448/rsd-v13i12.47905Keywords:
Accessory Pathway; Atrioventricular Block; Heart Failure; Ventricular Preexcitation; Wolff-Parkinson-White; Dog.Abstract
This article aims to present a case report of a canine patient with first-degree atrioventricular block and occult ventricular pre-excitation. A 9-year-old male dog, was referred for cardiological evaluation for suspected heart failure. The physical examination revealed a regular heart rhythm, loud holosystolic murmur over the left apex of the heart, accompanied by systolic thrill. Systolic blood pressure was 140 mmHg. The chest X-ray showed evidence of severe cardiomegaly and pulmonary edema, compatible with congestive heart failure. The echodoppler examination demonstrated presence of severe mitro-tricuspid insufficiency and enlargement of the four cardiac chambers. Serial electrocardiographic examination revealed presence of first-degree atrioventricular block concomitant with occult ventricular pre-excitation. To the best of our knowledge, the combination of such different electrocardiographic abnormalities wasn't reported before in a canine patient.
References
Atkins, C. E., et al. (1995). Orthodromic reciprocating tachycardia and heart failure in a dog with a concealed posteroseptal accessory pathway. Journal of Veterinary Internal Medicine, 9(1), 43-49.
Belachsen, O., et al. (2021). Segmental septal dyskynesia associated with an accessory pathway and preexcitation in two Golden Retriever dogs. Journal of Veterinary Cardiology 36, 6-11.
Belokon, N. A. & Barinova, V. S. (1984). Significance of atrioventricular block in the development of the Wolff-Parkinson-White syndrome. Kardiologiia. 24(12), 39-44. PMID: 6521225.
Chhabra, L., Goyal, A. & Benham, M. D. (2023). Wolff-Parkinson-White Syndrome. StatPearls [Internet]. StatPearls Publishing; 2024 Jan. www.ncbi.nlm.nih.gov/books/NBK554437/.
Chou, T. (1991). Wolff-Parkinson-White Syndrome and Its variants. Electrocardiography in Clinical Practice. WB Saunders Company. Philadelphia, 429-456.
Goldwasser, G. (2009). Síndrome de Wolff-Parkinson-White e Lown-Gannong-Levine. in: Eletrocardiograma orientado para o Clinico. (3.ed.). 289-300. Rubio Editora. Rio de Janeiro. ISBN978-85-7771-045-4.
Hill, B. L. & Tilley, L. P. (1985). Ventricular preexcitation in seven dogs and nine cats. Journal of the American Veterinary Medical Association 187(10), 1026-1031.
Florek, J. B., Lucas, A. & Girzadas, D. (2023). Amiodarone. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
Keene, B. W. et al (2019). ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med. 11; 33(3), 1127–1140. doi: 10.1111/jvim.15488.
Kent, A. F. (1893). Researches on the structure and function of the mammalian heart. J Physiol, 14, i2–254.
Nahas, K., Hanton, G., Lodola, A., Rabemampianina, Y., & Sacre-Salem, B. (1998). Type B Ventricular Preexcitation With Abnormal Contraction of the Ventricular Septum in a Dog. Journal of the American Association for Laboratory Animal Science, 37(5), 78-81.
Liu, L., et al. (2001). Atrioventricular conduction: a determinant for the manifestation of ventricular preexcitation in patients with Wolff-Parkinson-White syndrome. Clinical Physiology, 21(5), 534-540.
Melis, C., Beijerink, N., & Santilli, R. (2024). Spontaneous pre-excited supraventricular tachycardias in a Labrador Retriever. Journal of Veterinary Cardiology, 54, 57-62.
Noszczyk-Nowak, A. et al., (2017). Radiofrequency catheter ablation of concealed accessory pathway of the heart in Labrador Retriever. Med Weter 73, 505–509.
Oliveira, P. (2018). Junctional Rhythms. In: Willis R., Oliveira P. and Mavropoulou A. (Eds.) Electrocardiography. Guide to Canine and Feline Electrocardiography. Willey Blackwell. Philadelphia., 146-167.
Patterson, D. F., Detweiler, D. K., Hubben, K., Botts, R. P. (1961). Spontaneous abnormal cardiac arrhythmias and conduction disturbances in the dog (a clinical and pathologic study of 3.000 dogs). American Journal of Veterinary Research (22), 355–369.
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Editora UAB/NTE/UFSM.
Perego, M. et al. (2023). Electrocardiographic patterns of ventricular pre-excitation in dogs with right-sided accessory pathways. Vet Res Commun 47, 1393–1403.
Romito, G. et al (2019). Preexcitation alternans in a dog. Journal of Veterinary Cardiology (24), 1-6.
Santilli, R. A. et al (2006). Radiofrequency catheter ablation of concealed accessory pathways in two dogs with symptomatic atrioventricular reciprocating tachycardia. J Vet Cardiol, 8(2), 157-65. Doi: 10.1016/j.jvc.2006.06.001. PMID: 19083349.
Santilli, R. A. et al. (2007). Anatomic distribution and electrophysiologic properties of accessory atrioventricular pathways in dogs. Journal of the American Veterinary Association, 231(3), 393-398.
Santilli, R. A. et al. (2018). Radiofrequency catheter ablation of accessory pathways in the dog: the Italian experience. Journal of Veterinary Cardiology (5), 384-397.
Scherlag, B. J. et al., (1993). Radiofrequency ablation of a concealed accessory pathaway as treatment of incessant supraventricular tachicardia in a dog. Journal of the American Veterinary Medical Association 203(8), 1147-1152.
Sigfusson, G. A., Webber, S. A. & Lee, B., (1997). Coexistence of atrioventricular block and Wolff-Parkinson-White syndrome in children. Cardiol Young (7), 388-392.
Tilley, L. P. (1985). Ventricular pre-excitation and the Wolf-Parkinson-White syndrome. In: Essentials of canine and feline electrocardiography: interpretation and treatment. Second edition. Lea and Febiger, Philadelphia, USA, 176-177.
Tilley, L. P. & Smith Jr, F.W. K. (2016). Chapter 3: Electrocardiography in: Manual of Canine and Feline Cardiology, 49-775. Th Edition. Elsevier. St Louis. Missouri, 62-71.
Tilley, L. P., Miller, M. S. & Smith Jr., F. W. K. (1993) Canine and Feline Arrhythmias. Lea & Febi. Philadelphia. London.
Varshney, J. P. et al. (2013). Prospective Study of Cardiac Arrhythmias - A survey of 20,000 canines. Intas Polivet 14(1), 129-136.
Willys, R., Oliveira, P. & Mavropoulou, A. (2019). Electrocardiography. Guide to Canine and Feline Electrocardiography, 9-19. Wiley Blackwell. Hoboken, New Jersey. USA.
Wolff, M. D., Parkinson, J. & White, P D (1930). Bundle-branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia. Heart Journal (5), 685-704.
Wright, K. N. et al. (2018). Atrioventricular accessory pathways in 89 dogs: clinical features and outcome after radiofrequency catheter ablation. Journal of veterinary Internal Medicine, 32(5), 1517-1529.
Zhang, Y., Liu, R. & Chen, Y. (2013). Association of WPW syndrome and first-degree atrioventricular block. Electrocardiographic diagnosis. Herz, (39), 834–836.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Gustavo Luiz Gouvêa de Almeida; Marcelo Barbosa de Almeida; Ana Carolina Mendes dos Santos ; Ângela Vargas de Mattos; Sophie Ballot; Alexandre Lopes
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
