Sudden cardiac death in a dog during Holter recording—R on T phenomenon

Gunasekaran, T.; Sanders, Robert A.

doi:10.1016/j.jvc.2017.08.003

Cited by 9 publications

(3 citation statements)

References 24 publications

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“…In this report, the dog developed complex ventricular arrhythmias, followed by an episode of R‐on‐T phenomenon, which was followed by ventricular fibrillation and asystole. 26 This observation supports the idea that ventricular arrhythmias underlie SCD in dogs with AF. In contrast, a recent retrospective study reporting dogs that experienced transient loss of consciousness while undergoing ambulatory ECG described 7 cases of AF (out of 230 episodes; 3.3%) where loss of consciousness was associated with progressive slowing of AF rate followed by ventricular arrest.…”

Section: Discussionsupporting

confidence: 81%

Prevalence of sudden cardiac death in dogs with atrial fibrillation

Borgeat

Pack

Harris³

et al. 2021

Veterinary Internal Medicne

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Background: Atrial fibrillation (AF) is associated with increased risk of sudden cardiac death (SCD) in humans, independent of secondary risk factors such as thrombogenic disorders. In dogs, SCD is described in a number of heart diseases, but an association between AF and SCD is unreported.Hypothesis: (a) A higher proportion of dogs with AF will experience SCD, and (b) SCD will be associated with complex ventricular arrhythmias.Animals: One-hundred forty-two dogs with AF, and 127 dogs without AF.Methods: Retrospective, multicenter, case-control study. Dogs included in the AF group were compared to a control group of dogs in sinus rhythm, matched for echocardiographic diagnosis. Descriptive statistics were used to identify proportions of each group suffering SCD, compared using chi-squared testing. Risk factors for SCD in dogs with AF were evaluated at the univariable and multivariable level using binary logistic regression. Significance was P < .05.Results: A significantly higher proportion of dogs with AF suffered SCD than dogs in the control group (14.8% vs 5.5%; P = .01). Younger age at diagnosis, larger left atrial size, and a history of syncope all were independent predictors of SCD in dogs with AF (χ 2 , 16.3; P = .04).

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Section: Discussionsupporting

confidence: 81%

Prevalence of sudden cardiac death in dogs with atrial fibrillation

Borgeat

Pack

Harris³

et al. 2021

Veterinary Internal Medicne

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“…Single nucleotide polymorphisms on chromosome 4q25 that are strongly associated with AF have been found to increase the risk of sudden death, while variants of the SCN5A and SCN10A genes have independently been associated with both AF and VF, although a direct association is yet to be determined [25,26]. Rapidly conducted AF can also give rise to broad QRS complexes which can lead to an R-on-T phenomenon: a common culprit of ventricular arrhythmogenesis, leading to VT/VF, and subsequently asystole [27]. The abrupt changes in the cycle length and reduction in the ventricular refractory period owing to irregular, rapid ventricular rates as well as autonomic activation of the heart associated with AF may increase arrhythmogenicity and play a role in inducing VAs [28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation and the Risk of Ventricular Arrhythmias and Cardiac Arrest: A Nationwide Population-Based Study

Fawzy

Bisson

Bodin

et al. 2023

JCM

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Background: Atrial fibrillation (AF) has been linked to an increased risk of ventricular arrhythmias (VAs) and sudden death. We investigated this association in hospitalised patients in France. Methods: All hospitalised patients from 2013 were identified from the French National database and included if they had at least 5 years of follow-up data. Results: Overall, 3,381,472 patients were identified. After excluding 35,834 with a history of VAs and cardiac arrest, 3,345,638 patients were categorised into two groups: no AF (n = 3,033,412; mean age 57.2 ± 21.4; 54.3% female) and AF (n = 312,226; 78.1 ± 10.6; 44.0% female). Over a median follow-up period of 5.4 years (interquartile range (IQR) 5.0–5.8 years), the incidence (2.23%/year vs. 0.56%/year) and risk (hazard ratio (HR) 3.657 (95% confidence interval (CI) 3.604–3.711)) of VAs and cardiac arrest were significantly higher in AF patients compared to non-AF patients. This was still significant after adjusting for confounders, with a HR of 1.167 (95% CI 1.111–1.226) and in the 1:1 propensity score-matched analysis (n = 289,332 per group), with a HR of 1.339 (95% CI 1.313–1.366). In the mediation analysis, the odds of cardiac arrest were significantly mediated by AF-associated VAs, with an OR of 1.041 (95% CI 1.040–1.042). Conclusion: In hospitalised French patients, AF was associated with an increased risk of VAs and sudden death.

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“…Tachycardia, particularly fast and sustained ventricular tachycardia (VT), defined as 160 beats per minute (bpm) over more than 15–30 seconds, can result in syncope, weakness or ventricular fibrillation, and quickly culminate in sudden death 1 2. While the routine use of magnesium is not considered a standard treatment for VT, it is recommended for treatment of torsades de pointes in both human beings and dogs, as well as for refractory VT (at least two separate VT episodes requiring intervention in a 24-hour period) 3.…”

Section: Introductionmentioning

confidence: 99%

Reversal of sustained ventricular tachycardia with magnesium but not with lidocaine in a dog during the perianaesthetic period

Ranninger

Bartoszuk

Kutter

2019

Vet Record Case Reports

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A one-and-a-half-year-old, male neutered Pyrenean mountain dog was presented with bleeding after orchiectomy at a private veterinary practice. Drops of blood were emerging from the surgical site. Clinical evaluation evidenced slightly pale mucous membranes and a mildly elevated heart rate. Preoperative blood testing revealed a mild hyperlactataemia. Due to the haemorrhage, anaesthesia was induced for surgical ligation of the vessel. During dissection of the testicular vessels, repeated episodes of sudden sustained ventricular tachycardia (heart rate >190 beats per minute, lasting about one minute) and hypotension were observed. Despite repeated intravenous lidocaine boluses (8 mg/kg total) and a constant rate infusion (80 μg/kg/minute), the ventricular tachycardia did not cease. After an intravenous magnesium infusion, a sinus rhythm returned within 20 minutes of administration. In view of ventricular tachycardia resistant to conventional therapies, magnesium administration might be a safe adjuvant pharmacological option, as described in the case herein.

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Sudden cardiac death in a dog during Holter recording—R on T phenomenon

Cited by 9 publications

References 24 publications

Prevalence of sudden cardiac death in dogs with atrial fibrillation

Prevalence of sudden cardiac death in dogs with atrial fibrillation

Atrial Fibrillation and the Risk of Ventricular Arrhythmias and Cardiac Arrest: A Nationwide Population-Based Study

Reversal of sustained ventricular tachycardia with magnesium but not with lidocaine in a dog during the perianaesthetic period

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