Complication Rates Associated with Transvenous Pacemaker Implantation in Dogs with High‐Grade Atrioventricular Block Performed During versus After Normal Business Hours. (January 2015)

• Record Type: Journal Article
• Authors: Ward, J.L.; DeFrancesco, T.C.; Tou, S.P.; Atkins, C.E.; Griffith, E.H.; Keene, B.W.
• Is Part Of: Journal of veterinary internal medicine. Volume 29:Number 1(2015:Jan./Feb.)
• Page Start: 157
• Page End: 163
• Publication Date: 2015-01
• Subjects: Veterinary medicine -- Periodicals; 636.0896
• DOI: 10.1111/jvim.12512
• Languages: English
• ISSNs: 0891-6640

Abstract

<abstract abstract-type="main" id="jvim12512-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jvim12512-sec-0001" sec-type="section"> <title>Background</title> <p>Transvenous pacemaker implantation in dogs is associated with a relatively high complication rate. At our institution, pacemaker implantation in dogs with high‐grade atrioventricular block (HG‐AVB) frequently is performed as an after‐hours emergency.</p> </sec> <sec id="jvim12512-sec-0002" sec-type="section"> <title>Hypothesis</title> <p>Among dogs with HG‐AVB, the rate of major complications is higher when pacemakers are implanted after hours (AH) compared to during business hours (BH).</p> </sec> <sec id="jvim12512-sec-0003" sec-type="section"> <title>Animals</title> <p>Client‐owned dogs with HG‐AVB that underwent transvenous pacemaker implantation between January 2002 and December 2012 at the North Carolina State University Veterinary Teaching Hospital.</p> </sec> <sec id="jvim12512-sec-0004" sec-type="section"> <title>Methods</title> <p>Retrospective medical record review. Two‐year follow‐up was required for complications analysis.</p> </sec> <sec id="jvim12512-sec-0005" sec-type="section"> <title>Results</title> <p>Major complications occurred in 14/79 dogs (18%) and included lead dislodgement, lead or generator infection, lead or generator migration, and pacing failure. Incidence of major complications was significantly higher AH (10/36, 28%) compared to BH (4/43, 9%; <italic>P</italic> = .041), and all infectious complications occurred AH. Median survival time for all dogs was 27 months and did not differ between AH and BH groups for either all‐cause (<italic>P</italic> = .70) or cardiac (<italic>P</italic> = .40) mortality. AH dogs were younger than BH dogs (<italic>P</italic> = .010), but there were no other clinically relevant differences between BH and AH groups in terms of demographic, clinical, or procedural variables.</p> </sec> <sec id="jvim12512-sec-0006" sec-type="section"> <title>Conclusions and Clinical Importance</title> <p>At our institution, AH transvenous pacemaker placement is associated with a higher rate of major complications (especially infections) compared to BH placement. This difference may be because of a variety of human factor differences AH versus BH.</p> </sec> </abstract>