Introduction

Pacemaker implantation is the treatment of choice for clinically relevant bradyarrhythmias. Pacemaker-lead-associated thrombosis (PLAT) occurs in 23.0–45.0% of people with permanent transvenous pacemakers. Serious thromboembolic complications are reported in 0.6–3.5%. The incidence of PLAT in dogs is unknown.

Animals, materials and methods

multicenter retrospective study of seven centers with 606 client-owned dogs undergoing permanent pacemaker implantation between 2012 and 2019. 260 dogs with a transvenous pacemaker with echocardiographic follow-up, 268 dogs with a transvenous pacemaker without echocardiographic follow-up and 78 dogs with an epicardial pacemaker.

Results

10.4% (27/260) of dogs with transvenous pacemakers and echocardiographic follow-up had PLAT identified. The median time to diagnosis was 175 days (6–1853 days). Pacemaker-lead-associated thrombosis was an incidental finding in 15/27 (55.6%) dogs. Of dogs with a urine protein:creatinine ratio measured at pacemaker implantation, dogs with PLAT were more likely to have proteinuria at pacemaker implantation vs. dogs without PLAT (6/6 (100.0%) vs. 21/52 (40.4%), P=0.007). Urine protein:creatinine ratio was measured in 12/27 (44.4%) dogs at PLAT diagnosis, with proteinuria identified in 10/12 (83.3%) dogs. Anti-thrombotic drugs were used following the identification of PLAT in 22/27 (81.5%) dogs. The thrombus resolved in 9/15 (60.0%) dogs in which follow-up echocardiography was performed. Dogs with PLAT had shorter survival times from implantation compared to those without PLAT (677 days [9–1988 days] vs. 1105 days [1–2661 days], P=0.003).

Conclusions

Pacemaker-lead-associated thrombosis is identified in 10.4% (27/260) of dogs following transvenous pacing, is associated with proteinuria, can cause significant morbidity, and is associated with reduced survival times.

中文翻译：

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犬起搏器导线相关血栓形成：一项多中心回顾性研究

介绍

起搏器植入是临床相关缓慢性心律失常的首选治疗方法。23.0-45.0% 的永久经静脉起搏器患者发生起搏器导线相关血栓 (PLAT)。据报道，严重血栓栓塞并发症的发生率为 0.6-3.5%。PLAT 在狗中的发病率尚不清楚。

动物、材料和方法

对 7 个中心的 606 只客户自有的狗在 2012 年至 2019 年间接受永久性起搏器植入进行的多中心回顾性研究。其中 260 只狗装有经静脉起搏器并进行超声心动图随访，268 只狗装有经静脉起搏器但未进行超声心动图随访，78 只狗装有心外膜起搏器。

结果

10.4% (27/260) 的带有经静脉起搏器和超声心动图随访的狗已识别出 PLAT。诊断的中位时间为 175 天（6-1853 天）。起搏器导线相关血栓是 15/27 (55.6%) 狗的偶然发现。在植入起搏器时测量尿蛋白与肌酐比值的狗中，与未植入 PLAT 的狗相比，植入 PLAT 的狗在起搏器植入时更容易出现蛋白尿 (6/6 (100.0%) vs. 21/52 (40.4%)，P =0.007）。PLAT 诊断时，测量了 12/27 (44.4%) 狗的尿蛋白：肌酐比值，并在 10/12 (83.3%) 狗中发现了蛋白尿。在 22/27 (81.5%) 的狗中发现 PLAT 后，使用了抗血栓药物。9/15 (60.0%) 的狗中血栓消退，并进行了后续超声心动图检查。与未接受 PLAT 的狗相比，接受 PLAT 治疗的狗植入后的存活时间较短（677 天 [9–1988 天] vs. 1105 天 [1–2661 天]，P=0.003）。

结论

10.4% (27/260) 的狗在经静脉起搏后发现起搏器导线相关血栓形成，该血栓与蛋白尿有关，可导致显着的发病率，并与生存时间缩短有关。