Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지

Sinoatrial Reentrant Tachycardia in a Yorkshire Cross Dog

요크셔테리어 잡종견에서 나타난 동방회귀성 빈맥증

  • Nam, So-Jeong (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University) ;
  • Hyun, Chang-Baig (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University)
  • 남소정 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 현창백 (강원대학교 수의(학부)대학 소동물 내과교실)
  • Published : 2008.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

An 8-year-old intact male Yorkshire cross dog (7.5 kg of body weight) was referred with the primary complaint of exercise intolerance and occasional syncope. Initial cardiological examination could not identify any abnormalities except mild mitral regurgitation. Exercise stress test revealed chronotrophic incompetence. Furthermore the 1 hr-digital event recording found the sudden onset of paroxysmal sinus tachycaridas (156-172 bpm) lasting few minutes and stopping abruptly. In addition, the tachycardia terminated by vagal maneuver and verapamil administration. Based on this finding, the case was diagnosed as sinoatrial reentrant tachycardia (SART). The dog was treated with diltiazem and enalapril. Although the dog still has exercise intolerance, no syncope has been observed after medication.

8세령 수컷 요크셔테리어 잡종견(몸무게: 7.5kg)이 운동불내성과 실신을 주증상으로 강원대학교 동물병원에 내원하였다. 초기 심장 검사에서 경미한 이첨판 역류증이외에 특별한 이상소편은 관찰되지 않았다. 운동내성검사에서 환자는 심각한 chronotrophic incompetence소견을 보였고, 1시간-디지털 심전도 검사에서 돌발적으로 발생하여 종료되는 발작성 동성 빈맥소견(심박수: 156-172회)을 보였다. 추가적인 미주신경 자극시험과 verapamil 반응시험에서 빈맥이 종료되는 소견을 보였다. 이러한 소견을 토대로 본 증례는 동방회귀성 빈맥증으로 진단내렸다. 환자는 diltiarem과 enalapril로 치료하였고, 한달 후 재검사에서 운동 불내성 소견은 지속적으로 보였지만, 추가적인 실신소견은 관찰되지 않았다.

Keywords

References

  1. Barker PS, Wilson FN, Johnston FD. The mechanism of auricular paroxysmal tachycardia. Am Heart J 1943; 26:435-445 https://doi.org/10.1016/S0002-8703(43)90147-4
  2. Cossu SF, Steinberg JS. Supraventricular tachyarrhythmias involving the sinus node: clinical and electrophysiologic characteristics. Progr Cardiovasc Dis 1998; 41:51-63 https://doi.org/10.1016/S0033-0620(98)80022-4
  3. Gomes JA, Mehta D, Langan MN. Sinus node reentrant tachycardia. PACE 1995; 18:1045-1057 https://doi.org/10.1111/j.1540-8159.1995.tb04747.x
  4. Han J, Malozzi AM, Moe GK. Sino-atrial reciprocation in the isolated rabbit heart. Circ Res 1968; 22:355-362 https://doi.org/10.1161/01.RES.22.3.355
  5. Hendry PJ, Packer DL, Anstadt MP, Plunkett MD, Lowe JE. Surgical treatment of automatic atrial tachycardias. Ann Thorac Surg 1990; 49:253-260 https://doi.org/10.1016/0003-4975(90)90147-X
  6. Hyun C. Cardiac conduction disturbances. In: Small animal cardiology, Seoul :Panmun-publishing. 2005:329-351
  7. Kerr CR, Klein GG, Guiraudon GM, Webb JG. Surgical therapy for sinoatrial re-entrant tachycardia. PACE 1988; 11:776-783 https://doi.org/10.1111/j.1540-8159.1988.tb06028.x
  8. Lesh MD, Van Hare GF, Epstein LM, Fitzpatrick AP, Scheinman MM, Lee RJ, Kwasman MA, Grogin HR, Griffin JC. Radiofrequency catheter ablation of atrial arrhythmias. Results and mechanisms. Circulation 1994; 89:1074-1089 https://doi.org/10.1161/01.CIR.89.3.1074
  9. Narula OS. Sinus node re-entry. A mechanism for supraventricular tachycardia. Circulation 1974; 50:1114-1128 https://doi.org/10.1161/01.CIR.50.6.1114
  10. Pahlajani DB, Miller RA, Serratto M. Sinus node re-entry and sinus node tachycardia. Am Heart J 1975; 90:305-311 https://doi.org/10.1016/0002-8703(75)90317-8
  11. Paulay KL, Varghese J, Damato AN. Sinus node reentry. An in vivo demonstration in the dog. Circ Res 1973; 32:455-463 https://doi.org/10.1161/01.RES.32.4.455
  12. Sanders WE, Sorrentino RA, Greenfield RA, Shenasa H, Hamer ME, Wharton JM. Catheter ablation of sinoatrial node reentrant tachycardia. J Am Coll Cardiol 1994; 23:926-934 https://doi.org/10.1016/0735-1097(94)90639-4
  13. Simmers T, Sreeram N, Wittkampf F. Catheter ablation of sinoatrial reentry tachycardia in a 2-month-old infant. Heart 2003; 89:e1 https://doi.org/10.1136/heart.89.1.1
  14. Sperry RE, Ellenbogen KA, Wood MA, Belz MK, Stambler BS. Radiofrequency catheter ablation of sinus node reentrant tachycardia. PACE 1993; 16:2202-2209 https://doi.org/10.1111/j.1540-8159.1993.tb01027.x
  15. Weisfogel GM, Batsford WP, Paulay KL, Josephson ME, Ogunkelu JB, Akhtar M, Seides SF, Damato AN. Sinus node re-entrant tachycardia in man. Am Heart J 1975; 90:295-230 https://doi.org/10.1016/0002-8703(75)90316-6
  16. Wellens HJ. Role of sinus node reentry in the genesis of sustained cardiac arrhythmias. In: The sinus node: structure, function and clinical relevance. London: Martinus Nijhoff. 1978:422-427