Atrial Flutter with Poor Ventricular Response in a Bull Terrier Dog

불테리어종 개에서 발생한 미약한 심실반응이 있는 심방조동

  • Lee, Joon-Seok (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University) ;
  • Han, Suk-Hee (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)
  • 이준석 (강원대학교 수의과 대학 소동물 내과교실) ;
  • 한숙희 (강원대학교 수의과 대학 소동물 내과교실) ;
  • 현창백 (강원대학교 수의과 대학 소동물 내과교실)
  • Accepted : 2010.08.03
  • Published : 2010.08.30

Abstract

A six-year-old intact female Bull Terrier dog (weighing 17 kg) was referred to the Veterinary Teaching Hospital with exercise intolerance and occasional syncope as the primary complaint. Diagnostic studies revealed a rare case of atrial flutter with complete heart block and aberrant ventricular activation from the ectopic focus, possibly due to idiopathic dilated cardiomyopathy. Although the dog was responded with cardiac medication for right-sided heart failure and anti-arrhythmic agent (dofetilide), the dog died suddenly of cardiac arrest after 11 months of treatment.

6살된 암컷 불테리어종 개 (체중 17 kg)가 운동 불내성과 실신증상으로 내원하였다. 진단검사를 통해 특발성 심근확장증에 의한 심방조동과 완전 방실차단 증례로 진단되었다. 환자는 심근증에 대한 일반적인 치료와 dofetilide를 포함한 항부정맥 치료를 통해 11개월간 관리되었다. 하지만 환자는 갑작스런 심장마비로 폐사하였다.

Keywords

References

  1. Adin DB. Tricuspid valve dysplasia. In: Kirk's current veterinary therapy, XIV. Philadelphia, Pennsylvania :WB Saunders Company Ltd. 2009: 762-765
  2. Bonagura, J. D., O'Grady, M. R. and Herring, D. S. Echocardiography. Principles of interpretation. Vet Clin North Am Small Anim Pract 1985; 15: 1177-1194.
  3. Brady PA, Gersh BJ. Atrial fibrillation and flutter. In: Cardiovascular medicine. New York, New York: Springer Company. 1955-1978.
  4. Cosio F, Martin-Pennato A, Pastor A, Nunez A, Goicolea A. Atypical flutter: a review. PACE 2003; 26: 2157-2169. https://doi.org/10.1046/j.1460-9592.2003.00336.x
  5. Cosio F, Pastor A, Nunez A, Magalhaes AP, Awamleh P. Atrial flutter: an update. Rev Esp Cardiol 2006; 59: 816-831. https://doi.org/10.1157/13091886
  6. Inama G, Pedrinazzi C, Durin O, Agricola P, Romagnoli G, Gazzaniga P. Usefulness and limitations of the surface electrocardiogram in the classification of right and left atrial flutter. J Cardiovasc Med 2006; 7: 381-387. https://doi.org/10.2459/01.JCM.0000228686.87086.bd
  7. Kastor JA, Goldreyer BN, Josephson ME, Perloff JK, Scharf DL, Manchester JH, Shelburne JC, Hirshfeld JW. Electrophysiologic characteristics of Ebstein's anomaly of the tricuspid valve. Circulation 1975; 52: 987-995. https://doi.org/10.1161/01.CIR.52.6.987
  8. Kraus SM, Gelzer RM, Moise S. Treatment of cardiac arrhythmias and conduction disturbances. In:Manual of caninie and feline cardiology, 4th ed. Philadelphia, Pennsylvania: WB Saunders Company Ltd. 2008; 315-332.
  9. Lelorier P, Humphries KH, Krahn A, Connolly SJ, Talajic M, Green M, Sheldon R, Dorian P, Newman D, Kerr CR, Yee R, Klein GJ. Prognostic differences between atrial fibrillation and atrial flutter. Am J Cardiol 2004; 93: 647-649. https://doi.org/10.1016/j.amjcard.2003.11.042
  10. Newcombe CP, De Souza D, Towers JRH. Atrial flutter with complete heart block. Br Heart J 1960; 22: 691-694. https://doi.org/10.1136/hrt.22.5.691
  11. Puech P, Latour H, Grolleau R. Flutter and his limits. Arch Mal Coeur Vaiss 1980; 63: 116-144.
  12. Saoudi N, Cosio F, Waldo A, Chen SA, Iesaka Y, Lesh M, Saksena S, Salerno J, Schoels WA. Classification of atrial flutter and regular atrial tachycardia according to electrophy-siological mechanisms and anatomical bases. Eur Heart J 2001; 22: 1162-1182. https://doi.org/10.1053/euhj.2001.2658
  13. Scheinman MM, and Yang Y. Atrial flutter: Historical notes-Part I. PACE 2004; 27: 379-381. https://doi.org/10.1111/j.1540-8159.2004.00446.x
  14. Scheinman MM, Yang Y, Cheng J. Atrial flutter: Part II Nomenclature. PACE 2004; 27: 504-506. https://doi.org/10.1111/j.1540-8159.2004.00472.x
  15. Tai CT, Huang JL, Lin YK, Hsieh MH, Lee PC, Ding YA, Chang MS, Chen SA. Noncontact three-dimensional mapping and ablation of upper loop re-entry originating in the right atrium. J Am Coll Cardiol 2002; 40: 746-753. https://doi.org/10.1016/S0735-1097(02)02036-3
  16. Tsuchiya T, Okumura K, Tabuchi T, Iwasa A, Yasue H, Yamabe H. The upper turnover site in the reentry circuit of common atrial flutter. Am J Cardiol 1996; 78: 1439-1442. https://doi.org/10.1016/S0002-9149(97)89299-5
  17. Vidaillet H, Granada JF, Chyou PH, Maassen K, Ortiz M, Pulido JN, Sharma P, Smith PN, Hayes J. A population based study of mortality among patients with atrial fibrillation or flutter. Am J Med 2002; 113: 365-370. https://doi.org/10.1016/S0002-9343(02)01253-6
  18. Waldo A, MacLean WA, Karp RB, Kouchoukos NT, James TN. Entrainment and interruption of atrial flutter with atrial pacing: studies in man following open heart surgery. Circulation 1977; 56: 737-745. https://doi.org/10.1161/01.CIR.56.5.737