Abstract
Objective
To determine if the transesophageal atrial (A) wave amplitude or ventricular (V) wave
amplitude can be used to guide optimal positioning of a transesophageal pacing catheter
in dogs.
Study design
Prospective clinical study.
Animals
Fourteen client owned healthy dogs with a median weight of 15.4 kg (IQR = 10.6–22.4)
and a median age of 12 months (IQR = 6–12).
Materials and methods
Transesophageal atrial pacing (TAP) using a 6 Fr pacing catheter was attempted in
dogs under general anesthesia. The pacing catheter was inserted orally into the esophagus
to a position caudal to the heart. With the pulse generator set at a rate 20 beats
minute−1 above the intrinsic sinus rate, the catheter was slowly withdrawn until atrial pacing
was noted on a surface electrocardiogram (ECG). Then the catheter was withdrawn in
1 cm increments until atrial capture was lost. Minimum pacing threshold (MPT) and
transesophageal ECG were recorded at each site. Amplitudes of the A and V waves on
transesophageal ECG were then measured and their relationship to MPT was evaluated.
Results
TAP was achieved in all dogs. In 9/14 dogs the site of lowest overall MPT was the
same as the site of maximal A wave deflection. In dogs with at least three data points,
linear regression analysis of the relationship between the estimated site of the lowest
overall MPT compared to estimated site of the maximal A and V waveform amplitudes
demonstrated a strong correlation (R2 = 0.99).
Conclusion and clinical relevance
Transesophageal ECG A and V waveforms were correlated to MPT and could be used to
direct the placement of a pacing catheter. However, the technique was technically
challenging and was not considered to be clinically useful to guide the placement
of a pacing catheter.
Keywords
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References
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Article info
Publication history
Accepted:
February 20,
2014
Received:
October 23,
2013
Identification
Copyright
© 2015 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Inc. All rights reserved.
