Single center retrospective clinical audit and comparison of outcome between epicardial and transvenous endocardial permanent pacemaker implantations in dogs

• Published in: PloS one 2023-11, Vol.18 (11), p.e0290029-e0290029
• Main Authors: Köster, Liza S, Zhu, Xiaojuan, Smith, Christopher K, Aisa, Josep
• Format: Article
• Language: English
• Subjects: Analysis; Biology and Life Sciences; Bradycardia; Care and treatment; Complications and side effects; Dogs; Electrocardiogram; Electrocardiography; Electronic records; Engineering and Technology; Health aspects; Medical records; Medicine and Health Sciences; Pacemaker, Artificial (Heart)
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0290029

The aim of this retrospective cohort study was to provide a single-center clinical audit of complications for single chamber permanent pacemaker implantation (PPI) techniques and determine if the clinical parameters, PPI technique or complications were associated with outcome. The electronic medical records were searched for dogs treated for bradyarrhythmia with PPI. Data related to presenting complaint, signalment of the dog, ECG diagnosis, echocardiographic findings, PPI technique, and programing of the pacemaker were recorded. Survival length (days) was recorded as the last veterinary visit; if the dog was dead the reason was documented. Cumulative survival of each pacemaker was examined by a Kaplan-Meier survival curve and the two techniques compared with a logrank test. Chi-square was used to determine the association between major complications and death. A total of 66 dogs with 52 transvenous and 30 epicardial PPIs were included. All epicardial pacemakers were implanted via transdiaphragmatic approach. A total of 31 life-threatening complications were reported. There were nine deaths related to major complications (13.6% of the study sample). The median follow-up period was 366 days, with a median survival of 255 days, and a significant difference in cumulative survival of each pacemaker (P = 0.01) between epicardial (93 days, range 0-1882 days) and transvenous (334 days, range 0-2745) PPIs but no significant difference in cumulative survival between the two techniques when only the first pacemaker was considered (p = 0.07). The presence of a major complications had a significant association with death due to pacemaker complications (P