{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T03:22:09Z","timestamp":1764645729965,"version":"3.38.0"},"reference-count":35,"publisher":"American Veterinary Medical Association (AVMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>To describe complications and outcomes in dogs undergoing epicardial pacemaker (EP) implantation, identify factors associated with survival, and investigate improvement in clinical signs and health-related quality of life (HRQoL) following surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>ANIMALS<\/jats:title>\n<jats:p>52 client-owned dogs that underwent EP placement.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Medical records of 4 UK-based referral hospitals were searched and data reviewed retrospectively between July 2010 and December 2022. Factors contributing to outcomes after EP placement were assessed.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The primary reasons for referral included collapsing\/syncopal episodes (n = 36), exercise intolerance (15), and significant bradycardia (46). Third-degree atrioventricular block (39\/52 [75%]) was the predominant indication for pacemaker placement, and common reasons for EP placement included previous transvenous pacemaker dislodgment\/loss of capture (n = 12) and small body size (10). Intra- and postoperative complications were documented in 11% and 23% of dogs, respectively. Overall, 96% of dogs survived to discharge, and median follow-up time was 462 days (range, 31 to 3,139 days). Presence of coexistent myocardial or valvular disease at the time of EP implantation was associated with a reduced survival. Owners reported decreased clinical signs, increased activity levels, and improved HRQoL.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>Epicardial pacemaker implantation is a valuable option for dogs requiring artificial cardiac pacing. Complications were common but did not impact the overall outcome. Dogs with a coexisting cardiac pathology had a shorter life expectancy after EP placement, but their HRQoL appeared to be good, with an improvement in clinical signs and increased activity levels.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/javma.24.04.0232","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T15:23:23Z","timestamp":1718897003000},"page":"1-10","source":"Crossref","is-referenced-by-count":1,"title":["Epicardial pacemaker placement is associated with low complication rate and improved quality of life in dogs"],"prefix":"10.2460","volume":"262","author":[{"given":"Matteo","family":"Rossanese","sequence":"first","affiliation":[{"name":"Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Brockman","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Chanoit","sequence":"additional","affiliation":[{"name":"Langford Vets Small Animal Referral Hospital, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jilli","family":"Crosby","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Scott","sequence":"additional","affiliation":[{"name":"Langford Vets Small Animal Referral Hospital, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benito","family":"de la Puerta","sequence":"additional","affiliation":[{"name":"North Down Specialist Referrals, Bletchingley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Dukes-McEwan","sequence":"additional","affiliation":[{"name":"Small Animal Teaching Hospital, University of Liverpool, Neston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattia","family":"Basili","sequence":"additional","affiliation":[{"name":"Small Animal Teaching Hospital, University of Liverpool, Neston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"issue":"1","key":"ref1","series-title":"J Vet Intern Med.","first-page":"157","article-title":"Complication rates associated with transvenous pacemaker implantation in dogs with high-grade atrioventricular block performed during versus after normal business hours","volume":"29","author":"Ward JL","year":"2015","unstructured":"Ward JL, DeFrancesco TC, Tou SP, Atkins CE, Griffith EH, Keene BW. Complication rates associated with transvenous pacemaker implantation in dogs with high-grade atrioventricular block performed during versus after normal business hours. J Vet Intern Med. 2015;29(1):157-163. doi:10.1111\/jvim.12512"},{"key":"ref2","series-title":"J Vet Cardiol.","first-page":"65","article-title":"Epicardial pacemaker implantation in small animals","volume":"22","author":"Orton EC","year":"2019","unstructured":"Orton EC. Epicardial pacemaker implantation in small animals. J Vet Cardiol. 2019;22:65-71. doi:10.1016\/j.jvc.2018.11.004"},{"issue":"5","key":"ref3","series-title":"Vet Surg.","first-page":"544","article-title":"Outcomes and complications associated with epicardial pacemakers in 28 dogs and 5 cats","volume":"42","author":"Visser LC","year":"2013","unstructured":"Visser LC, Keene BW, Mathews KG, Browne WJ, Chanoit G. Outcomes and complications associated with epicardial pacemakers in 28 dogs and 5 cats. Vet Surg. 2013;42(5):544-550. doi:10.1111\/j.1532-950X.2013.12020.x"},{"key":"ref4","series-title":"J Vet Cardiol.","first-page":"20","article-title":"Indications for permanent pacing in dogs and cats","volume":"22","author":"Santilli RA","year":"2019","unstructured":"Santilli RA, Giacomazzi F, Porteiro V\u00e1zquez DM, Perego M. Indications for permanent pacing in dogs and cats. J Vet Cardiol. 2019;22:20-39. doi:10.1016\/j.jvc.2018.12.003"},{"issue":"4","key":"ref5","series-title":"J Vet Intern Med.","first-page":"877","article-title":"Applications, complications, and outcomes of transvenous pacemaker implantation in 105 dogs (1997-2002)","volume":"20","author":"Wess G","year":"2006","unstructured":"Wess G, Thomas WP, Berger DM, Kittleson MD. Applications, complications, and outcomes of transvenous pacemaker implantation in 105 dogs (1997-2002). J Vet Intern Med. 2006;20(4):877-884. doi:10.1892\/0891-6640(2006)20[877:acaoot]2.0.co;2"},{"issue":"1","key":"ref6","series-title":"J Vet Intern Med.","first-page":"97","article-title":"Third-degree atrioventricular block in 21 cats (1997-2004)","volume":"20","author":"Kellum HB","year":"2006","unstructured":"Kellum HB, Stepien RL. Third-degree atrioventricular block in 21 cats (1997-2004). J Vet Intern Med. 2006;20(1):97-103."},{"key":"ref7","series-title":"J Vet Cardiol.","first-page":"89","article-title":"A retrospective evaluation of the indications, complications, and outcomes associated with epicardial pacemakers in 20 cats from a single institution","volume":"36","author":"Frantz EW","year":"2021","unstructured":"Frantz EW, Tjostheim SS, Palumbo A, Kellihan HB, Stepien RL. A retrospective evaluation of the indications, complications, and outcomes associated with epicardial pacemakers in 20 cats from a single institution. J Vet Cardiol. 2021;36:89-98. doi:10.1016\/j.jvc.2021.05.001"},{"issue":"6","key":"ref8","series-title":"J Vet Intern Med.","first-page":"322","article-title":"Permanent transvenous pacemaker implantation in forty dogs","volume":"5","author":"Sisson D","year":"1991","unstructured":"Sisson D, Thomas WP, Woodfield J, Pion PD, Luethy M, DeLellis LA. Permanent transvenous pacemaker implantation in forty dogs. J Vet Intern Med. 1991;5(6):322-331. doi:10.1111\/j.1939-1676.1991.tb03145.x"},{"issue":"1","key":"ref9","series-title":"BMC Vet Res.","first-page":"112","article-title":"A retrospective review of 146 active and passive fixation bradycardia lead implantations in 74 dogs undergoing pacemaker implantation in a research setting of short term duration","volume":"14","author":"Swanson LE","year":"2018","unstructured":"Swanson LE, Huibregtse BA, Scansen BA. A retrospective review of 146 active and passive fixation bradycardia lead implantations in 74 dogs undergoing pacemaker implantation in a research setting of short term duration. BMC Vet Res. 2018;14(1):112. doi:10.1186\/s12917-018-1431-2"},{"issue":"1","key":"ref10","series-title":"J Vet Res.","first-page":"133","article-title":"Retrospective analysis of indications and complications related to implantation of permanent pacemaker: 25 years of experience in 31 dogs","volume":"63","author":"Noszczyk-Nowak A","year":"2019","unstructured":"Noszczyk-Nowak A, Micha\u0142ek M, Kapturska K,  Retrospective analysis of indications and complications related to implantation of permanent pacemaker: 25 years of experience in 31 dogs. J Vet Res. 2019;63(1):133-140. doi:10.2478\/jvetres-2019-0016"},{"issue":"3","key":"ref11","series-title":"J Vet Intern Med.","first-page":"229","article-title":"Practices and outcome of artificial cardiac pacing in 154 dogs","volume":"15","author":"Oyama MA","year":"2001","unstructured":"Oyama MA, Sisson DD, Lehmkuhl LB. Practices and outcome of artificial cardiac pacing in 154 dogs. J Vet Intern Med. 2001;15(3):229-239. doi:10.1892\/0891-6640(2001)015<0229:aooacp>2.3.co;2"},{"issue":"1","key":"ref12","series-title":"J Small Anim Pract.","first-page":"4","article-title":"Results of pacemaker implantation in 104 dogs","volume":"48","author":"Johnson MS","year":"2007","unstructured":"Johnson MS, Martin MWS, Henley W. Results of pacemaker implantation in 104 dogs. J Small Anim Pract. 2007;48(1):4-11. doi:10.1111\/j.1748-5827.2006.00190.x"},{"key":"ref13","series-title":"J Vet Cardiol.","first-page":"9","article-title":"Pacemaker-lead-associated thrombosis in dogs: a multicenter retrospective study","volume":"49","author":"McGrath C","year":"2023","unstructured":"McGrath C, Dixon A, Hirst C,  Pacemaker-lead-associated thrombosis in dogs: a multicenter retrospective study. J Vet Cardiol. 2023;49:9-28. doi:10.1016\/j.jvc.2023.06.004"},{"issue":"6","key":"ref14","series-title":"Med Sci Monit.","first-page":"BR168","article-title":"The implantation of a permanent transvenous endocardial pacemaker in 42 dogs: a retrospective study","volume":"11","author":"Domenech O","year":"2005","unstructured":"Domenech O, Santilli R, Pradelli D, Bussadori C. The implantation of a permanent transvenous endocardial pacemaker in 42 dogs: a retrospective study. Med Sci Monit. 2005;11(6):BR168-BR175."},{"key":"ref15","series-title":"J Am Anim Hosp Assoc.","first-page":"751","article-title":"Pacemaker implantation in the dog: survey and literature review","volume":"17","author":"Lombard CW","year":"1981","unstructured":"Lombard CW, Tilley LP, Yoshioka M. Pacemaker implantation in the dog: survey and literature review. J Am Anim Hosp Assoc. 1981;17:751-758."},{"issue":"1","key":"ref16","series-title":"J Am Vet Med Assoc.","first-page":"46","article-title":"Introduction of an endocardial pacing lead through the costocervical vein in six dogs","volume":"215","author":"Flanders JA","year":"1999","unstructured":"Flanders JA, Mo\u00efse NS, Gelzer AR, Waskiewicz JC, MacGregor JM. Introduction of an endocardial pacing lead through the costocervical vein in six dogs. J Am Vet Med Assoc. 1999;215(1):46-48. doi:10.2460\/javma.1999.215.01.46"},{"issue":"10","key":"ref17","series-title":"J Am Vet Med Assoc.","first-page":"1303","article-title":"Ventral abdominal, transdiaphragmatic approach for implantation of cardiac pacemakers in the dog","volume":"189","author":"Fox PR","year":"1986","unstructured":"Fox PR, Matthiesen DT, Purse D, Brown NO. Ventral abdominal, transdiaphragmatic approach for implantation of cardiac pacemakers in the dog. J Am Vet Med Assoc. 1986;189(10):1303-1308."},{"issue":"4","key":"ref18","series-title":"Vet Surg.","first-page":"329","article-title":"Transdiaphragmatic approach for permanent cardiac pacemaker implantation in dogs","volume":"15","author":"Fingeroth JM","year":"1986","unstructured":"Fingeroth JM, Birchard SJ. Transdiaphragmatic approach for permanent cardiac pacemaker implantation in dogs. Vet Surg. 1986;15(4):329-333. doi:10.1111\/j.1532-950X.1986.tb00237.x"},{"issue":"2","key":"ref19","series-title":"J Am Vet Med Assoc.","first-page":"149","article-title":"Complications associated with permanent pacemaker implantation in the dog","volume":"182","author":"Bonagura JD","year":"1983","unstructured":"Bonagura JD, Helphrey ML, Muir WW. Complications associated with permanent pacemaker implantation in the dog. J Am Vet Med Assoc. 1983;182(2):149-155."},{"issue":"8","key":"ref20","series-title":"Vet Surg.","first-page":"915","article-title":"Minimally invasive transxiphoid approach to the cardiac apex and caudoventral intrathoracic space","volume":"41","author":"Nelson DA","year":"2012","unstructured":"Nelson DA, Miller MW, Gordon SG, Saunders A, Fossum TW. Minimally invasive transxiphoid approach to the cardiac apex and caudoventral intrathoracic space. Vet Surg. 2012;41(8):915-917. doi:10.1111\/j.1532-950X.2012.01056.x"},{"issue":"3-4","key":"ref21","series-title":"Rev Vet Clin.","first-page":"71","article-title":"Case report: feasibility of thoracoscopic epicardial pacing in two dogs: clinical and surgical features, and outcome","volume":"52","author":"Bonneau L","year":"2017","unstructured":"Bonneau L, Libermann S, Bomassi E. Case report: feasibility of thoracoscopic epicardial pacing in two dogs: clinical and surgical features, and outcome. Rev Vet Clin. 2017;52(3-4):71-77. doi:10.1016\/j.anicom.2017.08.001"},{"issue":"1","key":"ref22","series-title":"J Am Vet Med Assoc.","first-page":"104","article-title":"Perceptions and priorities of owners of dogs with heart disease regarding quality versus quantity of life for their pets","volume":"233","author":"Oyama MA","year":"2008","unstructured":"Oyama MA, Rush JE, O\u2019Sullivan ML,  Perceptions and priorities of owners of dogs with heart disease regarding quality versus quantity of life for their pets. J Am Vet Med Assoc. 2008;233(1):104-108. doi:10.2460\/javma.233.1.104"},{"issue":"11","key":"ref23","series-title":"J Am Vet Med Assoc.","first-page":"1864","article-title":"Development and evaluation of a questionnaire for assessing health-related quality of life in dogs with cardiac disease","volume":"226","author":"Freeman LM","year":"2005","unstructured":"Freeman LM, Rush JE, Farabaugh AE, Must A. Development and evaluation of a questionnaire for assessing health-related quality of life in dogs with cardiac disease. J Am Vet Med Assoc. 2005;226(11):1864-1868. doi:10.2460\/javma.2005.226.1864"},{"issue":"1","key":"ref24","series-title":"J Small Anim Pract.","first-page":"21","article-title":"Health-related quality of life following surgical attenuation of congenital portosystemic shunts versus healthy controls","volume":"60","author":"Bristow P","year":"2019","unstructured":"Bristow P, Lipscomb V, Kummeling A,  Health-related quality of life following surgical attenuation of congenital portosystemic shunts versus healthy controls. J Small Anim Pract. 2019;60(1):21-26. doi:10.1111\/jsap.12927"},{"issue":"14","key":"ref25","series-title":"J Am Vet Med Assoc.","first-page":"1806","article-title":"Use of the Functional Evaluation of Cardiac Health questionnaire to assess health-related quality of life before and after mitral valve repair in dogs with myxomatous mitral valve disease","volume":"260","author":"Pennington C","year":"2022","unstructured":"Pennington C, Kurosawa TA, Navarro-Cubas X, Bristow P. Use of the Functional Evaluation of Cardiac Health questionnaire to assess health-related quality of life before and after mitral valve repair in dogs with myxomatous mitral valve disease. J Am Vet Med Assoc. 2022;260(14):1806-1812. doi:10.2460\/javma.22.02.0053"},{"issue":"1","key":"ref26","series-title":"Vet Surg.","first-page":"61","article-title":"A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats","volume":"49","author":"Follette CM","year":"2020","unstructured":"Follette CM, Giuffrida MA, Balsa IM,  A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats. Vet Surg. 2020;49(1):61-69. doi:10.1111\/vsu.13279"},{"key":"ref27","series-title":"J Vet Cardiol.","first-page":"84","article-title":"Artificial cardiac pacemaker placement in dogs with a cohort of myocarditis suspects and association of ultrasensitive cardiac troponin I with survival","volume":"22","author":"Wesselowski S","year":"2019","unstructured":"Wesselowski S, Cusack K, Gordon SG, Jeffery N, Saunders AB. Artificial cardiac pacemaker placement in dogs with a cohort of myocarditis suspects and association of ultrasensitive cardiac troponin I with survival. J Vet Cardiol. 2019;22:84-95. doi:10.1016\/j.jvc.2018.09.003"},{"issue":"2","key":"ref28","series-title":"J Am Vet Med Assoc.","first-page":"230","article-title":"Procedure times, complication rates, and survival times associated with single-chamber versus dual-chamber pacemaker implantation in dogs with clinical signs of bradyarrhythmia: 54 cases (2004-2009)","volume":"242","author":"Genovese DW","year":"2013","unstructured":"Genovese DW, Estrada AH, Maisenbacher HW, Heatwole BA, Powell MA. Procedure times, complication rates, and survival times associated with single-chamber versus dual-chamber pacemaker implantation in dogs with clinical signs of bradyarrhythmia: 54 cases (2004-2009). J Am Vet Med Assoc. 2013;242(2):230-236. doi:10.2460\/javma.242.2.230"},{"key":"ref29","series-title":"J Vet Cardiol.","first-page":"70","article-title":"Heart rate distribution in dogs with third degree atrioventricular block and rate responsive pacemakers","volume":"43","author":"Pires A","year":"2022","unstructured":"Pires A, Raheb S, Monteith G,  Heart rate distribution in dogs with third degree atrioventricular block and rate responsive pacemakers. J Vet Cardiol. 2022;43:70-80. doi:10.1016\/j.jvc.2022.07.001"},{"issue":"2","key":"ref30","series-title":"J Innov Card Rhythm Manag.","first-page":"4013","article-title":"Causes of failure to capture in pacemakers and implantable cardioverter-defibrillators","volume":"11","author":"Sabbagh E","year":"2020","unstructured":"Sabbagh E, Abdelfattah T, Karim MM, Farah A, Grubb B, Karim S. Causes of failure to capture in pacemakers and implantable cardioverter-defibrillators. J Innov Card Rhythm Manag. 2020;11(2):4013-4017."},{"issue":"1","key":"ref31","series-title":"Emerg Med News.","first-page":"11","article-title":"Diagnosis: pacemaker failure to capture","volume":"29","author":"Chan T","year":"2007","unstructured":"Chan T, Brady W, Harrigan R. Diagnosis: pacemaker failure to capture. Emerg Med News. 2007;29(1):11. doi:10.1097\/01.EEM.0000264633.08274.8f"},{"issue":"2","key":"ref32","series-title":"Heart Rhythm.","first-page":"206","article-title":"Risk factors for complications in the implantation of epicardial pacemakers in neonates and infants","volume":"14","author":"Chaouki AS","year":"2017","unstructured":"Chaouki AS, Spar DS, Khoury PR,  Risk factors for complications in the implantation of epicardial pacemakers in neonates and infants. Heart Rhythm. 2017;14(2):206-210. doi:10.1016\/j.hrthm.2016.10.017"},{"issue":"9","key":"ref33","series-title":"J Heart Lung Transplant.","first-page":"1016","article-title":"Preferences for quality of life or survival expressed by patients with heart failure","volume":"20","author":"Lewis EF","year":"2001","unstructured":"Lewis EF, Johnson PA, Johnson W, Collins C, Griffin L, Stevenson LW. Preferences for quality of life or survival expressed by patients with heart failure. J Heart Lung Transplant. 2001;20(9):1016-1024. doi:10.1016\/s1053-2498(01)00298-4"},{"issue":"15","key":"ref34","series-title":"Cancer.","first-page":"3534","article-title":"Importance of quality-of-life priorities and preferences surrounding treatment decision making in patients with cancer and oncology clinicians","volume":"126","author":"Williams CP","year":"2020","unstructured":"Williams CP, Miller-Sonet E, Nipp RD, Kamal AH, Love S, Rocque GB. Importance of quality-of-life priorities and preferences surrounding treatment decision making in patients with cancer and oncology clinicians. Cancer. 2020;126(15):3534-3541. doi:10.1002\/cncr.32961"},{"issue":"8","key":"ref35","series-title":"J Am Vet Med Assoc.","first-page":"1201","article-title":"Factors contributing to the decision for euthanasia of dogs with congestive heart failure","volume":"214","author":"Mallery KF","year":"1999","unstructured":"Mallery KF, Freeman LM, Harpster NK, Rush JE. Factors contributing to the decision for euthanasia of dogs with congestive heart failure. J Am Vet Med Assoc. 1999;214(8):1201-1204. doi:10.2460\/javma.1999.214.08.1201"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/262\/10\/javma.24.04.0232.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/262\/10\/javma.24.04.0232.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/262\/10\/javma.24.04.0232.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T14:09:38Z","timestamp":1741356578000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/262\/10\/javma.24.04.0232.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,1]]},"references-count":35,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.2460\/javma.24.04.0232","relation":{},"ISSN":["0003-1488"],"issn-type":[{"type":"print","value":"0003-1488"}],"subject":[],"published":{"date-parts":[[2024,10,1]]}}}