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Cranial vena caval thrombosis associated with endocardial pacing leads in three dogs
John D Murray1, M Lynne O'Sullivan, Kimberley C E Hawkes
1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1 Canada.
Insights
Transvenous pacing leads can cause cranial vena cava thrombosis in dogs, leading to serious complications. This condition significantly increases the risk of illness and death in affected animals.
Area of Science:
- Veterinary Cardiology
- Small Animal Internal Medicine
- Medical Device Complications
Background:
- Transvenous, single-lead, endocardial, right-ventricular permanent pacing systems are used in veterinary medicine.
- Cranial vena caval syndrome (CVCS) is a clinical condition with various potential causes.
Observation:
- Three dogs developed signs consistent with CVCS years after receiving permanent transvenous pacing systems.
- Diagnostic imaging revealed filling defects in the cranial vena cava and intracardiac regions in these dogs.
Findings:
- Postmortem examinations confirmed cranial vena caval and intracardiac thrombosis in two dogs.
- Medical management in two dogs resulted in short-term survival for one.
- Surgical intervention in one dog was unsuccessful, with the patient not surviving the postoperative period.
Implications:
- Transvenous pacing leads are associated with a significant risk of developing cranial vena caval thrombosis.
- This complication carries substantial morbidity and mortality in dogs.
- Further research into preventative strategies and management of pacing-related thrombosis is warranted.
Abstract:
Three dogs were examined several years following implantation of transvenous, single-lead, endocardial, right-ventricular permanent pacing systems for signs consistent with cranial vena caval syndrome. Angiograms performed in all dogs revealed filling defects within the cranial vena cava and, in some instances, intracardiac filling defects. Medical therapy was instituted in two dogs, with one surviving several weeks. One dog underwent surgery to address intra-cardiac thrombosis but did not survive the immediate postoperative period. Postmortem examinations were performed in two dogs and confirmed cranial vena caval and intracardiac thrombosis. Cranial vena caval thrombosis associated with transvenous pacing leads appears to carry significant morbidity and mortality.
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