Epicardial pacemaker implantation in small animals

Epicardial pacemaker implantation can be performed as a lone procedure or in combination with another thoracic or abdominal surgery. This article reviews the current literature and describes a minimally invasive approach for epicardial pacemaker implantation in small animals. The principal advantage of epicardial pacing is that it avoids contact with blood and intracardiac structures and thereby avoids uncommon but potentially devastating complications associated with endocardial pacemaker implantation. Epicardial pacing as a lone procedure can be accomplished via an abdominal transdiaphragmatic or minimal incision thoracotomy approach (minithoracotomy). A minithoracotomy offers the advantages of being less invasive and providing more direct access to the cardiac surface for suturing of epicardial electrodes. Epicardial pacing is a viable option for smaller animals, animals with pre-existing infections, animals at risk for thrombotic complications, or animals undergoing another thoracic or abdominal surgery.