Upper rate behavior in six dogs with dual-chamber pacemakers

Abstract

IntroductionThis report provides clinical examples of upper rate behavior in dogs with dual-chamber pacemakers, with suggestions for programming alterations to avoid detrimental upper rate behavior. AnimalsSix dogs with dual-chamber pacemakers displaying upper rate behavior at upper atrial tracking rates. MethodsMedical records of dogs with dual-chamber pacemakers with evidence of upper rate behavior were reviewed retrospectively from two institutions. Two of the six dogs were followed prospectively, and 24 h Holter monitors were placed to evaluate upper rate behavior correlated to programming settings. ResultsPacemaker Wenckebach or 2:1 atrioventricular block was documented in four of six dogs, and automatic mode switch was documented in two of six dogs. Twenty-four–hour Holter monitors placed on two dogs after pacemaker optimization documented a pacemaker Wenckebach window at increased atrial rates with neither dog reaching their respective 2:1 block point throughout the recording period. ConclusionsClinicians who implant dual-chamber pacemakers should be aware of upper rate behavior in animal species with high heart rates. Optimal programming of dual-chamber pacemakers can be achieved by selecting programmed timing intervals to limit deleterious upper rate behavior and create a more physiologic ventricular response at maximum tracking rates.