Pyro is a 12 year old female spayed chow mix who presented to Friendship Cardiology Specialists for recently diagnosed complete heart block.
Complete heart block is typically caused by aging changes to the conduction system of the heart. This results in a very slow heart rate which can cause symptoms such lethargy and fainting. Dogs with complete heart block are at risk for sudden death. Fortunately, veterinary cardiologists can perform pacemaker placement which is typically curative.
Pyro first underwent placement of a temporary pacemaker. This involves placing a catheter in a blood vessel of the back leg, and feeding a temporary pacing lead through this catheter up to the heart using fluoroscopy (moving x-ray) for guidance. This lead is plugged into a temporary generator that sits on the surgical table and allows us to control the patient’s heart rate so that they can safely be anesthetized. Once Pyro’s heart rate was normalized with the temporary pacemaker, our anesthesiology team was able to safely induce general anesthesia in preparation for permanent pacemaker placement. Pyro’s permanent pacemaker lead was placed through a small incision in the large vein in her neck (jugular vein) again using fluoroscopy for guidance, and the generator was stitched into a pocket under the skin in her neck. Once the permanent pacemaker was placed, her temporary pacemaker was removed. Her surgery was successful and she recovered in our intensive care unit overnight. She was discharged the following day to her happy owners!
Pyro enjoying some peanut butter post-operatively. 
Placing the permanent generator under the skin in the neck 
ECG shows a paced rhythm. Fluoroscopy shows the temporary pacemaker lead in her heart. 
Placing the permanent pacemaker through the jugular vein. 
Fluoroscopy shows the permanent pacemaker in place. 
Pyro at her recheck.
Pyro was rechecked 2 weeks after her surgery and she felt great! Her incision was healed and her stitches and neck bandage were removed. Her pacemaker function was checked and found to be excellent. She has two weeks of rest remaining, and then she can return to her normal activities. Her pacemaker will be rechecked periodically and the settings can be adjusted as needed.
Dr. Block earned her veterinary degree from the University of California, Davis, School of Veterinary Medicine in 2013. Dr. Block completed a rotating internship followed by a cardiology residency at the University of Pennsylvania and joined Friendship Cardiology Specialists in 2017.
