Treatment of a Paroxysmal Atrioventricular Block by Implantation of a Bipolar, Single-Chamber Cardiac Pacemaker in a Donkey.
Authors: Heun Frederik, Niebuhr Tobias, Gutierrez Bautista Alvaro, Wiedmann Felix, Verhaar Nicole, Kästner Sabine, Feige Karsten, Schmidt Constanze
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary A two-year-old donkey presented with recurrent syncope caused by paroxysmal atrioventricular block—a condition characterised by intermittent failure of electrical conduction between the atria and ventricles, with asystolic episodes lasting up to one minute and no reliable escape rhythm to maintain cardiac output. After ruling out reversible cardiac pathology through laboratory work and echocardiography, the clinical team opted for permanent pacemaker implantation under general anaesthesia, programming the device in VVI mode (ventricular-sensing, ventricular-pacing) to provide consistent heart rate support. Over a 17-month follow-up period, the donkey remained free from syncope, indicating successful long-term management of this rare condition. Whilst pacemaker implantation in equine species remains uncommon and technically challenging, this case demonstrates that the intervention can be adapted and sustained in donkeys experiencing life-threatening arrhythmias unresponsive to medical management. For practitioners managing animals with unexplained syncope or collapse, this work underscores the value of thorough electrocardiographic monitoring and highlights pacemaker therapy as a viable option when structural or metabolic causes have been excluded.
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Practical Takeaways
- •Recurrent syncope in donkeys warrants electrocardiographic investigation to rule out paroxysmal atrioventricular block, a potentially life-threatening arrhythmia.
- •Cardiac pacemaker implantation is a viable treatment option for equine species with PAVB when medical management is ineffective or unavailable.
- •Long-term outcomes following pacemaker implantation in equines appear favorable, with sustained symptom resolution beyond 12 months possible.
Key Findings
- •A 2-year-old donkey with recurrent syncope was diagnosed with paroxysmal atrioventricular block characterized by conduction pauses lasting up to one minute without ventricular escape rhythm.
- •Single-chamber VVI pacemaker implantation under general anesthesia successfully prevented further syncope episodes during 17-month follow-up.
- •No reversible underlying cause was identified via laboratory tests and echocardiography, confirming primary PAVB diagnosis.