Epicardial pacemaker placement in cats is associated with resolution of clinical signs and excellent quality of life

OBJECTIVE: To describe complications and outcomes in cats undergoing epicardial pacemaker (EP) implantation for artificial cardiac pacing and to investigate improvement in clinical signs and health-related quality of life (HRQoL) following surgery. METHODS: 39 client-owned cats that underwent EP placement. Medical records of 4 UK-based referral hospitals were searched and data reviewed retrospectively between July 2010 and December 2022. An HRQoL questionnaire was used to assess outcomes and HRQoL. RESULTS: The primary reasons for referral included collapsing episodes (n = 27) and bradycardia (31). Third-degree atrioventricular block (29 of 39) was the predominant indication for pacemaker placement. Intra- and postoperative complications were documented in 3 of 39 and 14 of 39 cats, respectively. All cats survived to discharge, and median follow-up time was 719 days (range, 9 to 2,285 days). Owners reported improvement in clinical signs, high level of satisfaction, and improved HRQoL. CONCLUSIONS: Epicardial pacemaker placement effectively resolves clinical signs of bradyarrhythmias in cats, leading to significant improvements in HRQoL. Postoperative complications are common but do not impact the overall outcome. Cats undergoing EP placement have an excellent HRQoL with an improvement in clinical signs and a high level of owner satisfaction. CLINICAL RELEVANCE: Epicardial pacemaker placement is the current method of choice for cats showing clinical signs and requiring artificial cardiac pacing. Despite the occurrence of postoperative complications, these did not adversely impact overall outcomes, with high owner satisfaction reported.