Intermittent ventricular pre-excitation in a dog with orthodromic reciprocating atrioventricular tachycardia

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Orthodromic reciprocating atrioventricular tachycardia with intermittent ventricular pre-excitation (n=1). Intervention: Ambulatory electrocardiography (Holter). Primary outcome: Detection of intermittent ventricular pre-excitation.

Marta Salvati; Christophe Bourguignon; Frane Ivasovic

doi:10.1016/j.jvc.2026.08.002

August 8, 2026ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam)Open Access

Intermittent ventricular pre-excitation in a dog with orthodromic reciprocating atrioventricular tachycardia

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Key result

Holter monitoring reveals sleep-exclusive intermittent ventricular pre-excitation in a dog with orthodromic reciprocating AV tachycardia.

n=1

Why the study?

Intermittent ventricular pre-excitation in dogs with orthodromic atrioventricular reciprocating tachycardia is infrequently reported and not well characterized.

Key Points

To describe the electrophysiological presentation, diagnosis, and electrocardiographic features of intermittent ventricular pre-excitation in a dog presenting with paroxysmal tachycardia.
Evaluated a four-year-old female neutered Labrador retriever presenting with paroxysmal tachycardia using physical examination, serum biochemistry, and transthoracic echocardiography.
Performed standard six-lead surface electrocardiography and continuous ambulatory electrocardiography (Holter monitoring) to evaluate cardiac conduction patterns and rhythm disturbances.
Physical examination identified paroxysmal regular tachycardia at an initial heart rate of 220 beats/min, alongside an elevated cardiac troponin I level of 1.35 ng/mL (reference: 0–0.015 ng/mL).
Six-lead surface electrocardiography documented narrow QRS complex tachycardia reaching 293 beats/min with regular RR intervals and a constant QP'/P'Q ratio of 0.80, consistent with orthodromic atrioventricular reciprocating tachycardia.
Ambulatory electrocardiography captured episodes of normal sinus rhythm interrupted during sleep by wide QRS complexes of 102 ms, shortened P-δQRS intervals of 59 ms, and delta waves, confirming an accessory pathway with intermittent pre-excitation.

Study Design

Type

Case Report (n=1)

Structured PICO

P

Population

A four-year-old female neutered Labrador retriever presenting with paroxysmal tachycardia and elevated cardiac troponin I.

E

Exposure

Diagnostic evaluation (six-lead electrocardiography and ambulatory Holter monitoring) and subsequent initiation of oral sotalol (1.6 mg/kg q 12 h).

O

Outcome

Identification of underlying electrophysiological conduction patterns causing the tachycardia.

This case highlights the diagnostic utility of ambulatory Holter monitoring in revealing intermittent ventricular pre-excitation during sleep in a canine patient with AP-mediated orthodromic atrioventricular reciprocating tachycardia.

Limitations

The patient was lost to follow-up after the initiation of sotalol therapy.
The diagnosis of accessory pathway-mediated tachycardia was made without the use of an invasive electrophysiological study.
Patient was lost to follow-up after treatment initiation
Lack of invasive electrophysiological study for definitive confirmation

Implication

Ambulatory monitoring may reveal sleep-specific pre-excitation in dogs with accessory pathway tachycardia; leaves open impact on diagnosis or management.

Abstract

A four-year-old female neutered Labrador retriever was referred for investigation of paroxysmal tachycardia. On physical examination, a heart rate of 220 beats/min with no heart murmurs was noticed. Cardiac troponin I was significantly increased. A six-lead electrocardiography revealed phases of narrow QRS complexes tachycardia with regular RR intervals and a QP'/P'Q of 0.80, compatible with orthodromic atrioventricular reciprocating tachycardia (OAVRT), alternating with sinus rhythm. On ambulatory electrocardiography, initial phases of OAVRT were followed by sinus rhythm. The sinus beats were interrupted by occasional wide QRS complexes with reduced PR interval and noticeable delta (δ) waves, which confirmed the presence of an accessory pathway. The diagnosis was of OAVRT with intermittent ventricular pre-excitation, and laddergrams were included to illustrate the underlying conduction patterns.

Discussion

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Cite This Study

Salvati et al. (2026) conducted a case report in Orthodromic reciprocating atrioventricular tachycardia with intermittent ventricular pre-excitation (n=1). Ambulatory electrocardiography (Holter) was evaluated on Detection of intermittent ventricular pre-excitation. Ambulatory Holter monitoring of a dog with orthodromic reciprocating atrioventricular tachycardia revealed intermittent ventricular pre-excitation occurring exclusively during sleep.

synapsesocial.com/papers/6ad0fc7415427f6a84040125 https://doi.org/10.1016/j.jvc.2026.08.002

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Intermittent ventricular pre-excitation in a dog with orthodromic reciprocating atrioventricular tachycardia

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Intermittent ventricular pre-excitation in a dog with orthodromic reciprocating atrioventricular tachycardia

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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