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Food for Thought
This page is an archive of our "Food for Thought" Facebook posts.  Each post is a summary of some interesting research going on about animals.  


4/14/2020: Pacemakers for Animals


Donated, Used, Human Pacemakers

Recently I read about a program at the University of Georgia's College of Veterinary Medicine (UGA) that outfits animals with used pacemakers donated by patients at The Medical Center, Navicent Health (MCNH) when their pacemakers are upgraded, exchanged, or removed. Since the inception of the Pacemaker Donation Program in 2018, 41 pacemakers have been donated by individuals at MCNH. Each of the pacemakers is sterilized and shipped to UGA for a canine patient. Many of the pacemakers still have over five years of battery life remaining, a good number to give older dogs a new lease on life. Pacemakers with a shorter battery life are used in classes for UGA’s vet students - a win-win in my opinion. (Note that all pacemakers for the MCNH/UGA project come from living patients. Also note that sterilization protocols use ethylene oxide (Crawford, Thomas C., et. al.).)

Is this interesting? I thought so and decided to dig a little deeper into the available literature....

Can Pacemakers Be "Re-calibrated" for Animals? 

The answer is yes. Pacemakers are comprised of two primary components: (1) the generator (a lithium battery and a computer chip that vets can program to meet an individual animal's needs) and (2) leads (wires that go from the generator to the heart). The computer chip enables vets to set the pacemaker to function at the level the animal needs.

Benefits of Pacemaker Implantation

Pacemakers can result in dramatic differences in patients. In 2010, my husband had a pacemaker put in. Almost immediately, I noted that his color was great; his alertness, speech, and thought processes were all vastly improved. Various reports indicate similar benefits can be achieved in dogs (and even cats). One such report about canine implantation indicates that a dog receiving a pacemaker has a normal life span after the implementation for its breed and size (http://www.gsdcstl.org/Documents/DogMedicine/Pacemakers%20Keep%20Dogs.pdf). Even if this particular observation is anecdotal, I find it very encouraging.

Potential Complications

As with any medical procedure, there may be complications. One study (Ward, 2015) reported a higher incidence of serious complications (e.g., lead dislodgement, infection, lead thrombus, ventricular perforation by the pacing lead, pacing failure, etc.) when the procedures were performed after regular business hours. I found similar results reported elsewhere in the literature (Noszczyk-Nowak, 2019). Clearly other variables of interest can impact the outcome and need to be studied further.

Pacemaker Repository

There is a non-profit organization, CanPacers (Companion ANimal PACEmaker Registry & RepoSitory). The CanPacers repository is sponsored by the American College of Veterinary Internal Medicine (ACVIM) Cardiology subspecialty, and is maintained by Dr. Kate Meurs at North Carolina State University.

Unlike the program at UGA, CanPacers no longer accepts used generators. CanPacers also charges for the equipment they distribute; however, all proceeds are used to fund Cardiology Resident Research Projects. Since it began, CanPacers has provided several thousand dollars for clinically important veterinary cardiology research, which in turn has led to a better understanding of heart disease in animals - and a publication that I list in the References section below (Oyama, 2001).

Ongoing Research

Since the first pacemaker was implanted in a dog (well before Y2K), much research has focused on procedures, analysis of outcomes (e.g., survival rates by species, breed, preexisting conditions, and incidence of serious and minor complications, etc.). Other reports have tracked animals receiving pacemakers over time.

In Conclusion

I hope that you found this 'Food for Thought' post a "decent read." Have a great day and stay safe and healthy in these uncertain, Coronavirus times.

Susan Keenan
Administrative Director, FLR
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REFERENCES

1. People Magazine article: https://people.com/pets/vet-college-hospital-donate-pacemakers-dogs/

2. Oyama MA, Sisson DD, Lehmkuhl LB. "Practices and outcomes of artificial cardiac pacing in 154 dogs at seven referral hospitals from 1991 to 1996." J Vet Int Med 2001; 15:229-239. Can be found online at: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-1676.2001.tb02316.x

3. CanPacers: https://www.canpacers.org/

4. UGA Pacemaker Research:

https://vet.uga.edu/love-for-the-dogs-navicent-health-university-of-georgia-partner-to-provide-pacemakers-for-pets/

https://vet.uga.edu/love-for-the-dogs-navicent-health-university-of-georgia-partner-to-provide-pacemakers-for-pets/

https://vet.uga.edu/at-the-heart-of-the-matter/

5. Online article: https://www.mspca.org/angell_services/pacemakers-for-veterinary-patients/

6. Crawford, Thomas C., et. al. "Cleaning and Sterilization of Used Cardiac Implantable Electronic Devices With Process Validation: The Next Hurdle in Device Recycling." JACC: Clinical Electrophysiology Volume 3, Issue 6, June 2017, Pages 623-631. Can be found at: https://www.sciencedirect.com/science/article/pii/S2405500X16305217

7. Ward, J.L. et. al. "Complication Rates Associated with Transvenous Pacemaker Implantation in Dogs with High‐Grade Atrioventricular Block Performed During versus After Normal Business Hours." J Vet Intern Med. 2015 Jan-Feb; 29(1): 157–163. Can be found at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858108/

8. Fact Sheet: https://vetspecialists.com/pacemaker-therapy-2/

9. Online information: https://vetmed.illinois.edu/pet_column/pacemakers-dogs

10. Noszczyk-Nowak, Agnieszka, et. al. "Retrospective Analysis of Indications and Complications Related to Implantation of Permanent Pacemaker: 25 Years of Experience in 31 Dogs." J Vet Res. 2019 Mar; 63(1): 133–140. Can be found at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458549/