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Emergency intraoperative transcutaneous pacing in a dog undergoing a high-pressure balloon inflation to relieve severe subaortic stenosis
  1. Daisy Jessica Norgate1 and
  2. Ludovic Pelligand2
  1. 1 Department of Anaesthesia, Royal Veterinary College, London, UK
  2. 2 Department of Pharmacology, Royal Veterinary College, London, UK
  1. Correspondence to Miss Daisy Jessica Norgate; dnorgate{at}


A 23-week-old, 25.7 kg Rottweiler presented with a grade V/VI left and right basilar systolic heart murmur with no other clinical signs. Echocardiography revealed severe congenital subaortic stenosis. The dog was given a poor prognosis due to a high risk of sudden death. A high-pressure balloon valvuloplasty was performed to reduce the pressure gradient. Immediately following the balloon inflation, the dog experienced complete atrioventricular block without a ventricular escape, and a rapid reduction in end-tidal carbon dioxide. In order to restore cardiac output, the dog was immediately paced transcutaneously. Normal sinus rhythm was restored 15 minutes after initiation of pacing, after which pacing was stopped. The remainder of the anaesthetic was uneventful; the dog recovered well and was discharged 48 hours later with no reoccurrence of atrioventricular block. The ability to perform immediate transcutaneous pacing was instrumental to this dog’s survival.

  • anaesthesia
  • dogs
  • transcutaneous pacing
  • aortic stenosis
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  • Contributors DJN was the main anaesthetist monitoring the case during the procedure with the help of LP as the senior anaesthetist.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All available data can be obtained by contacting the corresponding author.

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