A 12-year-old spayed female German shorthaired pointer dog sustained extensive bite wounds around the neck. At presentation, atrial fibrillation was identified with a rapid ventricular response rate of 300 beats per minute (bpm). The ventricular response rate rapidly decreased to 130 bpm following administration of hydromorphone and oxygen. Based on the rate, antiarrhythmic therapy was not initiated. The heart rhythm converted back to sinus rhythm by the time of the first recheck evaluation 2 days later, and the dog remained in sinus rhythm at all subsequent evaluations. With the resolution of the arrhythmia, paroxysmal atrial fibrillation was suspected. The underlying etiology of the arrhythmia was not determined; however, imbalances in autonomic tone associated with trauma and/or direct trauma to the heart were hypothesized. Key clinical message: This report indicates a possible role of imbalances in autonomic tone due to trauma in the development of paroxysmal atrial fibrillation and suggests that it should be a differential diagnostic consideration in patients with atrial fibrillation following trauma. Primary treatment of atrial fibrillation may not be needed in these cases if the ventricular response rate is not rapid, or if there is spontaneous conversion to sinus rhythm.
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Blood Rev
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The University of British Columbia Faculty of Pharmaceutical Sciences, Vancouver, British Columbia, Canada.
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