Page 144 - Rapid Review of ECG Interpretation in Small Animal Practice, 2nd Edition

New Holter Monitoring ECG Cases Question 60

Question 60
Holter recording summary from a Doberman Pinscher with a history of advanced dilated cardiomyopathy,
VetBooks.ir recent recurrence of congestive heart failure and a rapid irregular rhythm. An ECG recording revealed atrial
fibrillation with a heart rate >250 bpm. Treatment with diltiazem and digoxin was initiated. A 24-hour
Holter recording was obtained 1 week later. At that visit, the congestive heart failure was well controlled,
but the dog was reported to have lost his appetite over the last 2 days. (VPCs, ventricular premature
contractions; VT, ventricular tachycardia.)

Time Treatment 24 h mean VPC/24 h Runs of Ventricular ectopic beats
HR VT/24 h as percentage of total
number of beats/24 h
+1 week Diltiazem XR: 3.8 mg/kg BID 167 17,903 2 7.6%
Digoxin: 0.004 mg/kg BID

1 What is your interpretation of the Holter recording results?
2 What recommendations regarding drug therapy might be made?

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