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Raleigh et al: The development of ventricular fibrillation as a complication of pericardiectomy in 16 dogs
Veterinary Surgery 4, 2022

🔍 Key Findings

  • Ventricular fibrillation (VF) occurred in 3% of pericardiectomy cases across reporting institutions.
  • 14 of 16 dogs (88%) that developed intraoperative VF died, indicating high mortality.
  • Electrosurgical devices were used in 15/16 dogs; VF onset coincided with their use in 8 dogs, suggesting a potential but unproven association.
  • Preoperative arrhythmias were seen in 7 dogs (e.g., VPCs, VT, bradycardia), possibly serving as early warning signs.
  • Thoracoscopic approach was used in 75% of cases; however, conversion to open surgery was required in 9/13 thoracoscopic procedures after VF onset.
  • Defibrillation was attempted in 13 dogs, but only 3 converted to sinus rhythm, and only 2 survived postoperatively.
  • VF may result from stray current or cardiac manipulation; bipolar energy devices were implicated despite lower theoretical risk.
  • Preventative strategies include judicious electrosurgery use, close ECG monitoring, rapid CPR preparedness, and preop cardiac risk assessment.

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← Articles

Raleigh et al: The development of ventricular fibrillation as a complication of pericardiectomy in 16 dogs
Veterinary Surgery 4, 2022

🔍 Key Findings

  • Ventricular fibrillation (VF) occurred in 3% of pericardiectomy cases across reporting institutions.
  • 14 of 16 dogs (88%) that developed intraoperative VF died, indicating high mortality.
  • Electrosurgical devices were used in 15/16 dogs; VF onset coincided with their use in 8 dogs, suggesting a potential but unproven association.
  • Preoperative arrhythmias were seen in 7 dogs (e.g., VPCs, VT, bradycardia), possibly serving as early warning signs.
  • Thoracoscopic approach was used in 75% of cases; however, conversion to open surgery was required in 9/13 thoracoscopic procedures after VF onset.
  • Defibrillation was attempted in 13 dogs, but only 3 converted to sinus rhythm, and only 2 survived postoperatively.
  • VF may result from stray current or cardiac manipulation; bipolar energy devices were implicated despite lower theoretical risk.
  • Preventative strategies include judicious electrosurgery use, close ECG monitoring, rapid CPR preparedness, and preop cardiac risk assessment.

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Multiple Choice Questions on this study

In Raleigh 2022 et al., on pericardiectomy complications, what was the most common intraoperative outcome for dogs that developed VF?

A. Spontaneous conversion to sinus rhythm
B. Successful defibrillation in all cases
C. Conversion to open thoracotomy
D. Death from intraoperative VF
E. Postoperative recovery with supportive care

Answer: Death from intraoperative VF

Explanation: 14 of 16 dogs that developed VF died intraoperatively, indicating high fatality.
In Raleigh 2022 et al., on pericardiectomy complications, what preoperative finding may serve as a warning sign for intraoperative VF?

A. Hypoalbuminemia
B. Bradyarrhythmia only
C. Heart murmur
D. ECG-detected arrhythmias
E. Vasopressor use

Answer: ECG-detected arrhythmias

Explanation: 7 of 16 dogs had arrhythmias (e.g., VPCs, VT, bradycardia) before VF occurred.
In Raleigh 2022 et al., on pericardiectomy complications, which surgical tool was most frequently associated with the onset of ventricular fibrillation?

A. Manual scissors
B. Laser scalpel
C. Harmonic scalpel
D. Bipolar electrosurgical device
E. Stapling device

Answer: Bipolar electrosurgical device

Explanation: In 15 of 16 dogs, electrosurgical devices were used, and VF coincided with their use in 8.
In Raleigh 2022 et al., on pericardiectomy complications, which strategy is recommended to minimize VF risk when using electrosurgery?

A. Prefer monopolar coagulation mode
B. Use high power settings
C. Apply current for extended periods
D. Avoid cut mode in favor of coagulation
E. Use lowest power setting with brief applications

Answer: Use lowest power setting with brief applications

Explanation: Minimizing power settings and short application duration reduces stray current risk.
In Raleigh 2022 et al., on pericardiectomy complications, what was the approximate incidence of intraoperative ventricular fibrillation (VF)?

A. 1%
B. 3%
C. 5%
D. 7%
E. 10%

Answer: 3%

Explanation: An estimated 3% of pericardiectomy procedures resulted in intraoperative VF.

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