🔍 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.
