Transdiaphragmatic surgical access by thoracoscopy for epicardial pacemaker implantation in horses

ABSTRACT Cardiac arrhythmias are common in horses and can lead to a decline in performance and sudden death. The use of cardiac pacemakers in horses has been poorly investigated, with a scarcity of description and development of techniques for the device implantation procedure. This study therefore aimed to develop a new technique for epicardial pacemaker implantation in horses using video surgery. Five equine cadavers were used as models for the application of the video surgery technique applied for the implantation of an epicardial pacemaker via transdiaphragmatic and intercostal access. This technique was effective at fixing the pacemaker electrode to the left cardiac apex of five cadavers used as a study model. The surgical procedure was minimally invasive, with an average surgical time of 44 min. No lesions were observed during a horse necropsy performed at the end of the surgery. Pacemaker implantation via thoracoscopy and intercostal access is innovative and represents a potential therapeutic novelty in the treatment of horses with severe cardiac arrhythmias.