Pedro, B, Dukes-McEwan, J 
ORCID: 0000-0002-0326-8251, Oyama, MA, Kraus, MS and Gelzer, AR
(2018)
Retrospective Evaluation of the Effect of Heart Rate on Survival in Dogs with Atrial Fibrillation.
JOURNAL OF VETERINARY INTERNAL MEDICINE, 32 (1).
pp. 86-92.
Abstract
<h4>Background</h4>Atrial fibrillation (AF) usually is associated with a rapid ventricular rate. The optimal heart rate (HR) during AF is unknown.<h4>Hypothesis/objectives</h4>Heart rate affects survival in dogs with chronic AF.<h4>Animals</h4>Forty-six dogs with AF and 24-hour ambulatory recordings were evaluated.<h4>Methods</h4>Retrospective study. Holter-derived HR variables were analyzed as follows: mean HR (meanHR, 24-hour average), minimum HR (minHR, 1-minute average), maximum HR (maxHR, 1-minute average). Survival times were recorded from the time of presumed adequate rate control. The primary endpoint was all-cause mortality. Cox proportional hazards analysis identified variables independently associated with survival; Kaplan-Meier survival analysis estimated the median survival time of dogs with meanHR <125 bpm versus ≥125 bpm.<h4>Results</h4>All 46 dogs had structural heart disease; 31 of 46 had congestive heart failure (CHF), 44 of 46 received antiarrhythmic drugs. Of 15 dogs with cardiac death, 14 had CHF. Median time to all-cause death was 524 days (Interquartile range (IQR), 76-1,037 days). MeanHR was 125 bpm (range, 62-203 bpm), minHR was 82 bpm (range, 37-163 bpm), maxHR was 217 bpm (range, 126-307 bpm). These were significantly correlated with all-cause and cardiac-related mortality. For every 10 bpm increase in meanHR, the risk of all-cause mortality increased by 35% (hazard ratio, 1.35; 95% CI, 1.17-1.55; P < 0.001). Median survival time of dogs with meanHR<125 bpm (n = 23) was significantly longer (1,037 days; range, 524-open) than meanHR ≥125 bpm (n = 23; 105 days; range, 67-267 days; P = 0.0012). Mean HR was independently associated with all-cause and cardiovascular mortality (P < 0.003).<h4>Conclusions and clinical importance</h4>Holter-derived meanHR affects survival in dogs with AF. Dogs with meanHR <125 bpm lived longer than those with meanHR ≥ 125 bpm.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Electrocardiography, Heart failure, Holter, Rate control, Ventricular rate |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 14 Dec 2017 10:34 |
| Last Modified: | 19 Jan 2023 06:48 |
| DOI: | 10.1111/jvim.14896 |
| Open Access URL: | http://onlinelibrary.wiley.com/doi/10.1111/jvim.14... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3014137 |
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