Predictive Value of Cardiac Remodelling on Survival in Dogs with Persistent Atrial Standstill: The UK Perspective

Inigo Sanz-Gonzalez*, Joanna Aitken, Brigite Pedro, Mike Martin, Yolanda Martinez Pereira, Joanna Dukes-McEwan, Geoff Culshaw, Elizabeth Bode

*Corresponding author for this work

Research output: Contribution to conferenceAbstractpeer-review

Abstract

Objectives
Survival of dogs in the United Kingdom (UK) with persistent atrial standstill (PAS) after pacemaker implantation and the prognostic value of cardiac remodelling are unknown. Survival >800 days has been reported in non-UK dogs. We hypothesised that survival after pacing is predicted in PAS dogs by severity of cardiac remodelling.

Methods
This was a retrospective study, reviewing clinical records from three UK referral centres. Only dogs with PAS fitted with a pacemaker were included. Data at first presentation are mean±SD or median [range]. Pre and post-pacing clinical and echocardiographic variables (repeated measures ANOVA) and survival times were compared. Stepwise regression tested variables as predictors of death by one to three years post-pacing. Significance (P) was <0.05.

Results
Twenty-six dogs were included (20.0±9.3kg; 3.3 years [0.6-12.6]). Labrador retrievers and their crosses were most represented (9/26).

Clinical presentation included pre-syncope/syncope (14/26), lethargy/exercise intolerance (6/26), ascites (5/26) and coughing (3/26).

Heart rate was 52±13bpm. Left atrial enlargement was consistent (LA/Ao 2.3 [1.5-3.7]) but left ventricular dilation (LVIDdN 1.9 [0.9-2.8]) and systolic function (ESVI 25.8 ml/m2 [9-93.5]; PEP/LVET 0.26 [0.12-0.61]) were highly variable. Echocardiographic variables were not modified by pacing (all P>0.1).

Survival (1512 days, IQR 2404) was not influenced by syncope (P=0.9) or heart failure (P=0.6). Clinical and echocardiographic variables did not predict survival (all P>0.3).

Statement (conclusions)
Dogs with atrial standstill can survive >3 years post-pacing despite significant myocardial dysfunction and cardiomegaly. When advising clients, syncope and heart failure before pacing do not have prognostic value.
Original languageEnglish
Publication statusPublished - 24 May 2021
EventBSAVA Congress 2021 - Online only, United Kingdom
Duration: 24 May 202125 May 2021

Conference

ConferenceBSAVA Congress 2021
Country/TerritoryUnited Kingdom
Period24/05/2125/05/21

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