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Peer-reviewed veterinary case report

Best heart rate for dogs with atrial fibrillation and survival

By Pedro, Brigite et al.·Published in Journal of veterinary internal medicine·2023·Willows Veterinary Centre and Referral Service, United Kingdom·View original on PubMed

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Original publication title: Optimal rate control in dogs with atrial fibrillation-ORCA study-Multicenter prospective observational study: Prognostic impact and predictors of rate control.

Species:
dog

Plain-English summary

A group of 60 dogs with atrial fibrillation (AF) were studied to see how heart rate affects their survival. The research found that dogs with a heart rate of 125 beats per minute or lower lived significantly longer, averaging about 608 days, compared to those with higher rates, who lived only about 33 days. Factors like heart disease and certain blood markers were linked to a higher risk of death, while achieving a heart rate below 125 bpm improved survival chances. This suggests that controlling the heart rate in dogs with AF is crucial for their longevity.

People also search for: dog atrial fibrillation treatment · how to lower dog heart rate · dog heart disease survival rate

Abstract

BACKGROUND: The optimal heart rate (HR) in dogs with atrial fibrillation (AF) is unknown. Impact of HR on survival needs elucidation. HYPOTHESIS/OBJECTIVES: Dogs with a 24&#x2009;hours Holter-derived meanHR &#x2264;125 beats per minute (bpm; rate controlled) survive longer than dogs with higher meanHR. We further aimed to determine which variables predict ability to achieving rate control. ANIMALS: Sixty dogs with AF. METHODS: Holter-derived meanHR, clinical, echocardiographic, and biomarker variables were analyzed prospectively. Survival was recorded from time of rate control, with all-cause mortality as primary endpoint. Cox proportional hazards analysis identified variables independently associated with survival; Kaplan-Meier survival analysis estimated the median survival time of dogs with meanHR &#x2264;125&#x2009;bpm vs >125&#x2009;bpm. Logistic regression explored baseline variables associated with inability to achieve rate control. RESULTS: Structural heart disease was present in 56/60 dogs, 50/60 had congestive heart failure, and 45/60 died. Median time to all-cause death was 160&#x2009;days (range, 88-303&#x2009;days), dogs with meanHR >125&#x2009;bpm (n&#xa0;=&#xa0;27) lived 33&#x2009;days (95% confidence interval [CI], 15-141&#x2009;days), dogs with meanHR &#x2264;125&#x2009;bpm (n&#xa0;=&#xa0;33) lived 608&#x2009;days (95% CI, 155-880&#x2009;days; P&#xa0;<&#x2009;.0001). Congenital heart disease and N-terminal pro-B-type natriuretic peptide were independently associated with higher risk of death (P&#xa0;<&#x2009;.01 and <.0001, respectively) whereas meanHR &#x2264;125&#x2009;bpm decreased the risk of death (P&#xa0;<&#x2009;.001). Increased left atrial size, increased C-reactive protein concentration and lower blood pressure at admission were associated with failure to achieve rate control. CONCLUSIONS AND CLINICAL IMPORTANCE: Rate control affects survival; an optimal target meanHR <125&#x2009;bpm should be sought in dogs with AF. Baseline patient variables can help predict if rate control is achievable.

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Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37128174/