Sudden cardiac death risk in dogs with atrial fibrillation

Abstract

BACKGROUND: Atrial fibrillation (AF) is associated with increased risk of sudden cardiac death (SCD) in humans, independent of secondary risk factors such as thrombogenic disorders. In dogs, SCD is described in a number of heart diseases, but an association between AF and SCD is unreported. HYPOTHESIS: (a) A higher proportion of dogs with AF will experience SCD, and (b) SCD will be associated with complex ventricular arrhythmias. ANIMALS: One-hundred forty-two dogs with AF, and 127 dogs without AF. METHODS: Retrospective, multicenter, case-control study. Dogs included in the AF group were compared to a control group of dogs in sinus rhythm, matched for echocardiographic diagnosis. Descriptive statistics were used to identify proportions of each group suffering SCD, compared using chi-squared testing. Risk factors for SCD in dogs with AF were evaluated at the univariable and multivariable level using binary logistic regression. Significance was P&#x2009;<&#x2009;.05. RESULTS: A significantly higher proportion of dogs with AF suffered SCD than dogs in the control group (14.8% vs 5.5%; P&#xa0;=&#xa0;.01). Younger age at diagnosis, larger left atrial size, and a history of syncope all were independent predictors of SCD in dogs with AF (&#x3c7;, 16.3; P&#xa0;=&#x2009;.04). CONCLUSIONS AND CLINICAL IMPORTANCE: Atrial fibrillation was associated with a higher prevalence of SCD in dogs. A history of syncope may be a useful predictor of SCD risk.