Oral amiodarone therapy in dogs with atrial fibrillation.
ABSTRACT The medical records of client-owned dogs in which amiodarone was used to manage atrial fibrillation (AF) were reviewed. Data analyzed included signalment, history of heart failure, presenting complaint, clinical diagnosis, prescription drug history, number of re-examinations, outcome, and laboratory analysis including serum biochemical analysis, CBC, and thyroid function testing. Specific data for amiodarone included loading and maintenance dose, duration of loading dose, adverse effects, and reason for decreasing dose or discontinuation of amiodarone therapy. Follow-up data for 17 dogs were included in the analysis. Various cardiac diseases including cardiomyopathy, valvular endocardiosis, and congenital heart disease were diagnosed in the dogs. Median loading and maintenance dosages of amiodarone were 16.5 and 9.0 mg/kg of body weight/d, respectively. A >20% decrease in heart rate was achieved in 13 dogs (76%). Conversion to sinus rhythm was achieved and maintained in 6 dogs (35%). Amiodarone was discontinued in 5 dogs, and the dose was decreased because of symptomatic bradycardia (n = 1), asymptomatic (n = 1) and symptomatic (n = 3) increases in hepatic enzyme activities, and for unknown reason (n = 1). On the basis of >20% decrease in heart rate in 76% of the dogs and conversion to sinus rhythm in 35%, it was concluded that amiodarone may be useful in managing AF in dogs. The use of amiodarone in the medical management of AF in dogs warrants further investigation.
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ABSTRACT: L'auteur explique dans une première partie le fonctionnement normal de l'onde de dépolarisation cardiaque et la genèse de la fibrillation atriale chez les chevaux. Les différentes causes sont répertoriées, puis une démarche diagnostique est proposée aux lecteurs : de l'auscultation cardiaque caractéristique à l'échocardiographie, en passant par l'électrocardiographie. Le traitement à base de sulfate de quinidine par voie orale est largement détaillé, avant d'envisager les autres traitements existants. La deuxième partie est une étude rétrospective sur 9 chevaux dont un diagnostic de fibrillation atriale idiopathique a été posé à l'ENVT de 2002 à 2006. Le matériel et la méthode sont d'abord détaillés puis les résultats des diagnostics et des traitements effectués avec du sulfate de quinidine per os sont donnés. Cette étude donne 89 % de réussite au traitement, avec des chevaux qui reviennent à un niveau antérieur de compétition.
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ABSTRACT: To evaluate the efficacy of amiodarone in dogs with refractory supraventricular and ventricular arrhythmias and to document the side effects in treated dogs. Records of 28 dogs were retrospectively searched to document indication for amiodarone administration, heart rate, alkaline phosphatase, alanine aminotransferase, thyroxine (T4) and thyroid stimulating hormone values before and after starting treatment and during follow-up periods. Sixteen dogs with supraventricular and 12 dogs with ventricular arrhythmias were treated with amiodarone. Amiodarone treatment significantly reduced the heart rate (P<0.001) and resulted in improvement in the severity of the arrhythmia and clinical signs in 26 dogs. There were no significant differences in alkaline phosphatase (P=0.596), alanine aminotransferase (P=0.842), T4 (P=0.789) and thyroid stimulating hormone (P=0.064) before and after starting amiodarone. On maintenance therapy, median amiodarone blood levels were within the accepted reference range (0.5 to 2.0 mg/L) at 0.8 mg/L (range 0.2 to 11.6 mg/L), but the majority of the desethylamiodarone levels were below normal at 0.1 mg/L (range 0.1 to 0.9 mg/L), based on human reference intervals (0.5 to 2.0 mg/L). Amiodarone may be an effective and safe alternative to treat supraventricular and ventricular arrhythmias in dogs, when common anti-arrhythmic drugs are not effective or contraindicated.Journal of Small Animal Practice 11/2011; 53(1):19-26. DOI:10.1111/j.1748-5827.2011.01142.x · 0.91 Impact Factor
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ABSTRACT: A six-year-old female spayed mixed-breed dog was referred following a 3-week history of lameness and progressive neurological deficits in both hindlimbs, and a 1-week history of a cardiac arrhythmia. The dog was diagnosed with hypothyroidism, atrial fibrillation, myocardial dysfunction and arterial thromboembolism. Cardioversion occurred after 2 weeks of levothyroxine supplementation, with improved systolic function over time. To the authors' knowledge, this is the first case reported in the veterinary or human literature documenting hypothyroidism with persistent atrial fibrillation being converted to sinus rhythm with levothyroxine as sole therapy.Journal of Small Animal Practice 02/2014; DOI:10.1111/jsap.12184 · 0.91 Impact Factor