Efficacy of cilostazol in canine bradyarrhythmia

Abstract

Recently, cilostazol, a phosphodiesterase III inhibitor, has been described as alternative medical treatment for canine bradyarrhythmia in cases for which pacemaker implantation was not indicated or available. In this retrospective study, we investigated the use and efficacy of cilostazol in dogs with bradyarrhythmia in Japan. Dogs that had been brought to the Tokyo University of Agriculture and Technology Animal Medical Center and 23 veterinary hospitals in Japan and been treated with cilostazol initially as the only therapeutic strategy for bradyarrhythmia between January 2010 and August 2021 were included in this study. Survival analyses were performed using Cox proportional hazards analysis, the log-rank test, and the generalized Wilcoxon test to evaluate the efficacy of cilostazol. Fifty-nine privately owned dogs were included in this study. In the survival time analysis, the risk of death was significantly lower and the survival rate was higher in cases in which cilostazol was administered at 10 mg/kg or more per dose. A third-degree atrioventricular block also significantly increased the risk of death and was associated with a lower survival rate. However, in some patients with a third-degree atrioventricular block, there was an increase in the ventricular rate and improvement in clinical symptoms without disappearance or decrease of the atrioventricular block. This study had several important findings that have not previously been reported concerning the use of cilostazol for canine bradyarrhythmia, including the appropriate dose in a clinical setting and the efficacy and prognosis according to the type of bradyarrhythmia.

Evaluating the accuracy of a six‐lead smartphone‐based electrocardiographic device compared with standard electrocardiography in brachymorphic dogs

“…Then, the HR in beats per minute (bpm) was calculated by determining the number of QRS complexes in a 3‐second interval and multiplying this number by 20. For the purpose of this study, the classification of the heart rhythms/rate included 36–40 : sinus bradycardia: four or more successive sinus complexes at an HR less than 60 bpm; normal sinus rhythm: four or more successive sinus complexes at an HR of 60−180 bpm; sinus tachycardia: four or more successive sinus complexes at an HR greater than 180 bpm; supraventricular premature complexes (SvPC): a premature normal‐appearing QRS complex not preceded by any P wave or conducted by a P wave with abnormal morphology; supraventricular tachycardia: three or more SvPCs at an HR greater than 160 bpm; atrial fibrillation: replacement of isoelectric baseline and sinus P waves by sequential less‐defined deflections varying in amplitude, morphology and cycle length, associated with normal‐appearing QRS complexes and irregular ventricular rhythm; ventricular premature complex (VPC): a premature wide and bizarre looking QRS complex, not associated with a P wave; accelerated idioventricular rhythm: three or more VPCs at an HR of 60−180 bpm; ventricular tachycardia: three or more VPCs at an HR greater than 180 bpm; second‐degree atrioventricular block (AVB): a P wave without an associated QRS complex; third‐degree AVB: evidence of P waves dissociated from QRS complexes with a ventricular rate less than 60 bpm. …”

“…Then, the HR in beats per minute (bpm) was calculated by determining the number of QRS complexes in a 3-second interval and multiplying this number by 20. For the purpose of this study, the classification of the heart rhythms/rate included [36][37][38][39][40] :…”