Prevalence and prognostic role of L wave and selected clinical and echocardiographic variables in dogs with atrial fibrillation.

Background: Information regarding the frequency of L waves and their prognostic relevance in dogs with secondary atrial fibrillation (AF) is limited. Hypothesis/Objectives: To determine whether L waves occur and ascertain their prognostic role, as well as the role of other clinical and echocardiographic variables in dogs with AF. Animals: Fifty‐five dogs with AF associated with myxomatous mitral valve disease or dilated cardiomyopathy. Methods: Retrospective, multicenter observational study. In addition to L waves analysis, other clinical and echocardiographic variables, including type of antiarrhythmic treatment, were evaluated. A survival analysis was performed to test for predictors of cardiac death and all‐cause mortality using Cox proportional hazards regression models. Results: L waves were evident in 33/55 dogs (60%, 95% confidence interval [CI] = 47%‐72%) but their presence did not influence outcome. Increased left ventricular end‐systolic diameter normalized for body weight (LVSDn) was a significant predictor of both cardiac death (hazard ratio [HR] = 4.41, 95% CI = 1.18‐16.54; P =.03) and all‐cause mortality (HR = 9.39, 95% CI = 2.49‐35.32; P <.001). Heart rate assessed during echocardiography (Echo‐HR) represented an additional significant predictor of cardiac death (HR = 1.01, 95% CI = 1.00‐1.01; P =.04) and all‐cause mortality (HR = 1.01, 95% CI = 1.00‐1.01; P =.04). Conclusions and Clinical Importance: L waves occurred frequently in dogs with AF, but held no prognostic relevance. Conversely, LVSDn and Echo‐HR represented independent predictors of negative outcome in these animals. [ABSTRACT FROM AUTHOR]