Effect of preoperative administration of atenolol to dogs with pulmonic stenosis undergoing interventional procedures. (18th March 2022)

• Record Type: Journal Article
• Authors: Gomart, Samantha; MacFarlane, Paul; Payne, Jessie Rose; Hezzell, Melanie J.; Borgeat, Kieran
• Is Part Of: Journal of veterinary internal medicine. Volume 36:Number 3(2022)
• Page Start: 877
• Page End: 885
• Publication Date: 2022-03-18
• Subjects: balloon valvuloplasty -- beta‐blockers -- intravascular stent -- pulmonic stenosis; Veterinary medicine -- Periodicals; 636.0896
• DOI: 10.1111/jvim.16403
• Languages: English
• ISSNs: 0891-6640

Abstract

Abstract: Background: Beta‐blockade is sometimes used in dogs with pulmonic stenosis with the intent of reducing frequency of ventricular arrhythmias during right heart catheterization. Objectives: To evaluate if pretreatment with atenolol reduces frequency of ventricular arrhythmias, anesthetist interventions, or shortens procedure time. Animals: Thirty dogs with pulmonic stenosis scheduled for interventional procedures. Methods: Single center, prospective, randomized, open‐label study. Dogs were randomized to treatment with atenolol or no treatment preoperatively for a minimum of 10 days. Variables recorded included heart rate, arrhythmias and complexity, total procedure time and administration of antiarrhythmic treatment, vasopressors, positive chronotropes, or fluid boluses. Results: Fifteen dogs were enrolled in each group. Dogs receiving atenolol had lower mean heart rates during the procedure (atenolol 100 ± 11 bpm vs untreated 115 ± 19 bpm, P = .01). There were no significant differences between the atenolol and untreated groups in the frequency of ventricular ectopic complexes (535 [6‐5296] vs 553 [79‐2863], P = .9), ventricular couplets (46 [0‐481] vs 29 [3‐121], P = .59), ventricular triplets (20 [0‐265] vs 16 [1‐82], P = .67), ventricular tachycardia (8 [0‐224] vs 8 [1‐118], P = .99), proportion exhibiting R‐on‐T phenomenon (11/15 vs 14/15, P = .33), proportion receiving intraoperative lidocaine (1/15 vs 3/15, P = .6), vasopressors/positive chronotropes (11/15 vs 5/15, P = .06), or fluid boluses (12/15 vs 7/15, P = .13). The procedure time was similar (atenolol 41 [23‐68] min vs untreated 35 [18‐98] min, P = .91). Conclusions and Clinical Importance: No benefit of preoperative atenolol treatment was identified in this small group of dogs.