Does occurrence of ventricular arrhythmia reduce the survival rate in dogs with gastric dilatation volvulus (GDV)?



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PICO question

Does occurrence of ventricular arrhythmia reduce the survival rate in dogs with gastric dilatation volvulus (GDV)?


Clinical bottom line

Category of research question


The number and type of study designs reviewed

The number and type of study designs that were critically appraised were three retrospective observational case-control studies (Brourman et al., 1996; Green et al., 2012; and Mackenzie et al., 2010) and one prospective, observational study (Aona et al., 2017)

Strength of evidence

Critical evaluation and appraisal of the papers that met the inclusion criteria provided only weak evidence to support the clinical question. This is due to the lack of recent (within the last 5 years) and specific (do the presence of cardiac arrythmias affect mortality of dogs with GDV) studies conducted on the subject. Additionally, more in-depth statistical analysis (e.g. P values and confidence intervals (CI)) may also help to determine the strength of association between the presence of ventricular arrythmia and survival rates.

However, there is room for further research to continue investigating the proposed hypothesis. Several of the evaluated studies were carried out more than 10 years before this Knowledge Summary was written, meaning that the knowledge and technology at the time may not be relevant to clinical practice today

Outcomes reported

Green et al. (2012) concluded that ‘cardiac arrhythmia was not a prognostic indicator’ for GDV.

Of the two papers (Mackenzie et al., 2010; and Brourman et al., 1996) that found a significant association between the development of cardiac arrhythmias (specifically, those of ventricular origin) and an increase in the mortality rates of dogs with GDV, one (Brourman et al., 1996) noted that a greater number of dogs that died prior to discharge were diagnosed with preoperative ventricular tachycardia, while the other (Mackenzie et al., 2010) found that the greatest mortality rate was among those dogs that developed postoperative ventricular tachycardia.

The final study, Aona et al. (2017), was the only paper to categorise and grade the ventricular arrhythmias using previously published scales. It was discovered that increased levels of cTn1 (cardiac troponin 1) made a dog more likely to develop a higher grade of arrhythmia, however, no association was found between the type or grade of arrhythmia and patient mortality


Taking into account the strength of evidence and the outcomes presented by the appraised studies the following conclusion has been drawn; although there is some evidence to suggest that ventricular tachycardia may be associated with an increase in mortality rates in patients with GDV, further research is required in order to make any further conclusions that may definitively answer the clinical question


How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.


Open Access Peer Reviewed


Aona, B.D., Rush, J.E., Rozanski, E.A., Cunningham, S.M., Sharp, C.R. & Freeman, L.M. (2017). Evaluation of echocardiography and cardiac biomarker concentrations in dogs with gastric dilatation volvulus. Journal of Veterinary Emergency and Critical Care. 27(6), 631–637. DOI:

Brourman, J.D., Schertel, E.R., Allen, D.A., Birchard, S.J. & DeHoff, W.D. (1996). Factors associated with perioperative mortality in dogs with surgically managed gastric dilatation-volvulus: 137 cases (1988–1993). Journal of the American Veterinary Medical Association. Available at: [Accessed 11 Dec 2020].

Green, J.L., Cimino Brown, D. & Agnello, K.A. (2012). Preoperative thoracic radiographic findings in dogs presenting for gastric dilatation-volvulus (2000–2010): 101 cases. Journal of Veterinary Emergency and Critical Care. 22(5), 595–600. DOI:

Mackenzie, G., Barnhart, M., Kennedy, S., DeHoff, W. & Schertel, E. (2010). A retrospective study of factors influencing survival following surgery for gastric dilatation-volvulus syndrome in 306 dogs. Journal of the American Animal Hospital Association. 46(2), 97–102. DOI:

PDSA. (2020). GDV (Gastric Dilation Volvulus). [online] Available at: [Accessed 1 Jan 2021].

Rishniw, M. (2020). Ventricular Tachycardia. Vetlexicon Canis powered by Vetstream. [online] Available at: [Accessed 29 Dec 2020].

Vol. 6 No. 4 (2021): The fourth issue of 2021

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /  Exotics  /