Cardiac Arrhythmias in Patients with Exacerbation of COPD

Abstract

Supraventricular and ventricular arrhythmias are common among patients with chronic obstructive pulmonary disease (COPD). Multiple factors can contribute to the development of arrhythmias in patients with exacerbation of the disease, including: respiratory or heart failure, hypertension, coronary disease and also medications. In the present study we seek to determine the prevalence of cardiac arrhythmias and risk factors among patients with exacerbation of COPD. The study was a retrospective evaluation of 2753 24-h Holter recordings of patients hospitalized in 2004-2016. Exacerbation of COPD was diagnosed in 152 patients and the prevalence of arrhythmias in this group of patients was 97%. The commonest arrhythmia was ventricular premature beats (VPB) - 88.8%, followed by supraventricular premature beats (SPB) - 56.5%. Permanent atrial fibrillation accounted for 30.3% and paroxysmal atrial fibrillation (PAF) for 12.5%. Supraventricular tachycardia (SVT) was noted in 34.2% patients and ventricular tachycardia in 25.6%. Respiratory failure increased the risk of SPB, while heart failure increased the risk of VPB. Treatment with theophylline was associated with a higher proportion of PAF and SVT. In conclusion, COPD exacerbation is associated with a high prevalence of cardiac arrhythmias. COPD treatment and comorbidities increase the risk of arrhythmias.

Association of asthma–chronic obstructive pulmonary disease overlap syndrome with coronary artery disease, cardiac dysrhythmia and heart failure: a population-based retrospective cohort study

“…In addition, the use of a bronchodilator is associated with CAD and HF. 13 CD and CAD are predisposing factors of sudden death. Previous studies suggest a beneficial effect of beta-blockers on AE in mild to moderate COPD.…”

Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life

“…Systematic reviews and meta-analyses highlighted that up to one quarter of patients hospitalized with a suspected COPD exacerbation have a pulmonary embolism [18,19], with similar symptoms observed between patients who did and did not have a pulmonary embolism [18]. Additionally, many patients with COPD exacerbations have cardiac arrhythmias [20], and the presence of heart failure alongside COPD is common, resulting in diagnostic challenges in these patients since the symptoms for exacerbations of both diseases overlap [21][22][23].…”

Guía de Práctica Clínica Mexicana para el diagnóstico y tratamiento de la Enfermedad Pulmonar Obstructiva Crónica <br>GUÍA MEXICANA DE EPOC, 2020

“…En sentido horizontal se clasifican con o sin exacerbaciones, panel superior e inferior, respectivamente. 54 cardiopatía isquémica, insuficiencia cardiaca izquierda, trastornos de ansiedad o pánico, uso de beta bloqueadores no selectivos o sedantes. 2,16,17 Evidencia 3 Recomendación D El diagnóstico diferencial más importante de la EPOC es la distinción con el asma.…”