Journal de médecine pulmonaire

Incidence of cardiac arrhythmias in patients with moderate to severe chronic obstructive pulmonary disorder and their relationship to exacerbation

Bushra Mina

COPD and CAD are both highly prevalent and share common risk factors. There is an increased prevalence of arrythmias in patients with Chronic Obstructive Pulmonary Disorder (COPD) compared to the general population. Most of those arrythmias, particularly atrial fibrillation, remain undiagnosed due to their paroxysmal nature. Incidence of atrial fibrillation is 1.8 times more common in the COPD and tends to be refractory to medical and ablative therapies. In addition, cardiovascular events are a leading cause of death in COPD patients, with new studies suggesting arrhythmias and sudden cardiac death are substantial contributors. COPD patients are at a higher risk for ventricular tachycardia (VT) and mortality, and the frequency of inappropriate implantable cardioverter-defibrillator (ICD) shocks is higher in COPD patient compared to non-COPD patients. Many of those patients present with complications associated with those arrythmias namely acute stroke, syncope or even sudden death. The incidence of silent arrythmias and the temporal relationship between arrythmia occurrence and COPD exacerbation is not fully understood. Given the complex interplay of factors that may predispose COPD patients to arrhythmogenesis, understanding the relationship between COPD and VT could help physicians better identify those who could benefit from an arrhythmia intervention. The true incidence of silent arrhythmias and the temporal relationship between COPD exacerbation and occurrence of arrhythmias has not been fully investigated. Previous retrospective studies have sought to do so with the use of 24-hour Holter monitoring.