Arrhythmias in COPD
- Omar A Minai, MD
Omar A Minai, MD
- Pulmonary and Critical Care Associates
- Southside regional medical Center
- Section Editors
- James K Stoller, MD, MS
James K Stoller, MD, MS
- Section Editor — Chronic Obstructive Pulmonary Disease
- Jean Wall Bennett Professor of Medicine, Samson Global Leadership Academy Endowed Chair
- Cleveland Clinic Lerner College of Medicine
- Chairman, Education Institute, Cleveland Clinic
- Leonard I Ganz, MD, FHRS, FACC
Leonard I Ganz, MD, FHRS, FACC
- Section Editor — Cardiac Arrhythmias
- Director of Cardiac Electrophysiology
- Heritage Valley Health System
- Deputy Editors
- Helen Hollingsworth, MD
Helen Hollingsworth, MD
- Deputy Editor — Pulmonary, Critical Care, and Sleep Medicine
- Associate Professor of Medicine
- Boston University School of Medicine
- Brian C Downey, MD, FACC
Brian C Downey, MD, FACC
- Deputy Editor — Cardiology
- Assistant Professor of Medicine
- Tufts University School of Medicine
The natural history of chronic obstructive pulmonary disease (COPD) includes gradually worsening shortness of breath and functional limitation, caused by a progressive decline in lung function and the development of co-morbid illnesses . Multifocal atrial tachycardia, atrial fibrillation, and ventricular arrhythmias are common co-morbidities among patients with COPD .
The potential contributing factors, occurrence rates, and management of arrhythmias in patients with COPD will be discussed here. The management of stable COPD and atrial and ventricular arrhythmia is reviewed separately. (See "Management of stable chronic obstructive pulmonary disease" and "Clinical manifestations, diagnosis, and evaluation of narrow QRS complex tachycardias" and "Multifocal atrial tachycardia" and "Management of new onset atrial fibrillation" and "Rhythm control versus rate control in atrial fibrillation" and "Approach to the diagnosis of wide QRS complex tachycardias" and "Approach to the management of wide QRS complex tachycardias".)
POTENTIAL CONTRIBUTING FACTORS
Multiple factors have been evaluated as possible contributors to the development of arrhythmias in patients with COPD [3,4]. Some are related to comorbid disease processes with shared risk factors and others are more specifically related to COPD. Factors related to COPD that have been studied regarding their potential role in arrhythmia development are discussed in greater detail below.
Comorbid disease processes — COPD shares risk factors (eg, age, smoking) with a number of disease processes and related treatments that are also associated with cardiac arrhythmias, including [3,4]:
●Coronary heart disease
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- POTENTIAL CONTRIBUTING FACTORS
- Comorbid disease processes
- Hypoxemia and respiratory acidosis
- Beta-adrenergic agonists
- Cigarette smoking
- Cardiac autonomic dysfunction
- Ventricular diastolic dysfunction and respiratory failure
- OCCURRENCE OF ARRHYTHMIAS IN PATIENTS WITH COPD
- Holter monitoring in stable COPD
- Specific arrhythmias associated with COPD
- - Multifocal atrial tachycardia
- - Atrial fibrillation
- - Ventricular arrhythmias
- General measures
- Multifocal atrial tachycardia
- Atrial fibrillation and supraventricular tachyarrhythmias
- Symptomatic ventricular arrhythmias
- Asymptomatic ventricular arrhythmias
- SUMMARY AND RECOMMENDATIONS
- Clinical features