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Cardiac Arrhythmias in Patients with Exacerbation of COPD

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Clinical Management of Pulmonary Disorders and Diseases

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.

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References

  • Albouaini K, Andron M, Alahmar A, Egred M (2007) Beta-blockers use in patients with chronic obstructive pulmonary disease and concomitant cardiovascular conditions. Int J Chron Obstruct Pulmon Dis 2:535–540

    PubMed  PubMed Central  Google Scholar 

  • Anthonisen NR, Manfreda J, Warren CP, Hershfield ES, Harding GK, Nelson NA (1987) Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 106:196–204

    Article  CAS  PubMed  Google Scholar 

  • Baranowski R, Bieganowska K, Cygankiewicz I (2013) Guidelines on the implementation of long-term ECG recording. Kardiol Pol 71(Suppl. 9):225–242. Article in Polish

    Google Scholar 

  • Barnett MJ, Milavetz G, Kaboli PJ (2005) β-Blocker therapy in veterans with asthma or chronic obstructive pulmonary disease. Pharmacotherapy 25:1550–1559

    Article  CAS  PubMed  Google Scholar 

  • Barns P (2013) Theophylline. Am J Respir Crit Care Med 188:901–906

    Article  Google Scholar 

  • Bateman NT, Leach RM (1998) Acute oxygen therapy. BMJ 317:798–801

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Benjamin EJ, Levy D, Vaziri SM, D'Agostino RB, Belanger AJ, Wolf PA (1994) Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA 271:840–844

    Article  CAS  PubMed  Google Scholar 

  • Benowitz NL, Hansson A, Jacob P 3rd (2002) Smoking cardiovascular effects of nasal and transdermal nicotine and cigarette smoking. Hypertension 39:1107–1112

    Article  CAS  PubMed  Google Scholar 

  • Bhatt SP, Dransfield MT (2013) Chronic obstructive pulmonary disease and cardiovascular disease. Transl Res 162:237–251

    Article  PubMed  Google Scholar 

  • Bittar G, Friedman HS (1991) The arrhythmogenicity of theophylline. A multivariate analysis of clinical determinants. Chest 99:1415–1420

    Article  CAS  PubMed  Google Scholar 

  • Boyle M, Wong J (2006) Prescribing oxygen therapy. An audit of oxygen prescribing practices on medical wards at North Shore Hospital, Auckland, New Zealand. N Z Med J 119:2080

    Google Scholar 

  • Caglar IM, Dasli T, Turhan Caglar FN, Teber MK, Ugurlucan M, Ozmen G (2012) Evaluation of atrial conduction features with tissue Doppler imaging in patients with chronic obstructive pulmonary disease. Clin Res Cardiol 101:599–606

    Article  PubMed  Google Scholar 

  • Chatila WM, Thomashow BM, Minai OA, Criner GJ, Make BJ (2008) Comorbidities in chronic obstructive pulmonary disease. Proc Am Thorac Soc 5:549–555

    Article  PubMed  PubMed Central  Google Scholar 

  • Connors AF, Dawson NV, Thomas C, Harrell FE Jr, Desbiens N, Fulkerson WJ, Kussin P, Bellamy P, Goldman L, Knaus WA (1996) Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to understand prognoses and preferences for outcomes and risks of treatments). Am J Respir Crit Care Med 154:959–967

    Article  PubMed  Google Scholar 

  • Curkendall SM, DeLuise C, Jones JK, Lanes S, Stang MR, Goehring E Jr, She D (2006) Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada. Ann Epidemiol 16:63–70

    Article  PubMed  Google Scholar 

  • D'Alessandro A, Boeckelmann I, Hammwhöner M, Goette A (2012) Nicotine, cigarette smoking and cardiac arrhythmia: an overview. Eur J Prev Cardiol 19:297–305

    Article  PubMed  Google Scholar 

  • Falk JA, Kadiev S, Criner GJ, Scharf SM, Minai OA, Diaz P (2008) Cardiac disease in chronic obstructive pulmonary disease. Proc Am Thorac Soc 5:543–548

    Article  PubMed  PubMed Central  Google Scholar 

  • Farland MZ, Peters CJ, Williams JD, Bielak KM, Heidel RE, Ray SM (2013) β-Blocker use and incidence of chronic obstructive pulmonary disease exacerbations. Ann Pharmacother 47:651–656

    Article  PubMed  Google Scholar 

  • Fuso L, Incalzi RA, Pistelli R, Muzzolon R, Valente S, Pagliari G, Gliozzi F, Ciappi G (1995) Predicting mortality of patients hospitalized for acutely exacerbated chronic obstructive pulmonary disease. Am J Med 98:272–277

    Article  CAS  PubMed  Google Scholar 

  • GOLD (2016) Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease. https://www.goldcopd.org. Accessed 17 Oct 2016

  • Huerta C, Lanes SF, Garcia Rodriguez LA (2005) Respiratory medications and the risk of cardiac arrhythmias. Epidemiology 16:360–366

    Article  PubMed  Google Scholar 

  • Khan S, Jones S, Preston CL (2014) Theophylline interactions. Pharm J 293:7818

    Google Scholar 

  • Konecny T, Park JY, Somers KR, Konecny D, Orban M, Soucek F, Parker KO, Scanlon PD, Asirvatham SJ, Brady PA, Rihal CS (2014) Relation of chronic obstructive pulmonary disease to atrial and ventricular arrhythmias. Am J Cardiol 114:272–277

    Article  PubMed  Google Scholar 

  • Lahousse L, De Nocker P, Hofman A, Stricker B, Brusselle G, Verhamme K (2016) Potential use of β-blockers to reduce COPD exacerbations. Eur Respir J 48(Suppl 60). https://erj.ersjournals.com/content/48/suppl_60/OA1502.full. Accessed 10 Nov 2016

  • Lipworth B, Skinner D, Devereux G, Thomas V, Ling Zhi Jie J, Martin J, Carter V, Price DB (2016) Underuse of β-blockers in heart failure and chronic obstructive pulmonary disease. Heart 102:1909–1914

    Article  PubMed  PubMed Central  Google Scholar 

  • Maclay JD, MacNee W (2013) Cardiovascular disease in COPD: mechanisms. Chest 143:798–807

    Article  CAS  PubMed  Google Scholar 

  • McCord J, Borzak S (1998) Multifocal atrial tachycardia. Chest 113:203–209

    Article  CAS  PubMed  Google Scholar 

  • Roberts CM, Lopez-Campos JL, Hartl S (2012) The European COPD audit: brothers in arms. Breathe 8:267–270

    Article  Google Scholar 

  • Rudge J, Odedra S, Harrison D (2014) A new oxygen prescription produces real improvements in therapeutic oxygen use. BMJ Qual Improv Report 3(1). doi:10.1136/bmjquality.u204031.w1815

  • Shibata Y, Watanabe T, Osaka D, Abe S, Inoue S, Tokairin Y, Igarashi A, Yamauchi K, Kimura T, Kishi H, Aida Y, Nunomiya K, Nemoto T, Sato M, Konta T, Kawata S, Kato T, Kayama T, Kubota I (2011) Impairment of pulmonary function is an independent risk factor for atrial fibrillation: the Takahata study. Int J Med Sci 8:514–522

    Article  PubMed  PubMed Central  Google Scholar 

  • Sidney S, Sorel M, Quesenberry CP Jr, DeLuise C, Lanes S, Eisner MD (2005) COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente Medical Care Program. Chest 128:2068–2075

    Article  PubMed  Google Scholar 

  • Sliwinski P, Górecka D, Jassem E, Pierzchała W (2014) Polish Respiratory Society guidelines for chronic obstructive pulmonary disease. Pneumonol Alergol Pol 82:227–263

    Article  PubMed  Google Scholar 

  • Small D, Duha A, Wieskopf B, Dajczman E, Laporta D, Kreisman H, Wolkove N, Frank H (1992) Uses and misuses of oxygen in hospitalized patients. Am J Med 92:591–595

    Article  CAS  PubMed  Google Scholar 

  • Soler-Cataluña JJ, Martínez-García MÁ, Román Sánchez P, Salcedo E, Navarro M, Ochando R (2005) Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax 60:925–931

    Article  PubMed  PubMed Central  Google Scholar 

  • Terzano C, Romani S, Conti V, Paone G, Oriolo F, Vitarelli A (2014) Atrial fibrillation in the acute, hypercapnic exacerbations of COPD. Eur Rev Med Pharmacol Sci 18(19):2908–2917

    CAS  PubMed  Google Scholar 

  • Vestbo J, Anderson J, Brook RD, Calverley PM, Celli BR, Crim C, Haumann B, Martinez FJ, Yates J, Newby DE (2013a) The study to understand mortality and morbidity in COPD (SUMMIT) study protocol. Eur Respir J 41:1017–1022

    Article  CAS  PubMed  Google Scholar 

  • Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, Stockley RA, Sin DD, Rodriguez-Roisin R (2013b) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 187:347–365

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Tomasz Rusinowicz .

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Rusinowicz, T., Zielonka, T.M., Zycinska, K. (2017). Cardiac Arrhythmias in Patients with Exacerbation of COPD. In: Pokorski, M. (eds) Clinical Management of Pulmonary Disorders and Diseases. Advances in Experimental Medicine and Biology(), vol 1022. Springer, Cham. https://doi.org/10.1007/5584_2017_41

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