Patients who have pulmonary disorders, especially those with chronic obstructive pulmonary disease, often have atrial and ventricular arrhythmias. However, the pathogenesis of these arrhythmias is complex and may involve many factors. For example, these individuals often have anatomic cardiac abnormalities, such as right ventricular hypertrophy, with or without associated congestive heart failure. Cigarette smoking is protean in patients with chronic obstructive pulmonary disease, and, consequently, atherosclerotic heart disease may be present with its attendant complications. Hypoxia and hypercapnia occur in these patients and, under appropriate circumstances, can be arrhythmogenic. Patients may receive drugs that can cause arrhythmias. For example, diuretics may lead to hypokalemia, and aminophylline and adrenergic bronchodilator drugs may create the environment necessary for arrhythmias to emerge. Finally, patients with pulmonary disease are prone to any arrhythmias that occur in other people, for example, atrioventricular nodal reentry and Wolff-Parkinson-White reentry.
KeywordsChronic Obstructive Pulmonary Disease Ventricular Arrhythmia Chronic Obstructive Pulmonary Disease Patient Acute Respiratory Failure Chronic Lung Disease
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- 4.Coleridge JCG, Coleridge HM. Chemoreflex regulation of the heart. In Handbook of Physiology, Section 2: The Cardiovascular System, Berne RM, Sperelakis N, Geiger SR (eds). Bethesda, Md: American Physiological Society, 1979, pp. 653–676.Google Scholar
- 5.Korner PI. Central nervous control of autonomic cardiovascular function. In Handbook of Physiology, Section 2: The Cardiovascular System, Berne RM, Sperelakis N, Geiger SR (eds). Bethesda, Md: American Physiological Society, 1979, pp. 691–739.Google Scholar
- 7.Prystowsky EN, Jackman WM, Rinkenberger RL, Heger JJ, Zipes DP. Effect of autonomic blockade on ventricular refractoriness and atrioventricular nodal conduction in man. Evidence supporting a direct cholinergic action on ventricular muscle refractoriness. Circ Res 49: 511–518, 1981.PubMedGoogle Scholar
- 19.Holford FD, Mithoefer JC. Cardiac arrhythmias in hospitalized patients with chronic obstructive pulmonary disease. Am Rev Respir His 108: 879–885, 1973.Google Scholar
- 22.Goldberg LM, Bristow JD, Parker BM, et al. Paroxysmal atrial tachycardia with atrioventricular block. Its frequent association with chronic pulmonary disease. Circulation 21: 499, 1960.Google Scholar
- 23.Diener CF, Burrows B. Further observations on the course and prognosis of chronic obstructive lung disease. Am Rev Respir Dis III: 719–724, 1975.Google Scholar
- 24.Khokhar N. Cardiac arrhythmias associated with acute respiratory failure in chronic obstructive pulmonary disease. Milit Med 146: 856–858. 1981.Google Scholar
- 38.Washerman K. Cardiovascular manifestations of respiratory insufficiency. Clin Notes Respir Dis 12: 3–10, 1973.Google Scholar