Exploring the Rhythmic Symphony: The Harmonious Interplay between Chronic Obstructive Pulmonary Disease and Cardiac Arrhythmias

Abstract

Objective: This prospective cohort study aimed to investigate the pattern of arrhythmias in patients with chronic obstructive pulmonary disease (COPD) and explore the relationship between arrhythmia occurrence and the severity of COPD based on GOLD staging. Methods: The study included 100 diagnosed cases of COPD, divided into stable COPD and acute exacerbations. Routine blood investigations, electrocardiogram (ECG), 2D echocardiography, and 24-hour Holter monitoring were conducted to assess cardiac rhythm disturbances. The type of arrhythmia was noted for each patient. Statistical analysis was performed using SPSS 26 software. Results: Among the COPD patients, 53% had supraventricular ectopics, 20% had atrial tachycardia, 16% had conduction abnormalities, and 10% had ventricular ectopics. Males had a higher prevalence of COPD and arrhythmias compared to females. ECG abnormalities associated with right heart dysfunction, such as P-pulmonale, right ventricular hypertrophy (RVH), and right bundle branch block (RBBB), were more prevalent in patients with severe COPD. Sinus tachycardia was more common in severe COPD patients. Conclusion: The study findings highlight the relationship between COPD severity and the presence of arrhythmias. Patients with severe COPD had a higher incidence of ECG abnormalities associated with right heart dysfunction. The prevalence of arrhythmias in COPD patients was estimated at 12-14%, with supraventricular ectopics and atrial tachycardia being the most common types observed. Understanding the prevalence and types of arrhythmias in COPD patients can guide appropriate monitoring and interventions to reduce arrhythmia-related complications.

Keywords: Chronic obstructive pulmonary disease, arrhythmias, Holter monitoring, COPD severity, right heart dysfunction.