Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship

Abstract

Chronic obstructive pulmonary disease (COPD) is independently associated with atrial fibrillation (AF). Decreased oxygenation, hypercapnia, pulmonary hypertension, diastolic dysfunction, oxidative stress, inflammation, changes in atrial size by altered respiratory physiology, increased arrhythmogenicity from nonpulmonary vein foci commonly located in the right atrium, and respiratory drugs have been implicated in the pathogenesis of AF in COPD. The understanding of the relationship between COPD and AF is of particular importance, as the presence of the arrhythmia has significant impact on mortality, especially in COPD exacerbations. On the other hand, COPD in AF is associated with AF progression, success of cardioversion, recurrence of AF after catheter ablation, and increased cardiovascular and allcause mortality. Treatment of the underlying pulmonary disease and correction of hypoxia and acid-base imbalance represents first-line therapy for COPD patients who develop AF. Cardioselective b-blockers are safe and can be routinely used in COPD. In addition, AF ablation was proved to be efficient and safe, and improves quality of life in these patients. This review presents the association between COPD and AF, describes the pathophysiological mechanisms implicated in AF development in COPD, underlines the prognostic significance of AF in COPD patients and vice versa, and highlights emerging therapeutic approaches in this setting.

Causes and Predictors of Readmission in Patients With Atrial Fibrillation Undergoing Catheter Ablation: A National Population‐Based Cohort Study

“…Additionally, we noted diabetes mellitus and chronic pulmonary disease to be associated with a high likelihood of AF recurrence. Our findings support the previously noted observation by Goudis24 that concurrent COPD in AF patients leads to worse outcomes in terms of AF progression, AF recurrence after catheter ablation, and overall mortality. Increased hospital volume for the catheter ablation predicted lower AF recurrence in our study, again highlighting the salubrious importance of increased institutional experience.…”

Echocardiographic Evaluation of Females with Asthma

“…Inflammation, decreased oxygenation, pulmonary hypertension, diastolic function impairment, oxidative stress, changes of atrial size leading to deformation may cause atrial conduction abnormalities including prolongation of atrial conduction times in patients with obstructive pulmonary disease. 13,14 In the present study, RV free wall thickness informing that RV systolic function was higher in asthmatic group. In several studies by Ghandi, Ghaderian and Shedeed et al, similar results were found that RV wall thickness significantly different between asthmatic patients and healthy subjects.…”

Newer technologies for detection of atrial fibrillation

“…Echocardiographic abnormalities, such as left atrial enlargement,1516 left ventricular hypertrophy, and left ventricular systolic and diastolic dysfunction, have been associated with atrial fibrillation 1516171819. Other important risk factors include pulmonary diseases, such as obstructive sleep apnea and chronic obstructive pulmonary disease,2021 and systemic risk factors, such as hypertension, diabetes mellitus,1315 obesity,16 and cigarette smoking 22…”