Frequency and Significance of Cardiac Arrhythmias in Chronic Obstructive Lung Disease

Shih, Hue-Teh; Webb, Charles R.; Conway, William; Peterson, Edward L.; Tilley, Barbara C.; Goldstein, Sidney

doi:10.1378/chest.94.1.44

Cited by 112 publications

(64 citation statements)

References 20 publications

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“…The clinical significance, if any, of this magnitude of effect is not clear. In two studies, each following 64 -65 COPD patients, a high prevalence of cardiac arrhythmias was found ( including SVEs ), although arrhythmias were not found to be significant predictors of death ( Shih et al, 1988;Lewczuk et al, 1992 ). However, observing rats postexposure, Watkinson et al (1998 ) found some rats dying abruptly due to ''the initiation and propagation of an ectopically stimulated depolarization which 'captured' the heartbeat, producing a fatal arrhythmia'' upon exposure.…”

Section: Cardiovascular Health Endpointsmentioning

confidence: 99%

“…An increase of 200 g/m 3 SO 2 was associated with increases of 2.3-2.8 beats /min in the Peters et al (1999 ) study. Increased HR may be a significant indicator of mortality in COPD patients with severe hypoxemia ( Shih et al, 1988 ) and thus may also be considered an adverse effect of exposure to ambient PM. The other exposure metrics in our study had negative relationships with HR.…”

Section: Cardiovascular Health Endpointsmentioning

confidence: 99%

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Exposure of chronic obstructive pulmonary disease patients to particles: Respiratory and cardiovascular health effects

Bräuer

Ebelt

Fisher

et al. 2001

J Expo Sci Environ Epidemiol

109

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To examine hypotheses regarding air pollution health effects, we conducted an exploratory study to evaluate relationships between personal and ambient concentrations of particles with measures of cardiopulmonary health in a sample of patients with chronic obstructive pulmonary disease ( COPD ) . Sixteen currently non -smoking COPD patients ( mean age = 74 ) residing in Vancouver were equipped with a particle ( PM 2.5 ) monitor for seven 24 -h periods. Subjects underwent ambulatory heart monitoring, had their lung function and blood pressure ( BP ) measured, and recorded symptoms and medication use. Ambient PM 2.5 , PM 10 , sulfate, and gaseous pollutant concentrations were monitored at five sites within the study area. Although no associations between air pollution and lung function were statistically significant, an estimated effect of 3% and 1% declines in daily FEV 1 change ( ÁFEV 1 ) for each 10 g / m 3 increase in ambient PM 10 and PM 2.5 , respectively, was observed. Increases of 1 g / m 3 in personal or ambient sulfate were associated with 1.0% and 0.3% declines in ÁFEV 1 , respectively. Weak associations were observed between particle concentrations and increased supraventricular ectopic heartbeats and with decreased systolic BP. No consistent associations were observed between any particle metric and diastolic BP, heart rate, or heart rate variability ( r -MSSD or SDNN ) , symptom severity, or bronchodilator use. Of the pollutants measured, ambient PM 10 was most consistently associated with health parameters; the use of personal exposures did not improve the strength of any associations or lead to increased effect estimates.

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Section: Cardiovascular Health Endpointsmentioning

confidence: 99%

Section: Cardiovascular Health Endpointsmentioning

confidence: 99%

Exposure of chronic obstructive pulmonary disease patients to particles: Respiratory and cardiovascular health effects

Bräuer

Ebelt

Fisher

et al. 2001

J Expo Sci Environ Epidemiol

109

View full text Add to dashboard Cite

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“…Chronic hypoxia causes norepinephrine spill, which leads to increased sympathetic tone (increased sympathetic discharge or stimulation) and acceleration of heart rate. 1,2 The incidence of…”

Section: Introductionmentioning

confidence: 99%

The effect of ivabradine on functional capacity in patients with chronic obstructive pulmonary disease

et al. 2016

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Increased sympathetic tone and use of bronchodilators increase heart rate and this may worsen functional capacity in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to look at the short-term effect of the heart rate lowering drug ivabradine on clinical status in COPD patients. We randomised 80 COPD patients with sinus heart rate ≥90 bpm into either taking ivabradine 7.5 mg twice per day or placebo for two weeks. We assessed all patients using the modifi ed Borg scale and 6-minute walk test at baseline and then again 2 weeks after randomisation. There were no signifi cant differences in age, sex, severity of airway obstruction (measured using forceful exhalation), severity of diastolic dysfunction or pulmonary artery systolic pressure between the two groups. The ivabradine group showed signifi cant improvement in 6-minute walk distance (from 192.6±108.8 m at baseline to 285.1±88.9 m at the end of the study) compared with the control group (230.6±68.4 at baseline and 250.4±65.8 m at the end of study) (p<0.001). This improvement in the drug group was associated with signifi cant improvement of dyspnea on modifi ed Borg scale (p=0.007). Lowering heart rate with ivabradine can improve exercise capacity and functional class in COPD patients with resting heart rate >90 bpm.

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“…The risk of arrhythmias in patients with COPD is influenced by the state of the disease, with a higher frequency of supraventricular tachycardia during exacerbations [1, 2, 5]. However, even in patients with stable COPD the incidence of cardiac arrhythmias is considerable [6], and, in clinical practice, it is not uncommon to find atrial fibrillation (AF) in patients hospitalised for COPD. AF is by far the most common arrhythmia in the elderly population but only a few studies have analysed the relationship between lung function and the risk of developing AF in detail.…”

mentioning

confidence: 99%

Reduced lung function and risk of atrial fibrillation in The Copenhagen City Heart Study

Buch¹,

Friberg²,

Scharling³

et al. 2003

Eur Respir J

259

151

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Chronic obstructive pulmonary disease has been associated with a high frequency of arrhythmias. Few studies have analysed the role of reduced lung function in predicting atrial fibrillation (AF). The aim of the present study was to investigate the relationship between forced expiratory volume in one second (FEV1) and risk of first episode of AF in a prospective study.Data from 13,430 males and females without previous myocardial infarction, who participated in the Copenhagen City Heart Study, were analysed. New AF was assessed at re-examination after 5 yrs and by hospital admission for AF during a period of 13 yrs. Multivariate analyses were used with adjustment for cardiopulmonary risk factors. There were 62 new cases of AF at 5-yr follow-up (0.58%) and 290 cases (2.20%) diagnosed at hospitalisations.Risk of new AF at re-examination was 1.8-times higher for FEV1 between 60-80% of predicted compared with FEV1 o80% after adjustment for sex, age, smoking, blood pressure, diabetes and body mass index. The risk of AF hospitalisation was 1.3-times higher for FEV1 between 60-80% and 1.8-times higher for FEV1 v60% compared with FEV1 o80%, when additional adjustment was made for education, treatment with diuretics and chest pain at activity.The authors conclude that reduced lung function is an independent predictor for incident atrial fibrillation. The Copenhagen City Heart Study was funded by the Danish Heart Foundation. P. Buch was the recipient of a Danish Heart Foundation introduction grant (01-1-9-F3-22880).Chronic obstructive pulmonary disease (COPD) has been associated with a high frequency of cardiac arrhythmias. Hypoxaemia [1, 2], acidosis [3], cor pulmonale and coexisting ischaemic heart disease (IHD) [4,5] have been proposed as major causes for the relationship between COPD and arrhythmias. The risk of arrhythmias in patients with COPD is influenced by the state of the disease, with a higher frequency of supraventricular tachycardia during exacerbations [1, 2, 5]. However, even in patients with stable COPD the incidence of cardiac arrhythmias is considerable [6], and, in clinical practice, it is not uncommon to find atrial fibrillation (AF) in patients hospitalised for COPD. AF is by far the most common arrhythmia in the elderly population but only a few studies have analysed the relationship between lung function and the risk of developing AF in detail. It is important to investigate the correlation between reduced lung function and AF since the incidence of COPD is expected to increase considerably in the future, reflecting prior smoking habits of an ageing population [7,8]. The aim of the present study, therefore, was to investigate the role of reduced lung function in development of AF based on a representative sample of the general population free of IHD at baseline. Methods Study populationThis study was based on data from the Copenhagen City Heart Study (CCHS). The original cohort of CCHS comprised a random age-stratified sample of 19,329 males and females aged o20 yrs from an area of Copenha...

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Frequency and Significance of Cardiac Arrhythmias in Chronic Obstructive Lung Disease

Cited by 112 publications

References 20 publications

Exposure of chronic obstructive pulmonary disease patients to particles: Respiratory and cardiovascular health effects

Exposure of chronic obstructive pulmonary disease patients to particles: Respiratory and cardiovascular health effects

The effect of ivabradine on functional capacity in patients with chronic obstructive pulmonary disease

Reduced lung function and risk of atrial fibrillation in The Copenhagen City Heart Study

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