Ventricular Arrhythmias in Patients with COPD Are Associated with QT Dispersion

Yıldız, Pınar; Tükek, Tufan; Akkaya, Vakur; Sözen, Ahmet Bilge; Yıldız, Alaattin; Korkut, Ferruh; Yılmaz, Veysel

doi:10.1378/chest.122.6.2055

Cited by 48 publications

(42 citation statements)

References 25 publications

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“…QT dispersion is an index of the spatial differences in myocardial recovery times. QT dispersion >60 ms promotes the development of malignant ventricular arrhythmias [17] and SCD [11]. …”

Section: Discussionmentioning

confidence: 99%

“…There are previous cross-sectional studies investigating potential predictors of increased cardiac repolarization dispersion in COPD patients [17,31,32,33]. However, the included patients were mostly free from comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…A small case-control study with 30 COPD patients and 31 age- and sex-matched control subjects showed an association between increased maximal QT interval and the development of ventricular arrhythmia [17]. However, the mechanisms contributing to altered cardiac repolarization in patients with COPD are still a matter of debate.…”

Section: Introductionmentioning

confidence: 99%

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Chronic Obstructive Pulmonary Disease and Cardiac Repolarization: Data from a Randomized Controlled Trial

2016

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Background: Altered cardiac repolarization is a risk factor for sudden cardiac death and seems to be increased in chronic obstructive pulmonary disease (COPD) patients. Objective: Lung volume reduction surgery (LVRS) has been shown to improve breathing mechanics and lung function in patients with severe COPD and emphysema and possibly also improve altered cardiac repolarization. Methods: Thirty patients scheduled for LVRS were randomized to LVRS or to the control group. We investigated the treatment effect 3 months after LVRS on measures of cardiac repolarization and dispersion of repolarization (QTc interval, QT dispersion) derived from electrocardiography. Univariable and multivariable analyses were used to identify possible confounders influencing the treatment effect. Results: LVRSwas associated with an improvement in lung function (mean ± SD residual volume/total lung capacity of -9 ± 11% and forced expiratory volume in 1 s of +30 ± 29%). LVRS did not significantly reduce QTc (median -5.3 ms, 95% confidence interval, CI -15.5 to 3.7, p = 0.214) and QT dispersion (median -3.0 ms, 95% CI -13.0 to 7.0, p = 0.536) compared to the control group. No significant association between change in QTc and change in QT dispersion, respectively, and change in possible confounders was found. Conclusion: LVRS seems to have no effect on cardiac repolarization in patients with COPD. Thus, lung hyperinflation seems not to be a causal mechanism for altered cardiac repolarization in COPD patients.

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“…QT dispersion is an index of the spatial differences in myocardial recovery times. QT dispersion >60 ms promotes the development of malignant ventricular arrhythmias [17] and SCD [11]. …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Chronic Obstructive Pulmonary Disease and Cardiac Repolarization: Data from a Randomized Controlled Trial

2016

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“…Carjea found a higher prevalence of LVPs in patients with COPD, especially in moderate and severe cases [32]. Yildiz et al [33] reported a signiicantly increased total QRS duration in patients with COPD compared to control subjects and LVPs but no signiicant association with premature ventricular contractions. Despite higher prevalence of LVPs, premature ventricular contractions, and complex ventricular arrhythmias in patients with COPD compared to healthy controls, SAECG had litle value in stratiication of ventricular arrhythmia risk in a study including 41 patients with COPD and 63 patients without any history of pulmonary disease [27].…”

Section: Follow Up Referencesmentioning

confidence: 99%

Signal-Averaged ECG: Basics to Current Issues

Mozoş¹,

Stoian²

2017

Interpreting Cardiac Electrograms - From Skin to Endocardium

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Signal-averaged ECG (SAECG) is a high-resolution, noninvasive electrocardiographic method enabling detection of late ventricular potentials (LVP), which are low-amplitude and high-frequency signals, predicting reentry ventricular arrhythmias, and sudden cardiac death (SCD). Three criteria are used to detect late ventricular potentials as follows: signal-average ECG QRS duration (SAECG-QRS), the duration of the terminal part of the QRS complex with an amplitude below 40 μV (LAS40) and the root mean square (RSM) signal amplitude of the last 40 ms of the signal < 20 μV (RMS40). Late ventricular potentials can be detected not only at the end of a QRS complex but also as intra-QRS (IQRS) potentials. Signal-averaged ECG was modiied to enable the analysis of the P-wave and to detect atrial late potentials (ALPs), low-amplitude potentials at the terminal part of the iltered P-wave, and predictors of atrial ibrillation (AF). Late atrial and ventricular potentials originate from areas of delayed, fragmented, and heterogenous conduction within atrial or ventricular myocardium. This chapter reviews the most important mechanisms explaining the occurrence of late ventricular, intra-QRS, and atrial potentials; their predictive value for arrhythmia, focusing on recent clinical data, long-term follow-up, and outcome; and analysis of SAECG variables in cardiac and noncardiac diseases.

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“…It is postulated that chronic systemic inflammation and/or cardiovascular autonomic neuropathy may be involved [3][4][5][6] , since there is evidence that COPD patients present dysautonomia, sympathetic hyperactivity, reduced vagal tone and heart rate variability (HRV). These phenomena are highly associated with the appearance of arrhythmias and a risk of sudden death in this population [7][8][9][10][11][12][13] . An important method for diagnosing, classifying and following the progression of COPD is spirometry 1,14 , which is considered the best means of assessing pulmonary function [15][16][17] and is routinely performed via the forced vital capacity (FVC) maneuver 18,19 .…”

Section: Introductionmentioning

confidence: 99%