COPD - Risk Factor for Ventricular Arrhythmias

[gerald]

This is a fairly large study and seems to product solid results.    If provides us information of what we need to watch for and beware of


----------------------
Chronic Obstructive Pulmonary Disease as a Risk Factor for Ventricular Arrhythmias Independent of Left Ventricular Function

Background

The association between chronic obstructive pulmonary disease (COPD) and sudden cardiac death has not been fully elucidated.

Objective

Investigate if decreased left ventricular ejection fraction (LVEF) can explain the increased rate of ventricular tachycardias (VT) in COPD.

Methods

In this retrospective study, we included consecutive adult patients who underwent pulmonary function testing (PFT), Holter monitoring, and trans-thoracic echocardiography. COPD was correlated with the frequency of VT in a multivariate analysis which adjusted for known confounders including LVEF. Long term all-cause mortality of patients with COPD and VT was examined.

Results

From 6351 patients who were included in this study (age 66±15 years, 48% woman, 92% Caucasian, LVEF 59±12%), 2800 (44%) had PFT indicative of COPD. VT was nearly twice as likely to occur during the Holter monitoring in COPD patients (13%vs.23%;p<0.001), and the severity of COPD correlated with the risk of VT (21%vs.28%vs.37% for mild-moderate, severe, and very severe COPD;p<0.001). COPD and VT remained independently associated (p<0.001) even after adjusting for LVEF, demographics, and co-morbidities (age, sex, body mass index, hypertension, chronic kidney disease, coronary artery disease, cancer history, diabetes mellitus). COPD was associated with all-cause mortality independently of LVEF (p<0.001).

Conclusions

COPD patients are at a higher risk of VT and mortality. This may not be fully attributed to the confounding effect of systolic heart failure measured by LVEF. Further studies are needed to explore the mechanistic interactions between VT and COPD in order to identify if anti-arrhythmic strategies would apply especially to the severe COPD patients.

www.heartrhythmjournal.com/article/S1547-5271(17)31190-6/fulltext?rss=yes

full report

www.heartrhythmjournal.com/article/S1547-5271(17)31190-6/pdf

[judi]

Thanks for that article, I have something going on but not sure what.  I seem to get problems that way related to anticholinergics but not sure what it is.

[gerald]

Judi, I had Afib show up when I started using Spiriva.   And that is a known side effect.  I suspect it just increased an existing condition

[judi]

That is what I am thinking too although I have had a couple of EKGs that didn't show anything serious.  Did you stay on Spiriva?  I am taking Tudorza part of the time and Atrovent part time.  I think Atrovent is the worst for it of the two.

[gerald]

I have stayed on the Spiriva. 

I have tried the Turdoza and a few others and they stop working for me after 3 or 4 days.

They did a 24 hour holter monitor EKG on me for the afib. It did not show significant afib.  I believe it shows up once for 7 beats and then went away. 

[skate4life]

Spiriva, anticholinergic, also gave me PVC's for 1-2 hours after dosing. Plus I have a prolonged QT interval. Sometimes it was a bit scary as the PVC would hit on the T wave, but again it would only last a hour or less. I have my own miniature EKG real live monitor I hold in my hands. No sign of AFib. As time has gone by, none of this happens much anymore unless I am sick or badly dehydrated.

[judi]

Thanks Skate4Life,

I looked up PVCs and that seems to describe what happens.  Article said they could be triggered by caffeine and I have noticed that eating  dark chocolate  when I am taking Tudorza or Atrovent seems to be what does it most of the time.   Happy to hear yours went away.