Are the Exacerbations of Chronic Obstructive Pulmonary Disease a Risk Factor for Cardiac Arrhythmia?

Abstract

Aim: Hypoxemia, hypercapnia, and automaticity—which are dependent on exacerbation—increase the risk of arrhythmia by causing abnormal atrial and ventricular repolarization in chronic obstructive pulmonary disease (COPD). This study aimed to foresee the possibility of arrhythmia by evaluating the electrocardiograms (ECG) of patients having COPD attacks. Material and Method: In total, 120 patients (66 in the COPD group and 54 in the control group) were included. The differences between the two groups were statistically examined by determining (in milliseconds) QT and QTc interval maximum (max), minimum (min), and dispersion (disp); T-wave peak to end (Tp-e) max, min, and disp; Tp-e max/QT max, Tp-e max/QTc max proportions; and P wave max, min, and disp duration in the ECG parameters of the patients. Results: Forty-eight (64%) of the males included in the study were in the COPD group and 27 (36%) in the control group, whereas 18 (40%) of the females were in the COPD group and 27 (60%) in the control group. There was no significant difference between the ages of the patients and the levels of sodium and potassium (p = 0.189, 0.353, and 0.071). There was a significant difference between QT max and min in the groups, whereas there was no difference in terms of QT disp (p < 0.001, p < 0.001, and p = 0.490). There was a significant difference between the Tp-e max, min, and disp values in the COPD and control groups (p = 0.041, p < 0.001, and p = 0.001, respectively). There was no significant difference between the groups in terms of the P max duration (p = 0.442), but significant differences between the two groups in P min and disp durations were determined (p = 0.003 and p < 0.001, respectively). In receiver operating characteristic analysis made for P disp and Tp-e disp values in which a firm difference was made, 30 ms was determined as the cutoff for both parameters. Conclusion: To our knowledge, this is the first study that the rise of the dispersions of P wave and Tp-e intervals (without rise of QTc disp.) is detected on the evaluation of atrial and ventricular arrhythmia risks on COPD acute attacks.