Abstract:
Background. Cardiovascular comorbidities, especially arrhythmias burden COPD patients
by exceeding the pulmonary pathology and worsening the outcomes of the disease leading
to increased morbidity and higher mortality rates. Recognition of these cardiovascular
complications is crucial for the overall prognosis of COPD.
Objective(s). Evaluation of the incidence and mechanisms of arrhythmias to optimize the
management of cardiovascular complications associated with chronic obstructive
pulmonary disease.
Materials and methods. The results were collected by conducting a literature and clinical
review of articles, clinical observations and data, and meta-analyses published from 2013 to
2024. Clinical databases like PubMed, GOLD COPD document 2023, and medRvix were
incorporated into the research process. The mentioned articles were then chosen and
reviewed.
Results. Arrhythmogenicity in COPD arises from multifactorial processes that lead to
structural and electrical myocardial changes and remodeling. The integrated analysis shows
an incidence of arrhythmias in 48% of patients with moderate and severe COPD, with atrial
fibrillation (11%), premature atrial contraction (4%) and sinus tachycardia (6%)
predominating. Shortened P-wave duration, a prolonged PR interval and an increase in NTpro-BNP might predict the occurrence of atrial fibrillation. The presence of persistent
inflammation, chronic hypoxia and pulmonary hypertension eventually lead to myocardial
remodeling and endothelial dysfunction.
Conclusion(s). The link between COPD and arrhythmia requires clinical vigilance especially
during exacerbations. Atrial fibrillation was found to be the most common arrhythmia.
Optimal management includes arrhythmia screening, avoidance of pro-arrhythmic drugs in
high-risk patients and follow-up.
