A clinical study of cardiac rhythm disturbance in patients with chronic obstructive pulmonary disease using 24 hour Holter monitoring

Authors

  • Varsha S. Dabadghao Department of Medicine, Dr. DY Patil Medical College, Hospital and Research Centre, Pune, Maharashtra
  • Rajsinh Patil Department of Medicine, Dr. DY Patil Medical College, Hospital and Research Centre, Pune, Maharashtra
  • Suresh K. Sharma Department of Medicine, Dr. DY Patil Medical College, Hospital and Research Centre, Pune, Maharashtra
  • Arjun L. Kakrani Department of Medicine, Dr. DY Patil Medical College, Hospital and Research Centre, Pune, Maharashtra

DOI:

https://doi.org/10.18203/2320-6012.ijrms20160491

Keywords:

COPD, Arrhythmias, Holter monitoring

Abstract

Background: Chronic obstructive pulmonary disease (COPD) has been defined by GOLD (guidelines for obstructive lung disease) as a disease state characterised by airflow limitation that is not fully reversible, with FEV1/FVC <70%. COPD increases the risk of cardiac arrhythmias. In acute exacerbation and also in stable COPD, it has been found that arrhythmias are associated with more mortality. Holter monitoring enhances the possibility of observing cardiac rhythm during symptoms and can detect arrhythmias in asymptomatic patients. The aim of this study was to estimate the prevalence and types of arrhythmias in COPD patients and to correlate them with severity.

Methods: This was a cross-sectional prevalence, analytical study conducted for a period of two years. Fifty cases with sign and symptoms of COPD diagnosed on pulmonary function tests (PFT) as per GOLD’s criteria were included. Diagnosis of arrhythmia in COPD was on the basis of Holter monitoring. 24 hour Holter monitoring was done with Release 2.9 Digitrak XT Philips. The data was analysed using chi square test.

Results: The most common arrhythmias on Holter monitoring were atrial pair and atrial premature beats which were present in 29 (58%) and 25 (50%) patients respectively, atrial run (32%), ventricular premature beats (32%), ventricular couplets (30%), ventricular triplets (24%), ventricular trigeminy (24%) and ventricular run (22%). Atrial fibrillation was noted in 7 patients (14%).

Conclusions: The significant presence of supraventricular and ventricular arrhythmias in patients with COPD were detected on Holter monitoring.

 

References

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: Revised 2015. Global Initiative for Chronic Obstructive Lung Disease (GOLD). www.goldcopd.org.

Lopez AD, Shibuya K, Rao C, Mathers CD, Hansell AL, Held LS. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J. 2006;27:397-412.

Sin DD, Wu L, Man SF. The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature. Chest. 2005;127:1952-59.

Sidney S, Sorel M, Quesenberry CP, DeLuise C, Lanes S, Eisner MD. COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente Medical Care Program. Chest. 2005;128:2068-75.

Shih HT, Webb CR, Conway WA, Peterson E, Tilley B, Goldstein S. Frequency and significance of cardiac arrhythmias in chronic obstructive pulmonary disease. Chest. 1988;94:44-8.

Shoĭkhet IaN, Klester EB, Golovin VA. Heart rhythm disturbances in patients with chronic obstructive pulmonary disease in aggregate with coronary heart disease. Klin Med (Mosk). 2008;86(3):21-6.

Buch P, Friberg J, Scharling H, Lange P, Prescott E. Reduced lung function and risk of atrial fibrillation in the Copenhagen City Heart Study. Eur Respir J. 2003;21:1012-6.

Fuso L1, Incalzi RA, Pistelli R, Muzzolon R, Valente S, Pagliari G, et al. Predicting mortality of patients hospitalized for acutely exacerbated chronic obstructive pulmonary disease. Am J Med. 1995;98:272.

Miravitlles M, Moragas A, Hernández S, Bayona S, Llor C. It Possible to Identify Exacerbations of Mild to Moderate COPD That Do Not Require Antibiotic Treatment? Chest. 2013;144(5):1571-7.

Zaghla H, Atroush HA, Samir A, Kamal M. Arrythmias in patients with chronic obstructive pulmonary disease. Egyptian Journla of Chest Diseases and Tuberculosis. 2013;62(3):377-85.

Warnier MJ, Rutten FH, Numans ME, Kors JA, Tan HL, de Boer A et al. Electrocardiographic characteristics of patients with chronic obstructive pulmonary disease. COPD. 2013;10(1):62-71.

Cuttica MJ, Kalhan R, Shlobin OA, Shahzad Ahmadc, Gladwind M, Machadoe PF. Categorization and impact of pulmonary hypertension in patients with advanced COPD. Respiratory Medicine. 2010;104(12):1877-82.

Konecny T, Park JY, Somers KR, Konecny D, Orban M, Soucek F, et al. Relation of chronic obstructive pulmonary disease to atrial and ventricular arrhythmias. Am J Cardiol. 2014;114(2):272.

Terzano C, Romani S, Conti V, Paone G, Oriolo F, Vitarelli A. Atrial fibrillation in the acute, hypercapnic exacerbations of COPD. Eur Rev Med Pharmacol Sci. 2014;18(19):2908-17.

Downloads

Published

2016-12-27

How to Cite

Dabadghao, V. S., Patil, R., Sharma, S. K., & Kakrani, A. L. (2016). A clinical study of cardiac rhythm disturbance in patients with chronic obstructive pulmonary disease using 24 hour Holter monitoring. International Journal of Research in Medical Sciences, 4(3), 702–705. https://doi.org/10.18203/2320-6012.ijrms20160491

Issue

Section

Original Research Articles