IMPORTANCE OF ELECTROCARDIOGRAPHIC EVALUATIONIN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world and fourth leading cause after myocardial infarction, malignant diseases and cerebrovascular incidents. Patients with COPD are at increased risk of cardiovascular disease. Electrocardiography (ECG) carries valuable information about cardiac disease and prognosis. Aim: To evaluate major ECG changes and their corelation to COPD severity. Material and methods: Cross sectional study was conducted at 120 patients with COPD (age 40-75) and 60 subjects from general population without COPD, matched by age, gender and body mass index. All patients underwent resting ECG, 24 hour-ECG-Holter monitoring and pulmonary function tests. Results: Abnormal ECG is more prevalent in COPD (83,33%) than in controls (26,67%). ECG findings in COPD: atrial fibrillation (AFF) (13,33%), tachycardia (36,67%), right axis deviation (23,33%), p-pulmonale (41,67%), right bundle branch block (15%), premature supraventricular (PSCs) and ventricular (PVCs) contractions (15%). ECG abnormalities due to right ventricular hypertrophy are increasing with COPD severity. Mean oxygen saturation in patients with tachycardia is lower than in those without (79,5%<92,9%). 24-hour-ECG-Holter monitoring allows detection of arrhythmias in asymptomatic patients and detected abnormalities were significantly higher compared to resting 12-lead-ECG. 24-hour-ECG-Holter results: PSCs (56,67%), paroxysmal supraventricular tachycardia (20%), PVCs (41,66%), PVC bigeminy (15%), ventricular couplets (10%), un-sustained ventricular tachycardia (5%), atrio-ventricular block of first degree (1,67%). Conclusion: The prevalence of ECG abnormalities increases with COPD severity. Integrated-care approach for COPD patients is important for early detection of unrecognized coexisting cardiac disorders.