Cardiac arrhythmias are common in COPD patients and are a major cause of morbidity and
mortality, especially the persistent supraventricular and ventricular rhythm disorders.
Multiple factors such as hypoxemia! hypercapnia, acidosis. right heart failure and medication
e.g. xanthene derivatives, steroids and β2 agonists have been implicated.
Recently P wave dispersion and QTc wave dispersion have been reported to predict the
development of atrial fibrillation and ventricular arrhythmias respectively.
To determine the prevalence of cardiac arrhythmias among patients with COPD, and describe
the associated factors.
Cross-sectional descriptive study done over a period of six months prospectively
Outpatient Chest clinic and chest ward, Kenyatta National Hospital.
COPD patients who met the eligibility criteria.
A total of207 patients with COPD were studied. The male to female ratio was 2.3: I. The
mean (SO) age of the study population was 66.7(8.5.) years. The median duration of COPD
diagnosis was 1 year (range-0- 6 years) and the median duration of follow-up was also 1 year
(range- 0-5 years). Past smokers accounted for 99.8% while only 1% were current
smokers.The main occupation sited was agriculture at 72.9%.Most of the patients(97.1%)
were on medication with majority (35.7%) on a combination of LAB A, SABA, oral
theophylline, and inhaled steroids. A minority (21.6%) used the medications regularly; 'the
The prevalence of arrhythmia was 14% (95%C1 9.3-18.7). The commonest arrhythmia was
VPB (51.7%). Atrial fibrillation accounted for 24%. Atrial fib +VPB accounted for 10.3%,
while 13.8% had 3° heart block. Majority (96%) of those with arrhythmias were in stage III &
IV of COPD.
A higher COPD stage, Hypokalemia, hypomagnesaemia, hypoxia, hypercapnia, acidosis, and
longer QTc & P-wave dispersion was significantly associated with arrhythmias (p