[Sudden Cardiac Death in Patients With Chronic Obstructive Pulmonary Disease]

Abstract

The article contains review of data on the problem of sudden cardiac death (SCD) in patients with chronic obstructive pulmonary disease (COPD). Large studies have shown that risk of cardiovascular mortality in patients with chronic obstructive pulmonary disease (COPD) is 2-3 times greater than in general population. The incidence of COPD and ischemic heart disease (IHD) progressively rises with age. Combination of these diseases is often observed in clinical practice among patients older than 40 years. According to the population study published in 2015 COPD has been associated with elevated risk of SCD especially in patients with frequent exacerbations within 5 years after diagnosis. SCD risk rises in patients with combination of COPD and cardiovascular diseases (myocardial infarction, hypertension, disturbances of cardiac rhythm), with severe clinical course, with frequent exacerbator phenotype. One of main factors underlying SCD is development of arrhythmia. According to 24-hour ECG monitoring supraventricular arrhythmias including atrial fibrillation prevail in COPD. Ventricular rhythm disturbances have been registered in patients with COPD mostly after large myocardial infarctions. Pathogenesis of arrhythmias in COPD if multifactorial. Targeted detection of comorbidities would allow to take into consideration individual characteristics while choosing pharmaotherapy. In patients with COPD and high SCD risk one should limit use of broncholytics especially short-acting, methylxanthines, drugs with potential to induce QT prolongation.

Keywords: cardiac rhythm disturbances; chronic obstructive pulmonary disease (COPD); sudden cardiac death.