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Dr. Seema
Dr. Kamna Tiwari
Dr. Ajay Pal Singh
Dr.Sanjay Rawat


Chronic obstructive pulmonary disease,, arrhythmias, Holter monitoring, COPD severity, right heart dysfunction.



Introduction- Chronic obstructive pulmona1y disease (COPD) is a prevalent respiratory condition characterized by airflow limitation that is not completely reversible, with a forced expiratory volume in one second to forced vital capacity (FEVl/FVC) ratio of less than 70%. It ranks as the fom1h leading cause of mortality worldwide, following myocardial infarction, cancer, and stroke. COPD is associated with significant morbidity and mortality, and cardiovascular events have been identified as the leading cause of death in COPD patients

 Aims Objective: This prospective cohort study aimed to investigate ‘’Compare the ECG findings, ECHO findings and Holter monitoring  findings’’ will be carried out in the Department of Medicine, J.A. Group of Hospitals, Gwalior from June 2020 to June 2021

Methods: The study included 100 diagnosed cases of COPD, divided into stable COPD and acute exacerbations. Routine blood investigations, electrocardiogram (ECG), 2D echocardiography, and 24-hour Holter monitoring were conducted to assess cardiac rhythm disturbances. The type of arrhythmia was noted for each patient. Statistical analysis was performed using SPSS 26 software.

Results: Among the COPD patients, 53% had supraventricular ectopic, 20% had atrial tachycardia, 16% had conduction abnormalities, and 10% had ventricular ectopics. Males had a higher prevalence of COPD and arrhythmias compared to females. ECG abnormalities associated with right heart dysfunction, such as P-pulmonale, right ventricular hypertrophy (RVH), and right bundle branch block (RBBB), were more prevalent in patients with severe COPD. Sinus tachycardia was more common in severe COPD patients. ECG abnormalities showing Right heart dysfunction like P- pulmonale +RVH +RBBB and P-Pulmonale +Right atrial enlargement+ Right ventricular hypertrophy (RVH) were significantly higher in patients with GOLD stage III/IV.

 Conclusion: The study findings highlight the relationship between COPD severity and the presence of arrhythmias. Patients with severe COPD had a higher incidence of ECG abnormalities associated with right hea11 dysfunction. The prevalence of arrhythmias in COPD patients was estimated at 12-14%, with supraventricular ectopics and atrial tachycardia being the most common types observed. Understanding the prevalence and types of arrhythmias in COPD patients can guide appropriate monitoring and interventions to reduce arrhythmia-related complications.

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