Factors associated with the development of atrial fibrillation in COPD patients: the role of P-wave dispersion.
BACKGROUND
Supraventricular tachyarrhythmia is a common problem in chronic obstructive pulmonary disease (COPD) patients. The purpose of this study is to analyze the factors associated with paroxysmal atrial fibrillation (AF) in COPD patients.


METHODS
Forty COPD patients (38 male, 2 female, mean age 60 +/- 9 years) and 33 healthy controls (29 male, 4 female, mean age: 58 +/- 10 years) were included in this study. Echocardiography, 24-hour ambulatory and 12-lead ECG, pulmonary function tests, arterial blood gases, and serum electrolytes were measured. On ECG, maximum (P(max)) and minimum (P(min)) duration of P wave and its difference, P-wave dispersion (PWd), were measured.


RESULTS
On echocardiography, diastolic dysfunction was found in 14 of the 40 (35%) COPD patients. Heart rate variability analysis revealed that COPD patients had decreased SDANN, SDNN, SDNNIDX in time-domain, and decreased LF in frequency domain parameters. Fourteen of the 40 COPD patients (35%) had AF. Patients with AF were older (57 +/- 10 vs 64 +/- 5 years, P = 0.03) and had lower SDANN, SDNN, and LF/HF ratio as compared to patients without AF in univariate analysis. All P-wave intervals (P(max), P(min,) and PWd) were increased in COPD patients compared to controls. P-wave dispersion was significantly increased in COPD patients with AF, as compared to patients without AF (57 +/- 11 vs 44 +/- 7 ms, P = 0.001). In logistic regression analysis PWd was found to be the only factor associated with the development of AF (P = 0.04).


CONCLUSIONS
The presence of AF was significantly related to the prolongation of PWd, but not with pulmonary function, arterial blood gasses, and left and right atrial function.
Tükek
Tufan
T
Department of Internal Medicine, Istanbul School of Medicine, Turkey. Tufan.tukek@hotmail.com
Yildiz
Pinar
P
Akkaya
Vakur
V
Karan
Mehmet Akif
MA
Atilgan
Dursun
D
Yilmaz
Veysel
V
Korkut
Ferruh
F
D017677:Age Distribution; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011336:Probability; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution