title: Pneumonia: an arrhythmogenic disease?
abstract: BACKGROUND
  Recent studies suggest that there is an increase in cardiovascular disease after pneumonia; however, there is little information on cardiac arrhythmias after pneumonia. The aims of this study were to assess the incidence of, and examine risk factors for, cardiac arrhythmias after hospitalization for pneumonia.
  
  
  METHODS
  We conducted a national cohort study using Department of Veterans Affairs administrative data including patients aged ≥65 years hospitalized with pneumonia in fiscal years 2002-2007, receiving antibiotics within 48 hours of admission, having no prior diagnosis of a cardiac arrhythmia, and having at least 1 year of Veterans Affairs care. We included only the first pneumonia-related hospitalization, and follow-up was for the 90 days after admission. Cardiac arrhythmias included atrial fibrillation, ventricular tachycardia/fibrillation, cardiac arrest, and symptomatic bradycardia. We used a multilevel regression model, adjusting for hospital of admission, to examine risk factors for cardiac arrhythmias.
  
  
  RESULTS
  We identified 32,689 patients who met the inclusion criteria. Of these, 3919 (12%) had a new diagnosis of cardiac arrhythmia within 90 days of admission. Variables significantly associated with increased risk of cardiac arrhythmia included increasing age, history of congestive heart failure, and a need for mechanical ventilation or vasopressors. Beta-blocker use was associated with a decreased incidence of events.
  
  
  CONCLUSIONS
  An important number of patients have new cardiac arrhythmia during and after hospitalization for pneumonia. Additional research is needed to determine whether use of cardioprotective medications will improve outcomes for patients hospitalized with pneumonia. At-risk patients hospitalized with pneumonia should be monitored for cardiac arrhythmias during the hospitalization.
authors.affiliation: University of Texas Health Science Center, San Antonio TX, USA.
authors.forename: Natalia
authors.initials: N
authors.lastname: Soto-Gomez
authors.forename: Antonio
authors.initials: A
authors.lastname: Anzueto
authors.forename: Grant W
authors.initials: GW
authors.lastname: Waterer
authors.forename: Marcos I
authors.initials: MI
authors.lastname: Restrepo
authors.forename: Eric M
authors.initials: EM
authors.lastname: Mortensen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D011014:Pneumonia / Q000453:epidemiology*; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology