Chronic Obstructive Pulmonary Disease and Sudden Cardiac Death: A Systematic Review

• Published in: Trends in cardiovascular medicine 2016-10, Vol.26 (7), p.606-613
• Main Authors: van den Berg, Marten E., MD, Stricker, Bruno H., PhD, Brusselle, Guy G., MD, PhD, Lahousse, Lies, PhD
• Format: Article
• Language: English
• Subjects: Arrhythmias, Cardiac - mortality; Arrhythmias, Cardiac - physiopathology; Arrhythmias, Cardiac - therapy; Cardiac arrest; Cardiac arrhythmia; Cardiovascular; Cardiovascular disease; Chronic obstructive pulmonary disease; COPD; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - prevention & control; Electrocardiography; Female; Health risk assessment; Humans; Male; Mortality; Predictive Value of Tests; Prognosis; Pulmonary Disease, Chronic Obstructive - mortality; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Risk Assessment; Risk Factors; Sex Factors; Sudden cardiac death; Ventricular arrhythmia
• ISSN: 1050-1738; 1873-2615
• DOI: 10.1016/j.tcm.2016.04.001

Background Both chronic obstructive pulmonary disease (COPD) and sudden cardiac death (SCD) are major health burdens. A number of studies have addressed their interrelationship, but currently no systematic review has been published. Our objective is to give an overview of the literature of the association between COPD and SCD. Methods A search on PubMed with both MeSH headings and free-text key words was performed. We selected all original articles of studies in humans that assessed COPD on the one hand and SCD, electrocardiographic markers for SCD, ventricular arrhythmias or asystole on the other. Results The electronic search yielded 251 papers, from which 27 full publications were selected after careful evaluation of the full-text papers. In these studies, COPD was associated with a prolonged and shortened QT interval. In patients with a myocardial infarction (MI), COPD was associated with an increased risk of ventricular arrhythmias and decreased survival. COPD was a risk factor for SCD both in cardiovascular patient groups and in community based studies, independent from cardiovascular risk profile. Studies of the potential impact of respiratory treatment on the occurrence of SCD showed conflicting results. Conclusion Cumulating evidence associates COPD with an increased risk of SCD. Asystole and pulseless electric activity could be more common than VT/VF in deaths associated with COPD. Underlying mechanisms explaining this association require further investigation.