Study of Electrocardiographic Abnormalities in Patients with Chronic Obstructive Pulmonary Disease and its Correlation With Severity

The current study aimed to identify the electrocardiographic (ECG) changes in chronic obstructive pulmonary disease (COPD) patients and their correlation to severity.

A prospective observational study was conducted on 100 patients with COPD with expiratory volume in the first second (FEV1) < 0.7. Patients were categorized according to GOLD criteria and underwent Spirometry and ECG.

Among the COPD cases, 40% belonged to severe airflow limitation followed by very severe (32%), moderate (22%), and mild (6%) categories. The mean forced FEV1% in mild, moderate, severe, and very severe COPD was 81.3 + 0.57, 63.9 + 6.28, 41.15 ± 4.59, and 25.625 ± 2.41, respectively (P < 0.05). The higher risk factor for COPD is smoking in 80% with a mean pack of 20.67 ± 6.5 years. The most ECG abnormality in COPD patients was right ventricular hypertrophy (RVH) (52%), followed by right bundle branch block (RBBB) in 40% of patients, right axis deviation (34%), P pulmonale (32%), and atrial fibrillation in 22% of COPD cases, respectively. Furthermore, there was a strong association between ECG abnormalities and COPD severity. COPD patients with a poor FEV1/FVC% ratio had more ECG abnormalities, and the ECG abnormalities were shown to be highly correlated with the severity, duration, and length of symptoms.

COPD is a common condition in patients with a smoking history of > 20 packyears, being more common in males in their 5th decade of life. Moreover, low FEV1 values were associated with ECG abnormalities. As the duration/severity of the disease rises, ECG abnormalities become more common. To avoid cardiac mortality and morbidity, all COPD patients should undergo cardiac examination through ECG for the management of co-morbidities.