Prognostic significance of pulmonary ventilation disorders in the development of arrhythmia recurrence in patients with chronic obstructive pulmonary disease and paroxysmal atrial fibrillation

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Abstract

Aim. To evaluate the prognostic value of pulmonary ventilation disorders in the development of arrhythmia recurrence in patients with chronic obstructive pulmonary disease (COPD) and paroxysmal atrial fibrillation (AF).

Materials and methods. The study included 387 patients with COPD, who were divided into two groups: group 1 consisted of 54 (13.9%) patients with COPD and paroxysmal AF, who had AF paroxysm during hospitalization; group 2 (comparison group) – 333 (86.1%) patients with COPD without arrhythmia.

Results. Significantly more severe bronchial obstruction was found in group 1 patients than in group 2 patients. A one-factor regression analysis revealed that a decrease in forced exhalation volume in 1st second of less than 35% increased the risk of AF recurrence in patients with COPD by 2.49 times (odds ratio 0.401, 95% confidence interval 0.218–0.856; p=0.012). According to the results of bodyplethysmography, patients in group 1 showed a significant decrease in the diffusion capacity of the lungs for carbon monoxide, an increase in aerodynamic and specific bronchial resistance compared with group 2, a decrease in the diffusion capacity of the lungs of less than 8 ml/min/mm. Mercury increased the risk of AF paroxysm in COPD patients by 1.297 times (odds ratio 0.771, 95% confidence interval 0.53–0.92; p=0.013). To assess the risk of arrhythmia recurrence in patients with COPD and paroxysmal AF, we developed a mathematical model (sensitivity – 73.8%, specificity – 70.3%).

Conclusion. Decreased ventilation capacity of the lungs increases the risk of arrhythmia recurrence in patients with COPD and paroxysmal AF.

About the authors

Valery I. Podzolkov

Sechenov First Moscow State Medical University (Sechenov University)

Email: tarzimanova@mail.ru
ORCID iD: 0000-0002-0758-5609

д-р мед. наук, проф., зав. каф. факультетской терапии №2, дир. клиники факультетской терапии №2 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Aida I. Tarzimanova

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: tarzimanova@mail.ru
ORCID iD: 0000-0001-9536-8307

д-р мед. наук, проф. каф. факультетской терапии №2 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Evgeniya V. Kazantseva

Sechenov First Moscow State Medical University (Sechenov University)

Email: tarzimanova@mail.ru
ORCID iD: 0000-0001-8552-5364

аспирант каф. факультетской терапии №2 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

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2. Fig. 1. SpO2 value in the study groups.

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3. Fig. 2. ROC curve of the sensitivity and specificity of the mathematical model to assess the risk of recurrence of an arrhythmia attack in patients with chronic obstructive pulmonary disease and paroxysmal atrial fibrillation.

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