Frequency of New-Onset Atrial Fibrillation in Chronic Obstructive Pulmonary Disease Patients: Insights from A Hospital-Based Cross-Sectional Study

OBJECTIVES This study aimed to determine the frequency of new-onset atrial fibrillation (AF) in patients with chronic obstructive pulmonary disease (COPD).METHODOLOGY This cross-sectional study was conducted in the Department of Medicine at Hayatabad Medical Complex, Peshawar, Pakistan, from July 20, 2023, to January 15, 2025. Patients of COPD who were in normal sinus rhythm within the three months before admission were eligible for the study. Patients with the following were excluded: Ischemic heart disease, mitral valve disease, left-sided heart failure, diabetes mellitus, hypertension, hypo- or hyperkalemia, or thyroid disorders. A total of 147 patients who met the inclusion and exclusion criteria were enrolled in the study. All study participants underwent an electrocardiogram on admission and daily until discharge to look for new-onset AF. RESULTSMost patients were male (74.1%, n = 109) with a median age of 60 years (IQR: 53–67) and a median duration of COPD of 5 years (IQR: 4–7). New-onset AF was identified in 22 patients (15%; 95% CI: 9–21%). Patients with AF were significantly older than those without AF (71.5 years [IQR: 63.75–75.5] versus 58 years [IQR: 52–65], p < 0.001). Likewise, patients with AF had a significantly longer duration of COPD [8 years (IQR: 6 – 9)] than those without AF [5 years (IQR: 4 – 7)] (p<0.001). There was no significant difference in the frequency of AF by gender. CONCLUSION Older age and higher duration of COPD are significant risk factors for the development of AF in patients with COPD. Patients with COPD need regular surveillance for the timely diagnosis of AF and subsequent risk stratification to guide optimal management.