Key result
In patients with COPD, deceleration capacity was a significant predictor of supraventricular tachycardias (AUC 0.76; 95% CI 0.62-0.90; P=0.002) and combined ventricular arrhythmias.
Why the study?
Does the measurement of deceleration and acceleration capacities predict arrhythmic risk in patients with COPD?
Cohort (n=111)
Does the measurement of deceleration and acceleration capacities predict arrhythmic risk in patients with COPD?
Deceleration capacity and acceleration capacity derived from 24-hour Holter monitoring can serve as predictors for supraventricular and ventricular arrhythmias in patients with COPD.
Answers are grounded in this paper and cite their sources.
May aid arrhythmia risk stratification in COPD; hypothesis-generating and requires prospective validation.
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have an increased risk for both supraventricular and ventricular arrhythmias. Autonomic dysregulation may be responsible for the development of arrhythmias in these patients, and its analysis could be useful for identifying those at high risk for arrhythmias. STUDY QUESTION: Our purpose is to analyze the role of acceleration capacity (AC) and deceleration capacity (DC), novel markers of the autonomic balance, as potential arrhythmic risk predictors in patients with COPD. STUDY DESIGN: We prospectively included 47 patients diagnosed with COPD, and a control group of 64 age-matched subjects without COPD. AC and DC values were obtained using 24-hour Holter monitoring. The arrhythmias were isolated premature atrial complexes, supraventricular tachycardias, isolated premature ventricular beats (PVC), and combined ventricular arrhythmias consisting in ventricular tachycardias or more than 10 PVC per hour. RESULTS: Supraventricular arrhythmias and isolated PVC were more frequent in the COPD group. The DC was significantly lower (3.10 vs. 5.60, P < 0.0001) and AC higher (-4.60 vs. -6.60, P = 0.002) in patients with COPD. DC was identified as a predictor of arrhythmic events with an area under the curve (AUC) for premature atrial complexes >70/d of 0.72 (0.56-0.87, P = 0.013), for supraventricular tachycardias 0.76 (0.62-0.90, P = 0.002), and for combined ventricular arrhythmias 0.69 (0.54-0.82, P = 0.025). AC was predictor only for combined ventricular arrhythmias with an AUC of 0.74 (0.58-0.85, P = 0.002). CONCLUSIONS: Patients with COPD associate a significant autonomic imbalance and a higher incidence of arrhythmias. DC could be a strong predictor for supraventricular and ventricular arrhythmias in patients with COPD with no clinically apparent cardiac disease. AC could be useful alongside with DC regarding the risk for ventricular arrhythmias, but seems to have lesser value as a predictor for supraventricular arrhythmias.
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Buzea et al. (2016) conducted a cohort in Chronic Obstructive Pulmonary Disease (n=111). Deceleration capacity (DC) and acceleration capacity (AC) was evaluated on Supraventricular tachycardias (AUC 0.76, 95% CI 0.62-0.90, p=0.002). In patients with COPD, deceleration capacity was a significant predictor of supraventricular tachycardias (AUC 0.76; 95% CI 0.62-0.90; P=0.002) and combined ventricular arrhythmias.
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