Chronic obstructive pulmonary disease and atrial fibrillation: an interdisciplinary perspective.

European Heart Journal
Sami O SimonsDominik Linz

Abstract

Chronic obstructive pulmonary disease (COPD) is highly prevalent among patients with atrial fibrillation (AF), shares common risk factors, and adds to the overall morbidity and mortality in this population. Additionally, it may promote AF and impair treatment efficacy. The prevalence of COPD in AF patients is high and is estimated to be ∼25%. Diagnosis and treatment of COPD in AF patients requires a close interdisciplinary collaboration between the electrophysiologist/cardiologist and pulmonologist. Differential diagnosis may be challenging, especially in elderly and smoking patients complaining of unspecific symptoms such as dyspnoea and fatigue. Routine evaluation of lung function and determination of natriuretic peptides and echocardiography may be reasonable to detect COPD and heart failure as contributing causes of dyspnoea. Acute exacerbation of COPD transiently increases AF risk due to hypoxia-mediated mechanisms, inflammation, increased use of beta-2 agonists, and autonomic changes. Observational data suggest that COPD promotes AF progression, increases AF recurrence after cardioversion, and reduces the efficacy of catheter-based antiarrhythmic therapy. However, it remains unclear whether treatment of COPD improves AF o...Continue Reading

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Citations

Dec 9, 2020·International Journal of Environmental Research and Public Health·Jiangang ChenJing Zhang
Mar 6, 2021·Circulation. Cardiovascular Quality and Outcomes·Aditya BhatTimothy C Tan
Dec 12, 2020·IJC Heart & Vasculature·Dominik Linz, Dobromir Dobrev
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