Factors associated with the development of atrial fibrillation in COPD patients: the role of P-wave dispersion.

Background: Supraventricular tachyarrhythmia is a common problem in chronic obstructive pulmonary disease (COPD) patients. The purpose of this study is to analyze the factors associated with paroxysmal atrial fibrillation (AF) in COPD patients.
Methods: Forty COPD patients (38 male, 2 female, mean age 60 +/- 9 years) and 33 healthy controls (29 male, 4 female, mean age: 58 +/- 10 years) were included in this study. Echocardiography, 24-hour ambulatory and 12-lead ECG, pulmonary function tests, arterial blood gases, and serum electrolytes were measured. On ECG, maximum (P(max)) and minimum (P(min)) duration of P wave and its difference, P-wave dispersion (PWd), were measured.
Results: On echocardiography, diastolic dysfunction was found in 14 of the 40 (35%) COPD patients. Heart rate variability analysis revealed that COPD patients had decreased SDANN, SDNN, SDNNIDX in time-domain, and decreased LF in frequency domain parameters. Fourteen of the 40 COPD patients (35%) had AF. Patients with AF were older (57 +/- 10 vs 64 +/- 5 years, P = 0.03) and had lower SDANN, SDNN, and LF/HF ratio as compared to patients without AF in univariate analysis. All P-wave intervals (P(max), P(min,) and PWd) were increased in COPD patients compared to controls. P-wave dispersion was significantly increased in COPD patients with AF, as compared to patients without AF (57 +/- 11 vs 44 +/- 7 ms, P = 0.001). In logistic regression analysis PWd was found to be the only factor associated with the development of AF (P = 0.04).
Conclusions: The presence of AF was significantly related to the prolongation of PWd, but not with pulmonary function, arterial blood gasses, and left and right atrial function.