Arrhythmias in Chronic Lung Disease

Patients who have pulmonary disorders, especially those with chronic obstructive pulmonary disease, often have atrial and ventricular arrhythmias. However, the pathogenesis of these arrhythmias is complex and may involve many factors. For example, these individuals often have anatomic cardiac abnormalities, such as right ventricular hypertrophy, with or without associated congestive heart failure. Cigarette smoking is protean in patients with chronic obstructive pulmonary disease, and, consequently, atherosclerotic heart disease may be present with its attendant complications. Hypoxia and hypercapnia occur in these patients and, under appropriate circumstances, can be arrhythmogenic. Patients may receive drugs that can cause arrhythmias. For example, diuretics may lead to hypokalemia, and aminophylline and adrenergic bronchodilator drugs may create the environment necessary for arrhythmias to emerge. Finally, patients with pulmonary disease are prone to any arrhythmias that occur in other people, for example, atrioventricular nodal reentry and Wolff-Parkinson-White reentry.