Electrocardiographic Abnormalities in Patients with Severe versus Mild or Moderate Chronic Obstructive Pulmonary Disease Followed in an Academic Outpatient Pulmonary Clinic

Background: The prevalence of some electrocardiographic (ECG) abnormalities in severe versus mild or moderate chronic obstructive pulmonary disease (COPD) has been reported.

Methods: ECGs were interpreted blindly in 63 patients with severe COPD (group 1) versus 83 patients with mild or moderate COPD (group 2).

Results: Right atrial enlargement (RAE) occurred in 44% of group 1 and 15% of group 2 patients (P < 0.001). Right ventricular hypertrophy (RVH) occurred in 29% of group 1 and 4% of group 2 patients (P < 0.001). Right bundle branch block (RBBB) occurred in 29% of group 1 and 11% of group 2 patients (P < 0.01). Marked clockwise rotation of heart occurred in 40% of group 1 and 18% of group 2 patients (P < 0.005). Low voltage in limb leads occurred in 24% of group 1 and 11% of group 2 patients (P < 0.05). A QS pattern in leads III and aVF occurred in 16% of group 1 and 4% of group 2 patients (P < 0.01). Left axis deviation (LAD) occurred in 16% of group 1 and 4% of group 2 patients (P < 0.01). Premature atrial complexes (PACs) occurred in 19% of group 1 and 7% of group 2 patients (P < 0.05). Supraventricular tachyarrhythmias (SVTs) occurred in 16% of group 1 and 5% of group 2 patients (P < 0.025).

Conclusions: RAE, RVH, RBBB, marked clockwise rotation of heart, a QS pattern in leads III and aVF, LAD, PACs, and SVTs were significantly more prevalent in patients with severe COPD than in patients with mild or moderate COPD.

Ann Noninvasive Electrocardiol 2011;16(1):30–32