Chest
Volume 75, Issue 1, January 1979, Pages 8-11
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CLINICAL INVESTIGATIONS
Nocturnal vs Diurnal Cardiac Arrhythmias in Patients with Chronic Obstructive Pulmonary Disease

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Continuous electrocardiograms were recorded from ten patients with chronic obstructive pulmonary disease. During 24 hours of recording, the patients breathed air; and for 24 hours, they breathed oxygen at 2 L/min by nasal cannula. Oxygenation, as monitored by ear oximetric studies and by periodic analysis of arterial blood, showed frequent nocturnal desaturation. Nine patients demonstrated arrhythmias daring the monitoring period, and the frequency of premature ventricular contractions was significantly greater at night. Therapy with supplemental oxygen dramatically reduced the frequency of premature ventricular contractions in four patients, but the reduction in frequency of arrhythmias in the total group did not reach statistical significance. These results show that cardiac arrhythmias occur commonly at night during sleep in patients with chronic obstructive pulmonary disease. The data suggest that arterial desaturation may be responsible for some of these arrhythmias.

Section snippets

Materials and Methods

Ten patients with stable chronic obstructive pulmonary disease were chosen for study, with the criteria that their forced expiratory volume in one second (FEV1.0) be less that 1.15 L and their FEV1.0 expressed as a percentage of the forced vital capacity (FEV1.0/FVC%) be less than 60 percent.

In general, the patients had severe obstructive disease of the airways; the mean FEV1.0 was 0.76 L, the mean FEV1.0/FVC% was 38 percent, and the mean steady-state carbon monoxide diffusing capacity was 44

Results

We have previously reported in detail the results of the studies of pulmonary function in these patients.2

Discussion

A high frequency of cardiac arrhythmias in patients with chronic obstructive pulmonary disease was first reported by Corazza and Pastor3 in a retrospective study of ECGs randomly obtained from a mixed group of patients with pulmonary disease. Of these patients, 31 percent had arrhythmias. Three retrospective random reviews of ECGs have followed this initial observation;4, 5, 6 all examined mixed groups of patients with varied respiratory status and found a high prevalence of arrhythmias. A poor

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Supported by the Medical Research Service of the Veterans Administration.

Read in part before the American Thoracic Society, New Orleans, May 18, 1976, and published in abstract form in the American Review of Respiratory Disease (113:126, 1976)

Manuscrit received February 27; revision accepted May 10.

**

Currently Research Fellow, Cardiovascular Research Institute, School of Medicine, University of California, San Francisco.

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