Study of Electrocardiographic Abnormalities in Patients with Chronic Obstructive Pulmonary Disease and its Correlation With Severity

Introduction: The current study aimed to identify the electrocardiographic (ECG) changes in chronic obstructive pulmonary disease (COPD) patients and their correlation to severity. Methods: A prospective observational study was conducted on 100 patients with COPD with expiratory volume in the first second (FEV1)<0.7. Patients were categorized according to GOLD criteria and underwent Spirometry and ECG. Results: Among the COPD cases, 40% belonged to severe airflow limitation followed by very severe (32%), moderate (22%), and mild (6%) categories. The mean forced FEV1% in mild, moderate, severe, and very severe COPD was 81.3+0.57, 63.9+6.28, 41.15±4.59, and 25.625±2.41, respectively (P<0.05). The higher risk factor for COPD is smoking in 80% with a mean pack of 20.67±6.5 years. The most ECG abnormality in COPD patients was right ventricular hypertrophy (RVH) (52%), followed by right bundle branch block (RBBB) in 40% of patients, right axis deviation (34%), P pulmonale (32%), and atrial fibrillation in 22% of COPD cases, respectively. Furthermore, there was a strong association between ECG abnormalities and COPD severity. COPD patients with a poor FEV1/FVC% ratio had more ECG abnormalities, and the ECG abnormalities were shown to be highly correlated with the severity, duration, and length of symptoms. Conclusion: COPD is a common condition in patients with a smoking history of>20 pack-years, being more common in males in their 5th decade of life. Moreover, low FEV1 values were associated with ECG abnormalities. As the duration/severity of the disease rises, ECG abnormalities become more common. To avoid cardiac mortality and morbidity, all COPD patients should undergo cardiac examination through ECG for the management of co-morbidities.