[Sudden Cardiac Death in Patients With Chronic Obstructive Pulmonary Disease]

Area of Science:

• Cardiology
• Pulmonology
• Public Health

Background:

• Chronic obstructive pulmonary disease (COPD) is associated with a 2-3 times higher risk of cardiovascular mortality compared to the general population.
• The incidence of COPD and ischemic heart disease (IHD) increases with age, frequently co-occurring in patients over 40.
• COPD exacerbations and combined cardiovascular diseases elevate the risk of sudden cardiac death (SCD).

Purpose of the Study:

• To review data on sudden cardiac death (SCD) in patients with chronic obstructive pulmonary disease (COPD).
• To identify risk factors for SCD in COPD patients.
• To discuss the role of arrhythmias and comorbidities in SCD pathogenesis and management.

Main Methods:

• Review of existing studies and population data on COPD, cardiovascular mortality, and SCD.
• Analysis of 24-hour ECG monitoring data in COPD patients.
• Examination of the multifactorial pathogenesis of arrhythmias in COPD.

Main Results:

• COPD is linked to an elevated risk of SCD, particularly in patients with frequent exacerbations within 5 years of diagnosis.
• SCD risk is higher in COPD patients with co-existing cardiovascular diseases (myocardial infarction, hypertension, arrhythmias), severe disease, or frequent exacerbator phenotype.
• Supraventricular arrhythmias, including atrial fibrillation, are prevalent in COPD, while ventricular arrhythmias are more common after myocardial infarctions.

Conclusions:

• Arrhythmia development is a key factor in SCD among COPD patients.
• Targeted detection of comorbidities is essential for personalized pharmacotherapy in COPD patients.
• Limiting certain medications like short-acting bronchodilators, methylxanthines, and QT-prolonging drugs is recommended for COPD patients at high SCD risk.