Chronic obstructive pulmonary disease and atrial fibrillation
| Autor: | Michael Arzt, Dominik Linz, Manuel Sastry, Jeroen M.L. Hendriks, Hein Heidbuchel, Prashanthan Sanders, Sami O. Simons, Stanley Nattel, Isabelle C. Van Gelder, Jonathan M. Kalman, Geertjan Wesseling, Frits M.E. Franssen, Adrian D. Elliott, Michiel Rienstra, Ulrich Schotten, Harry J.G.M. Crijns |
|---|---|
| Přispěvatelé: | Cardiovascular Centre (CVC) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Spirometry
CLINICAL-OUTCOMES medicine.medical_specialty Heart disease Exacerbation medicine.medical_treatment Population Medizin EXERTIONAL DYSPNEA Hyperinflation Catheter ablation 030204 cardiovascular system & hematology Cardioversion Pulmonary Disease Chronic Obstructive 03 medical and health sciences 0302 clinical medicine Internal medicine Atrial Fibrillation HATCH SCORE medicine COPD Humans Prospective Studies 030212 general & internal medicine Hypoxia education Aged education.field_of_study medicine.diagnostic_test business.industry Chronic obstructive pulmonary disease Atrial fibrillation medicine.disease RESPIRATORY EVENTS PREVALENCE respiratory tract diseases 2016 ESC GUIDELINES LUNG-FUNCTION RISK-FACTORS Catheter Ablation Cardiology HEART-FAILURE Human medicine Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents |
| Zdroj: | European heart journal European Heart Journal, 42(5), 532-540. Oxford University Press |
| ISSN: | 0195-668X |
| Popis: | Chronic obstructive pulmonary disease (COPD) is highly prevalent among patients with atrial fibrillation (AF), shares common risk factors, and adds to the overall morbidity and mortality in this population. Additionally, it may promote AF and impair treatment efficacy. The prevalence of COPD in AF patients is high and is estimated to be ∼25%. Diagnosis and treatment of COPD in AF patients requires a close interdisciplinary collaboration between the electrophysiologist/cardiologist and pulmonologist. Differential diagnosis may be challenging, especially in elderly and smoking patients complaining of unspecific symptoms such as dyspnoea and fatigue. Routine evaluation of lung function and determination of natriuretic peptides and echocardiography may be reasonable to detect COPD and heart failure as contributing causes of dyspnoea. Acute exacerbation of COPD transiently increases AF risk due to hypoxia-mediated mechanisms, inflammation, increased use of beta-2 agonists, and autonomic changes. Observational data suggest that COPD promotes AF progression, increases AF recurrence after cardioversion, and reduces the efficacy of catheter-based antiarrhythmic therapy. However, it remains unclear whether treatment of COPD improves AF outcomes and which metric should be used to determine COPD severity and guide treatment in AF patients. Data from non-randomized studies suggest that COPD is associated with increased AF recurrence after electrical cardioversion and catheter ablation. Future prospective cohort studies in AF patients are needed to confirm the relationship between COPD and AF, the benefits of treatment of either COPD or AF in this population, and to clarify the need and cost-effectiveness of routine COPD screening. |
| Databáze: | OpenAIRE |
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