In-hospital arrhythmias detected by Holter monitoring are highly prevalent among patients hospitalized for AECOPD, NT-proBNP is consistently associated with multiple arrhythmia phenotypes and may aid arrhythmic risk stratification, and hypercapnia, but not arrhythmia status, remained independently associated with COPD-related readmission despite the limited sample and observational design.
Arrhythmias were present in most patients hospitalized for AECOPD who underwent continuous Holter monitoring.
Atrial arrhythmias were the most frequent subtype, followed by ventricular arrhythmias and AF/AFL, and over one-fifth of patients had multiple arrhythmia types.
Older age, male sex, higher heart rate, elevated NT-proBNP, and larger left atrial diameter were independently associated with in-hospital arrhythmias.
NT-proBNP was consistently associated with all arrhythmia phenotypes and showed moderate discrimination for identifying arrhythmias.
AF/AFL was independently associated with prolonged hospitalization.
Hypercapnia (PaCO2 ≥45 mmHg) was independently associated with a higher risk of COPD-related readmission, whereas arrhythmia status was not.
This study looked at 548 patients hospitalized for a flare-up of chronic obstructive pulmonary disease (COPD) who wore continuous heart rhythm monitors (Holter monitors). About 6 in 10 patients had at least one abnormal heart rhythm during their stay. Rhythm problems in the upper heart chambers were the most common, followed by those in the lower chambers and atrial fibrillation or flutter, and about one in five patients had more than one type. Older age, male sex, a faster heart rate, a larger left atrium, and higher levels of a blood marker called NT-proBNP were linked to having these arrhythmias. NT-proBNP showed moderate ability to identify who had arrhythmias, suggesting it might help flag patients at higher risk. Atrial fibrillation or flutter was linked to longer hospital stays. When researchers followed patients for readmission related to COPD, high blood carbon dioxide levels (hypercapnia) were associated with a higher risk of returning to hospital, but having an arrhythmia was not. This research suggests that checking carbon dioxide levels and NT-proBNP could be useful for assessing risk, though the study was from a single center, retrospective, and fairly small, so the findings need confirmation in further studies.
Ding N, Chen J, Qiu W, Lu Y, Chen Z, Cai R, et al.. (2026). Holter-Detected Arrhythmias in Acute Exacerbations of COPD: NT-proBNP Correlates and Hypercapnia Associated with COPD-Related Readmission.. International journal of chronic obstructive pulmonary disease. https://doi.org/10.2147/COPD.S642161