Arrhythmias Associated with Acute Respiratory Failure in Patients with Chronic Airway Obstruction

Abstract

Electrocardiograms of 70 patients with chronic airway obstruction were examined from 148 consecutive admissions for acute respiratory failure. Forty-seven percent of the patients had major supraventricular or ventricular arrhythmias. These arrhythmias were documented on 36 percent of hospital admissions. Supraventricular arrhythmias were slightly more common than ventricular arrhythmias, the most frequent being atrial tachycardia and multifocal atrial tachycardia. Supraventricular arrhythmias tended to recur. Ventricular arrhythmias were often preceded by premature ventricular contractions, supraventicular arrhythmias, or other ventricular arrhythmias. Ventricular arrhythmias were associated with a poor prognosis; 70 percent of patients with ventricular arrhythmia died during the hospital admission and none survived to the end of the study period. These data suggest that continuous electrocardiographic monitoring of chronic airway obstruction patients with acute respiratory failure would be of value in predicting prognosis and identifying patients likely to develop serious arrhythmias; these findings may have therapeutic implications.