COPD and AFib: Is There a Link?

If you have COPD, you and your doctor are no doubt working hard to take care of your lungs. But did you know that your heart health is also a key priority?

Having COPD makes you more likely to develop a common heart rhythm problem called atrial fibrillation (AFib).

If you have both conditions, it’s important to get both under control. AFib complicates COPD, and COPD can make it harder for AFib treatments to succeed. Make sure you follow your doctor’s advice to keep your COPD symptoms and AFib in check. Doing that will go a long way toward keeping you healthier longer.

If you only have COPD now, there’s a lot you can do to help manage your risk of getting AFib.

How COPD and AFib Are Connected

The heart and lungs are like fraternal twins. Each has its own role, but they also work as a pair. In chronic obstructive pulmonary disease (COPD), the close relationship between the heart and lungs can put you at risk for an abnormal heart rhythm (arrhythmia) such as AFib.

AFib is the most common arrhythmia. It's caused by erratic beating in your heart’s two upper chambers, the atria. Your atria pump oxygen-poor blood from the body to the lungs, and they send oxygen-rich blood from the lungs to the body. Some people describe AFib as feeling like a flutter, a racing heart, skipped beats, or lightheadedness, but others feel nothing at all.

In a study of more than 1.3 million people with COPD, about 18% also had AFib. It’s more likely to start as your COPD worsens.

Doctors don’t know exactly how COPD and atrial fibrillation are connected. But given the close ties between the heart and lungs, researchers think AFib and COPD may be related in some of the following ways.

Some medications that treat COPD, such as inhaled bronchodilators, can raise your heart rate and lower your potassium levels, both of which can trigger AFib.

Also, if you take a type of medicine called glucocorticoids for a long time to treat COPD, that can cause high blood pressure, diabetes, heart failure, and blood vessel damage. Over time, this raises your chances of developing AFib.

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If you smoke, that may lead to physical changes in your atria that can cause AFib or make it worse.

Also, hypoxia (low levels of oxygen) causes veins and arteries to constrict and the heart to pump harder. That can make AFib more likely. So can high levels of carbon dioxide (CO2) in the blood, a condition common in late-stage COPD.

Upper respiratory infections and bronchitis are common in COPD. This can cause the lung’s arteries to narrow or become blocked, a condition called pulmonary hypertension, which can lead to AFib.

Finally, other heart conditions caused or worsened by COPD put you at risk for AFib.

Treating COPD and AFib

Treating AFib may include taking medications or getting a procedure called cardioversion. Cardioversion sends electrical impulses to your heart to restore it to a normal rhythm. But these treatments are less effective if COPD isn’t under control. Also, having COPD may affect the type of medication your doctor recommends to treat your AFib.

If you see more than one doctor, make sure they’re aware of all of the conditions you have and all of your medications. This will help you get the best care.

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on July 19, 2019

Sources

SOURCES:

CDC.gov: “Atrial Fibrillation Fact Sheet.”

Chronic Obstructive Pulmonary Disease Open Access: “The Association between Chronic Obstructive Pulmonary Disease (COPD) and Atrial Fibrillation: A Review.”

COPD.net: “Atrial Fibrillation: Here’s What to Know.”

Drugs.com: “Glucocorticoids,” “Non-cardioselective Beta Blockers.”

Journal of Cardiology: “Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship.”

Mayo Clinic: “Albuterol (Inhalation Route)," “Atrial Fibrillation,” “Cardioversion.”

Oncotarget: “The progression in atrial fibrillation patients with COPD: a systematic review and meta-analysis.”

Pulmonary Advisor: “Atrial Fibrillation Prevalence Increasing in End-Stage COPD.”

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