Abstract
Background: the employment of nebulized short acting β2-agonists (SABA) and muscarinic antagonists (SAMA) in place of the chronic inhaled therapy is common practice in patients hospitalized for a COPD exacerbation (AECOPD). The role of these drugs on the incidence of cardiac rhythm abnormalities is still poorly understood.
Aim: to investigate the in-hospital incidence of arrhythmia during a AECOPD and its relationship with the use of SABA and SAMA.
Methods: a retrospective, observational study conducted in the Respiratory Disease Unit of L. Sacco University Hospital, Milan, Italy between 2015 and 2020. All patients hospitalized for an AECOPD were included. An arrhythmia event was the appearance of atrial fibrillation (AF), atrial flutter (AFl) or a frequent extra systolic (ES) rhythm in patients entering the Unit in sinus rhythm and without previously known rhythm disturbances.
Results: 296 patients were enrolled (mean±SD age 71±10; 61% males). Before hospitalization, 55% of patients were on chronic long acting anti-muscarinics, 57% on long acting β2-agonists and 45% on inhaled corticosteroids. 208 patients (70.3%) were shifted to nebulized SABA/SAMA. 8 patients (3.8% of those shifted to SABA + SAMA) had an arrhythmic event (5 AF; 1 AFl; 2 ES). In 2 cases the arrhythmia was present at discharge. Patients continuing their chronic therapy were free of rhythm disturbances.
Conclusion: the management of the inhaled therapy during AECOPD should be reconsidered in view of the potential risk of cardiovascular events in patients treated with nebulized SABA and SAMA.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1024.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020