Atrial fibrillation in chronic obstructive pulmonary disease shows complex interactions

A narrative review reports that COPD is linked with higher risk of atrial fibrillation and that each condition raises the other's mortality risk. The review also notes treatment interactions and calls for research on COPD‑specific risk tools and AF screening with AI and telemonitoring.

A recent narrative review in npj Primary Care Respiratory Medicine examines the relationship between atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD). COPD is a common respiratory condition and a leading cause of illness and death. The review reports multiple mechanisms that may contribute to AF in people with COPD, including hypoxemia, hypercapnia, inflammation, changes in cardiac geometry, and autonomic dysfunction. It also summarises evidence that the presence of COPD and AF each relate to higher mortality. Key points: - COPD is associated with an increased risk of atrial fibrillation and with higher rates of thromboembolic events, AF recurrence after cardioversion, and all‑cause mortality. - Reported physiological contributors include hypoxemia, hypercapnia, heightened inflammation, altered cardiac geometry, and autonomic changes. - The review describes treatment interactions: many bronchodilators have been observed to increase heart rate and can trigger AF episodes, antimuscarinic agents appear better tolerated than β‑receptor agonists in COPD, and some therapies for AF may worsen respiratory status. - Catheter ablation for AF in people with COPD is described as having established efficacy and safety, and the authors call for further research on COPD‑specific thromboembolic risk tools and on AF screening protocols incorporating artificial intelligence and telemonitoring. Summary: The review emphasises reciprocal risks between COPD and AF and notes complex interactions between treatments for each condition. It reports that catheter ablation appears effective and safe in COPD and that further research is needed on COPD‑specific risk assessment and on screening approaches using AI and remote monitoring.