Chest
Clinical Investigations: COPDCardiac Effects of Formoterol and Salmeterol in Patients Suffering from COPD with Preexisting Cardiac Arrhythmias and Hypoxemia
Section snippets
Materials and Methods
We have conducted a randomized, single-blind, balanced, crossover, placebo-controlled study to assess the cardiac effects of formoterol, 12 μg and 24 and salmeterol, 50 μg, in 12 patients suffering from COPD with preexisting mild-to-moderate cardiac arrhythmias and hypoxemia (PaO2 <60 mm Hg). The study design was approved by an independent ethics committee and each subject gave written informed consent before participation. All patients fulfilled the criteria proposed by the American Thoracic
Results
The mean heart rate for all patients on 4 study days is shown in Figure 1. Formoterol, 24 μg, induced a statistically significant increase when compared with placebo and formoterol, 12 μg, and salmeterol, 50 μg. Both formoterol, 12 μg, and salmeterol, 50 μg, had a significant greater effect than placebo, but there were no differences between these two treatments.
Isolated supraventricular premature beats (SVPBs) were observed in 11 patients after placebo and salmeterol and in 12 patients after
Discussion
Supraventricular and ventricular dysrhythmias, as well as conduction disturbances of varying severity, are frequently observed in COPD patients. The type of arrhythmia that occurs in patients with COPD is influenced by their clinical state. Coexisting coronary heart disease, severe blood gas abnormalities, and medication may precipitate the rhythm disturbances.9 In particular, patients with hypoxemic COPD may have a subclinical autonomic neuropathy that has been associated with a prolonged ECG
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