Occurrence and prognostic significance of ventricular arrhythmia is related to pulmonary function - A study from "men born in 1914," Malmo, Sweden

Background-Reduced lung function has been associated with increased rates o f myocardial infarction. Whether the occurrence and prognostic significance of ventricular arrhythmia is related to lung function is largely unknown, Methods and Results-We performed a population-based study of 68-year-old me n without a history of stroke or myocardial infarction; 402 men participate d. Mortality and coronary events (fatal or nonfatal) were studied in relati on to ventricular arrhythmia during 24 hours, percentage of the predicted f orced expiratory volume (FEV1(%pred)), vital capacity (VC%pred), and the FE V/VC ratio. During 14 years of follow-up. 181 men died and 87 experienced a coronary event. Occurrence of frequent or complex ventricular arrhythmia ( Lown class 2 to 5) was significantly and inversely associated with FEV1(%pr ed). Men with Lown class 2 to 5 and a low FEV1(%pred) (below median) had si gnificantly higher mortality (71.5 versus 26.8 per 1000 person-years; P<0.0 001) and coronary event rates (37.7 versus 18.0: P=0.02) than men with Lown class 2 to 5 and a high FEV1(%pred). These associations remained significa nt after adjustments for potential confounders (mortality: relative risk [R R], 2.91; 95% CI,1.68 to 5.04; coronary events: RR, 2.16: 95% CI, 1.07 to 4 .37), In men without frequent or complex arrhythmia (Lown 0 to 1), a low FE V1(%pred) was not significantly associated with mortality (RR, 1.37; 95% CI , 0.92 to 2.05) or coronary events (RR, 1.24; 95% CI, 0.67 to 2.27) after a djustments for confounders. The FEV/VC ratio showed similar associations wi th arrhythmia, mortality, and coronary events. Conclusions-Lung function is inversely associated with the occurrence of ve ntricular arrhythmia. The increased incidence of myocardial infarction and death associated with arrhythmia was mainly limited to men with a low FEV1( %pred) or FEV/VC. We suggest that lung function should be considered when a ssessing the prognostic significance of ventricular arrhythmia.