The ventricular arrhythmia (VA)–chronic obstructive pulmonary disease (COPD) association and related risk factors remain unclear. Using 2001–2012 data from National Health Insurance Research Database, we retrospectively reviewed 71,838 patients diagnosed as having COPD and 71,838 age- and sex-matched controls. After adjustments for comorbidities, medication, urbanization level, and monthly income, patients with COPD had higher incidence rates of VA than did the controls (adjusted hazard ratio [aHR] [95% confidence interval (CI)]: 1.45 [1.25–1.68]). More hospitalization or emergency visits because of acute COPD exacerbation (aHRs [95% CIs] for first, second, and third visits: 1.28 [1.08–1.50], 1.75 [1.32–2.32], and 1.88 [1.46–2.41], respectively) and asthma–COPD overlap (aHR [95% CI]: 1.49 [1.25–1.79]) were associated with high VA risk in patients with COPD. In the multivariate analysis, heart failure (aHR [95% CI]: 2.37 [1.79–3.14]), diabetes (aHR [95% CI]:1.64 [1.29–2.08]), age ≥75 (aHR [95% CI]: 2.48 [1.68–3.67]), male (aHR [95% CI]: 1.69[1.34–2.12]), and class III antiarrhythmic drug use (aHR [95% CI]: 2.49 [1.88–3.28]) are the most significant risk factors of new onset of VA in patients with COPD.
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