Production of arrhythmias by elevated carboxyhemoglobin in patients with coronary artery disease

Journal Article · Sat Sep 01 04:00:00 EDT 1990 · Annals of Internal Medicine; (USA)

DOI:https://doi.org/10.7326/0003-4819-113-5-343· OSTI ID:6519035

Sheps, D S; Herbst, M C; Hinderliter, A L; Adams, K F; Ekelund, L G; O'Neil, J J; Goldstein, G M; Bromberg, P A; Dalton, J L; Ballenger, M N ^[1]

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1. Univ. of North Carolina, Chapel Hill (USA)

The object of this study was to assess the effects of exposure to 4% and 6% carboxyhemoglobin on ventricular arrhythmias in patients with coronary artery disease. This was a randomized, double-blind, crossover design. Forty-one nonsmokers with documented coronary artery disease were tested. On day 1, a training session with no exposure, the baseline carboxyhemoglobin level was measured, and a supine bicycle exercise test was done. On days 2 to 4, patients were exposed to room air, 100 ppm carbon monoxide (target, 4% carboxyhemoglobin) or 200 ppm carbon monoxide (target, 6% carboxyhemoglobin), and they then did supine bicycle exercise with radionuclide ventriculography. Ambulatory electrocardiogram recordings were made during the 4 consecutive days to determine the frequency of ventricular premature depolarization (VPD) at various intervals. The frequency of single VPD/h was significantly greater on the 6% carboxyhemoglobin day than on the room air day during the exercise period (167.72 +/- 37.99 for 6% carboxyhemoglobin compared with 127.32 +/- 28.22 for room air, P = 0.03). During exercise, the frequency of multiple VPD/h was greater on the 6% carboxyhemoglobin day compared with room air (9.59 +/- 3.70 on the 6% carboxyhemoglobin compared with 3.18 +/- 1.67 on room air, P = 0.02). Patients who developed increased single VPD during exercise on the 6% carboxyhemoglobin day were significantly older than those who had no increased arrhythmia, whereas patients who developed complex arrhythmias were also older and, in addition, exercised longer and had a higher peak workload during exercise. The number and complexity of ventricular arrhythmias increases significantly during exercise after carbon monoxide exposure producing 6% carboxyhemoglobin compared with room air but not after exposure producing 4% carboxyhemoglobin.

• OSTI ID: 6519035
• Journal Information: Annals of Internal Medicine; (USA), Journal Name: Annals of Internal Medicine; (USA) Vol. 113:5; ISSN 0003-4819; ISSN AIMEA
• Country of Publication: United States
• Language: English

Related Subjects

550601 -- Medicine-- Unsealed Radionuclides in Diagnostics
560300* -- Chemicals Metabolism & Toxicology
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
AGE DEPENDENCE
AIR POLLUTION
CARBON COMPOUNDS
CARBON MONOXIDE
CARBON OXIDES
CARBOXYHEMOGLOBIN
CARDIOVASCULAR DISEASES
CHALCOGENIDES
COUNTING TECHNIQUES
DIAGNOSIS
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
EXERCISE
OXIDES
OXYGEN COMPOUNDS
PATIENTS
POLLUTION
RADIOISOTOPE SCANNING
TOXICITY