Fatal arrhythmias are a common cause of death in chronic obstructive pulmonary disease (COPD). Two major hypotheses for arrhythmogenesis in COPD have been proposed: arrhythmias are a consequence of hypoxaemia, hypercapnia or acid-base disturbances or arrhythmias are the result of the autonomic neuropathy that characterizes COPD. Autonomic neuropathy has been associated with a prolonged electrocardiograph QTc interval and risk of ventricular arrhythmias and death.