Introduction: COPD is a common, preventable, and treatable chronic lung disease Characterized by airflow limitation that is not fully reversible causing breathing-related problems. Cardiovascular disease accounts for significant morbidity and mortality in COPD. Severe COPD can cause heart failure or long-term cardiac complications. Electrocardiography provides a rapid, non-invasive method to evaluate cardiac functions.

Aims and Objective: To study the ECG changes in COPD patients and assess these ECG changes with severity of the disease.

Materials and Methods: It is a cross sectional study from September 2022 to November 2022 done in Department of General Medicine, KR hospital, MMCRI, Mysore. Study conducted on 100 COPD patients confirmed by PFT. After taking institutional ethical clearance 12 lead ECG is performed and assessed with severity categorized by GOLD criteria into mild, moderate, severe, and very severe.

Statistical Analysis: Data obtained from the study will be entered in excel sheets and it will be double checked. Data analysed using SPSS software version 22.0 and it will be presented as descriptive statistics in form of frequency table and figures. Result will be expressed. Correlation of parameters is done by Pearson’s correlation formula. A p value of <0.05 is considered statistically significant.

Results and Conclusion: In our study 2 cases in mild, 48 cases in moderate, 39 cases in severe and 11 cases in very severe group.68% had RAD,60% had sinus tachycardia,63% had p pulmonale,44% has R/S(V1>1),36% had R/S(v6<1),33% had RBBB,17% had MAT,11% had lead 1 sign. Long smoking duration had very severe PFT changes and more prevalent ECG changes were in severe group. ECG can be used as a screening test in assessing the severity of the disease and further preventing morbidity.