Air Pollution and Incidence of Cardiac Arrhythmia

TLDR

Air pollution episodes are linked to higher cardiovascular hospital admissions and mortality in time‑series studies. The study tested whether patients with implanted cardioverter defibrillators experience life‑threatening arrhythmias following air pollution episodes. The authors compared defibrillator interventions in 100 patients in eastern Massachusetts to daily variations in particulate matter, black carbon, and gaseous pollutants measured from 1995 to 1997. A 26‑ppb rise in nitrogen dioxide was associated with a 1.8‑fold increase in defibrillator interventions two days later, and patients with many interventions showed higher arrhythmia rates with nitrogen dioxide, carbon monoxide, black carbon, and fine particles, indicating that elevated air pollutants trigger potentially life‑threatening arrhythmias requiring device therapy.

Abstract

Air pollution episodes have been associated with increased cardiovascular hospital admissions and mortality in time-series studies. We tested the hypothesis that patients with implanted cardioverter defibrillators experience potentially life-threatening arrhythmias after such air pollution episodes. We compared defibrillator discharge interventions among 100 patients with such devices in eastern Massachusetts, according to variations in concentrations of particulate matter, black carbon, and gaseous air pollutants that were measured daily for the years 1995 through 1997. A 26-ppb increase in nitrogen dioxide was associated with increased defibrillator interventions 2 days later (odds ratio = 1.8; 95% confidence interval = 1.1–2.9). Patients with ten or more interventions experienced increased arrhythmias in association with nitrogen dioxide, carbon monoxide, black carbon, and fine particle mass. These results suggest that elevated levels air pollutants are associated with potentially life-threatening arrhythmia leading to therapeutic interventions by an implanted cardioverter defibrillator.