Association of Air Pollution with Increased Incidence of Ventricular Tachyarrhythmias Recorded by Implanted Cardioverter Defibrillators

Abstract

Epidemiologic studies have demonstrated a consistent link between sudden cardiac deaths and particulate air pollution. We used implanted cardioverter defibrillator (ICD) records of ventricular tachyarrhythmias to assess the role of air pollution as a trigger of these potentially life-threatening events. The study cohort consisted of 203 cardiac patients with ICD devices in the Boston metropolitan area who were followed for an average of 3.1 years between 1995 and 2002. Fine particle mass and gaseous air pollution plus temperature and relative humidity were measured on almost all days, and black carbon, sulfate, and particle number on a subset of days. Date, time, and intracardiac electrograms of ICD-detected arrhythmias were downloaded at the patients’ regular follow-up visits (about every 3 months). Ventricular tachyarrhythmias were identified by electrophysiologist review. Risk of ventricular arrhythmias associated with air pollution was estimated with logistic regression, adjusting for season, temperature, relative humidity, day of the week, patient, and a recent prior arrhythmia. We found increased risks of ventricular arrhythmias associated with 2-day mean exposure for all air pollutants considered, although these associations were not statistically significant. We found statistically significant associations between air pollution and ventricular arrhythmias for episodes within 3 days of a previous arrhythmia. The associations of ventricular tachyarrhythmias with fine particle mass, carbon monoxide, nitrogen dioxide, and black carbon suggest a link with motor vehicle pollutants. The associations with sulfate suggest a link with stationary fossil fuel combustion sources.

Comparison of heart rate variability and cardiac arrhythmias in polluted and clean air episodes in healthy individuals

“…Similar results have previously been shown in patients with underlying coronary artery disease [25]. Dockery et al [26] found increased risks of supraventricular arrhythmia associated with two-day exposure to all of the air pollutants considered. It was also suggested that increased levels of ambient sulfate and ozone might increase the risk of supraventricular arrhythmia, especially in the elderly [27].…”

Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study

“…[34][35][36] We measured exposure to ETS using questionnaire data and used CO measures to validate smoking status. We believe that self-reporting gives a better estimate for exposure to ETS during the past year than measurement of biomarkers, which reflect the level of exposure to passive smoking in the immediate past with half-lifes of only several hours.…”

Real-Time Black Carbon Emission Factor Measurements from Light Duty Vehicles

“…BC has adverse impacts on human health, 1 contributes to visibility degradation, 2 and influences climate by scattering and absorbing solar radiation 3 and acting as cloud condensation nuclei. 4 One important source of primary anthropogenic BC in urban areas is motor vehicles, with vehicular primary particulate emissions dominated by BC and particulate organic matter (POM, defined as the sum of particulate organic carbon and non-carbon components).…”