Association between arrhythmias and air pollution in subjects with cardiovascular vulnerabilities

Air pollution – in particular, particulate matter – has a significant risk for arrhythmia for people with a preexisting cardiovascular condition. The study, published in the journal The Lancet Planetary Health, evaluated the short-term effects of air pollution on patients prone to ventricular arrhythmias – especially those with implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy defibrillators (ICD-CRT).

• The prospective multicenter study collated data from 281 patients across nine centers in Veneto, Italy.
• The authors of the study used a diagnostic device for measuring incidences of ventricular tachycardia and ventricular fibrillation.
• Air quality data, particularly for particulate matter concentrations less than 10 micrometers (PM10) and 2.5 ?m (PM2.5), were gleaned from monitoring stations daily. Aside from particulate matter, carbon monoxide, nitrogen dioxide, sulfur dioxide, and ozone were gathered as well. Each patient was grouped with the exposure data from the monitoring station closest to them.
• The study ran from April 1, 2011 to Septemeber 30, 2012, with a follow-up conducted within a year after the review, and a closing visit was done a year after.
• Researchers discovered that episodes of ventricular tachycardia and ventricular fibrillation were associated with PM2.5 but not PM10. They also found out that incidences of ventricular fibrillation also increased when the levels of PM2.5 and PM10 were higher. Other gaseous pollutants, however, did not have a noticeable correlation with ventricular tachycardia or ventricular fibrillation.
• In particular, patients with a previous case of myocardial infarction had a pointed association with ventricular tachycardia or ventricular fibrillation as well.

Researchers believe that the results of the study will bolster claims to consider environmental conditions when addressing arrhythmic events, especially in patients with coronary heart disease. See Pollution.news for more coverage.

Journal Reference:

Folino F, Buja G, Zanotto G, Marras E, Allocca G, Vaccari D, Gasparini G, Bertaglia E, Zoppo F, Calzolari V, et al. ASSOCIATION BETWEEN AIR POLLUTION AND VENTRICULAR ARRHYTHMIAS IN HIGH-RISK PATIENTS (ARIA STUDY): A MULTICENTRE LONGITUDINAL STUDY. The Lancet Planetary Health. 2017;1(2):58–64. DOI: 10.1016/S2542-5196(17)30020-7