Abstract 13211: Acute Exposure to Air Pollution Associated with an Increased Risk of Atrial Arrhythmias
Background: Air pollution has been associated with increased cardiovascular morbidity and mortality, and stroke. While this risk may be partially mediated through atrial rather than ventricular arrhythmias, little is known about the relation of pollution to atrial arrhythmias in vulnerable populations.
Methods: Patients with dual chamber implantable cardioverter defibrillators (ICDs) were enrolled and followed prospectively. Atrial arrhythmias documented by the ICD were confirmed by independent adjudication. The association of incidence of atrial arrhythmias with air quality including particular matter (PM2.5, black carbon, sulfate) and gaseous pollutants (SO2, NO2, and O3) was examined utilizing a case cross-over analysis. Air pollution exposure was included as 6-hour, 12-hour and 24-hour moving averages.
Results: Of 200 patients, 112 patients had 3057 atrial arrhythmias. In these 112 followed for a mean of 1.6 years, 1649 atrial tachycardias, 181 atrial flutters, 1196 atrial fibrillations, and 49 other SVTs were documented. Increased risks of atrial fibrillation were associated with 6-hour mean PM2.5(OR 1.20 for a 7.8 μg/m3 increase, 95% CI 1.00 to 1.42) and black carbon (OR 1.25 for an 0.7 μg/m3 increase, 95%CI 1.02 to 1.52), and were not associated with sulfate (OR 1.02 for an 1.9 μg/m3 increase, 95%CI 0.91 to 1.13). The ORs for other atrial arrhythmias were estimated as 1.24 (1.07 to 1.44) for PM2.5, 1.22 (1.10 to 1.34) for sulfate, and 1.06 (0.91 to 1.24) for black carbon. There was a dose response for atrial arrhythmias and PM2.5. Results for the 12-h and 24-h exposure metrics were similar. No association was found for ambient gases and SVTs.
Conclusion: Acute exposure to particulate matter including PM2.5, black carbon, and sulfate is associated with a 20 to 25% increased risk of atrial arrhythmias, and there appears to be a dose response with PM2.5. The increased mortality associated with air pollution may in part be due to atrial arrhythmias.
- © 2010 by American Heart Association, Inc.