Air Pollution Related to Fatal Cardiac Rhythm Disorders-ScienceDaily

“Our study suggests that people at high risk of ventricular arrhythmias, such as those with ICDs, need to check their daily contamination levels,” said the former at Maggiore Hospital in Bologna. Said Dr. Alessia Zanni, a research author who worked at the Piacenza Hospital in Italy. “When the concentration of a specific substance (PM) 2.5 and PM 10 is high (35 μg / m or more)³ And 50 μg / m³, Each), especially in heavy traffic areas, it is wise to stay indoors as much as possible and wear N95 masks outdoors. You can use an air purifier at home. “

According to the World Health Organization, outdoor air pollution kills an estimated 4.2 million people each year.² Almost one-fifth of deaths from cardiovascular disease are due to air pollution and are ranked as the fourth highest risk factor for mortality following high blood pressure, tobacco use and poor diet.³

This study investigated the relationship between air pollution and ventricular arrhythmias in Piacenza, northern Italy. The European Environment Agency rated 307 of the 323 cities as the worst for the average annual PM2.5 concentration in 2019 and 2020. The value is 20.8 μg / m.³..

“We have observed that visits to the emergency room for arrhythmias in ICD patients tend to be particularly concentrated on days with high air pollution,” said Dr. Zanni. “Therefore, we decided to compare the concentration of air pollutants on the day the patient had an arrhythmia with the pollution level on the day without the arrhythmia.”

This study included 146 consecutive patients who underwent ICD between January 2013 and December 2017. Of these, 93 had ICDs due to heart failure after a heart attack, and 53 had genetic or inflammatory heart disease. Over half (79 patients) had never experienced ventricular arrhythmia, and 67 patients had previously experienced ventricular arrhythmia.

Data on ventricular arrhythmias (ventricular tachycardia and ventricular fibrillation) were collected remotely from the ICD until the study was completed at the end of 2017. The researchers also recorded the treatments offered by the device. This includes anti-tachycardia pacing of ventricular tachycardia (fast heartbeat). It sends an electrical impulse to the heart muscle to restore normal heart rate and rhythm. The second treatment was an electric shock to reset the heartbeat during ventricular fibrillation.

Daily levels of PM10, PM2.5, carbon monoxide (CO), nitrogen dioxide (NO2), and ozone (O3) were obtained from the Environmental Protection Agency (ARPA) monitoring station. Patients were assigned exposures based on their home address. Researchers analyzed the association between contaminant levels and the development of ventricular arrhythmias.

A total of 440 ventricular arrhythmias were recorded during the study, of which 322 were treated with anti-tachycardia pacing and 118 were treated with shock. Researchers have found a significant association between PM2.5 levels and shock-treated ventricular arrhythmias. This corresponds to a 1.5% increase in risk for every 1 μg / m3 increase in PM2.5. They also found that if PM2.5 levels increased by 1 μg / m3 throughout the week, there was a 2.4% increase in the likelihood of ventricular arrhythmia, regardless of temperature, compared to mean levels. When PM10 exceeded the weekly average by 1 μg / m3, the risk of arrhythmia increased by 2.1%.

Dr. Zanni said: “Particulate matter can cause acute inflammation of the heart muscle and trigger arrhythmias. These toxic particles are released from power plants, industry and automobiles, so a green project is needed to protect health. . Actions that individuals can take to protect themselves. “

She concluded that: “These data confirm that environmental pollution is not only a climate emergency, but also a public health problem. The study found that survival of heart disease patients is pharmacological therapy and heart disease. It suggests that it will be affected not only by academic progress, but also by the air. This battle will be won by an alliance between scientific groups and politicians to protect not only the environment but also human health. I can.”

¹The session “Heart Failure ePosters-Focusing on Arrhythmias and Devices” on May 21 will present a summary “Exposure of particulate matter and risk of ventricular arrhythmias in ICD patients”.

²World Health Organization: https://www.who.int/health-topics/air-pollution#tab=tab_2..

³Brauer M, Casadei B, Harrington RA, et al.. Confront air pollution-impacts on cardiovascular disease. European Heart J.. 2021; 42: 1460-1463.