Air pollution linked to deadly heart rhythm disorder
Life-threatening arrhythmias are more common on days with highly polluted air, according to research presented today at Heart Failure 2022, a scientific congress of the European Society of Cardiology (ESC).1 The study was conducted in patients with an implantable cardioverter defibrillator (ICD), enabling the authors to track the occurrence of arrhythmias and delivery of life-saving therapy.
“Our study suggests that people at high risk of ventricular arrhythmias, such as those with an ICD, should check daily pollution levels,” said study author Dr. Alessia Zanni, now working at Maggiore Hospital, Bologna and previously at Piacenza Hospital, Italy. “When particular matter (PM) 2.5 and PM 10 concentrations are high (above 35 μg/m3 and 50 μg/m3, respectively), it would be sensible to stay indoors as much as possible and wear an N95 mask outside, particularly in areas of heavy traffic. An air purifier can be used at home.”
Outdoor air pollution kills an estimated 4.2 million people every year, according to the World Health Organization.2 Nearly one in five cardiovascular disease deaths are due to dirty air, which was ranked the fourth highest risk factor for mortality after 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 graded the city 307 worst out of 323 cities for annual mean PM2.5 concentrations in 2019 and 2020, with a figure of 20.8 μg/m3.
“We had observed that emergency room visits for arrhythmias in patients with ICDs tended to cluster on days with particularly high air pollution,” noted Dr. Zanni. “We therefore decided to compare the concentration of air pollutants on days when patients had an arrhythmia versus pollution levels on days without an arrhythmia.”
The study included 146 consecutive patients who received an ICD between January 2013 and December 2017. Of those, 93 received an ICD because of heart failure after a heart attack while 53 had a genetic or inflammatory heart condition. Just over half (79 patients) had never experienced a ventricular arrhythmia, and 67 patients had previously had a ventricular arrhythmia.
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