Rapid effects of air pollution on ventricular arrhythmias.

• AIMS: Air pollution has been associated with ventricular arrhythmias in patients with implantable cardioverter defibrillators (ICDs) for exposure periods of 24-48 h. Only two studies have investigated exposure periods <24 h. We aimed to explore such effects during the 2 and 24 preceding hours as well as in relation to distance from the place of the event to the air pollution monitor. METHODS AND RESULTS: We used a case-crossover design to investigate the effects of particulate matter <10 microm in diameter (PM10) and nitrogen dioxide (NO2) in 211 patients with ICD devices in Gothenburg and Stockholm, Sweden. Events interpreted as ventricular arrhythmias were downloaded from the ICDs, and air pollution data were collected from urban background monitors. We found an association between 2 h moving averages of PM10 and ventricular arrhythmia [odds ratio (OR) 1.31, 95% confidence interval (CI) 1.00-1.72], whereas the OR for 24 h moving averages was 1.24 (95% CI 0.87-1.76). Corresponding ORs for events occurring closest to the air pollution monitor were 1.76 (95% CI 1.18-2.61) and 1.74 (95% CI 1.07-2.84), respectively. Events occurring in Gothenburg showed stronger associations than in Stockholm. CONCLUSION: Moderate increases in air pollution appear to be associated with ventricular arrhythmias in ICD patients already after 2 h, although future studies including larger numbers of events are required to confirm these findings. Representative geographical exposure classification seems important in studies of these effects.

Nyckelord

Adult

Aged

Aged

80 and over

Air Pollution

adverse effects

Arrhythmias

Cardiac

chemically induced

Cross-Over Studies

Death

Sudden

Cardiac

etiology

Defibrillators

Implantable

adverse effects

Environmental Exposure

adverse effects

Environmental Monitoring

Female

Heart Arrest

chemically induced

Humans

Male

Middle Aged

Nitrogen Dioxide

toxicity

Odds Ratio

Oxidants

Photochemical

toxicity

Particulate Matter

toxicity

Sweden

Time Factors

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)