Association of Air Pollution with Increased Incidence of Ventricular Tachyarrhythmias Recorded by Implanted Cardioverter Defibrillators

• Published in: Environmental health perspectives Vol. 113; no. 6; pp. 670 - 674
• Main Authors: Dockery, Douglas W., Luttmann-Gibson, Heike, Rich, David Q., Link, Mark S., Mittleman, Murray A., Gold, Diane R., Koutrakis, Petros, Schwartz, Joel D., Verrier, Richard L.
• Format: Journal Article
• Language: English
• Published: United States National Institute of Environmental Health Sciences. National Institutes of Health. Department of Health, Education and Welfare 01.06.2005; National Institute of Environmental Health Sciences; National Institue of Environmental Health Sciences
• Subjects: Adult; Aged; Aged, 80 and over; Air pollutants; Air Pollutants - adverse effects; Air Pollutants - analysis; Air pollution; Air Pollution - adverse effects; Carbon - adverse effects; Carbon - analysis; Carbon Monoxide - adverse effects; Carbon Monoxide - analysis; Cardiac patients; Defibrillators, Implantable; Dysrhythmias; Environmental health; Female; Humans; Incidence; International Statistical Classification of Diseases; Male; Middle Aged; Myocardial infarction; Nitrogen Dioxide - adverse effects; Nitrogen Dioxide - analysis; Particle Size; Particulate matter; Public health; Statistical significance; Sulfates - adverse effects; Sulfates - analysis; Sulfur Dioxide - adverse effects; Sulfur Dioxide - analysis; Tachycardia; Tachycardia, Ventricular - epidemiology; Tachycardia, Ventricular - therapy; USA, Massachusetts, Boston
• ISSN: 0091-6765; 1552-9924
• DOI: 10.1289/ehp.7767

Epidemiologic studies have demonstrated a consistent link between sudden cardiac deaths and particulate air pollution. We used implanted cardioverter defibrillator (ICD) records of ventricular tachyarrhythmias to assess the role of air pollution as a trigger of these potentially life-threatening events. The study cohort consisted of 203 cardiac patients with ICD devices in the Boston metropolitan area who were followed for an average of 3.1 years between 1995 and 2002. Fine particle mass and gaseous air pollution plus temperature and relative humidity were measured on almost all days, and black carbon, sulfate, and particle number on a subset of days. Date, time, and intracardiac electrograms of ICD-detected arrhythmias were downloaded at the patients' regular follow-up visits (about every 3 months). Ventricular tachyarrhythmias were identified by electrophysiologist review. Risk of ventricular arrhythmias associated with air pollution was estimated with logistic regression, adjusting for season, temperature, relative humidity, day of the week, patient, and a recent prior arrhythmia. We found increased risks of ventricular arrhythmias associated with 2-day mean exposure for all air pollutants considered, although these associations were not statistically significant. We found statistically significant associations between air pollution and ventricular arrhythmias for episodes within 3 days of a previous arrhythmia. The associations of ventricular tachyarrhythmias with fine particle mass, carbon monoxide, nitrogen dioxide, and black carbon suggest a link with motor vehicle pollutants. The associations with sulfate suggest a link with stationary fossil fuel combustion sources.