Effects of Extreme Humidity and Heat on Ventricular Arrhythmia Risk in Patients With Cardiac Devices

• Published in: JACC. Advances (Online) Vol. 4; no. 1; p. 101463
• Main Authors: Keeler, Corinna, Cleland, Stephanie E., Hill, K. Lloyd, Mazzella, Anthony J., Cascio, Wayne E., Rappold, Ana G., Rosman, Lindsey A.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.01.2025; Elsevier
• Subjects: arrhythmia; extreme weather; humidity; implantable cardioverter-defibrillator; pacemaker; Social Determinants; temperature; CVD; VF; Social Determinants; extreme weather; pacemaker; arrhythmia; temperature; humidity; ICD; implantable cardioverter-defibrillator; VT
• DOI: 10.1016/j.jacadv.2024.101463
• ISSN: 2772-963X

Climate change is increasing the frequency of high heat and high humidity days. Whether these conditions can trigger ventricular arrhythmias [ventricular tachycardia/ventricular fibrillation, VT/VF] in susceptible persons is unknown. The purpose of this study was to determine the relationship between warm-season weather conditions and risk of VT/VF in individuals with pacemakers and defibrillators. Baseline clinical and device data from 5,944 patients in North Carolina (2010-2021) were linked to daily weather data geocoded to individuals’ residential addresses. Associations between extreme humidity, temperature, and VT/VF overall and by patient, community, and built environment factors were estimated using a case time-series design with distributed lag nonlinear models, adjusting for temporal trends and individual factors. VT/VF events occurred on 4,486 of the 484,988 person-days. Extreme humidity (95th percentile: 90% relative humidity) increased odds of VT/VF in the 7 days following exposure (aOR 1.23 [95% CI: 1.00-1.51]). Humidity-associated VT/VF risk was highest among those who were male (aOR: 1.38 [95% CI: 1.08-1.76]), age 67 to 75 years (aOR: 1.65 [95% CI: 1.16-2.35]) with coronary artery disease (aOR: 1.79 [95% CI: 1.25-2.57]), heart failure (aOR: 1.72 [95% CI: 1.2-2.46]), diabetes (aOR: 3.01 [95% CI: 1.99-4.56]), hypertension (aOR: 2.06 [95% CI: 1.48-2.88]), and prior myocardial infarction (aOR: 1.75 [95% CI: 1.23-2.48]). Communities with high socioeconomic deprivation (aOR: 1.83 [95% CI: 1.28-2.62]), high income inequality (aOR: 1.56 [95% CI: 1.19-2.04]), and urban areas with less greenspace (aOR: 1.29 [95% CI: 0.93-1.78]) also had increased VT/VF risk. High temperatures were not associated with VT/VF. In patients with preexisting cardiovascular disease, exposure to extreme humidity increased VT/VF risk, especially among vulnerable individuals, disadvantaged communities, and urban areas with less green space. These findings emphasize the need for policies that address environmental risks in susceptible individuals and communities. [Display omitted]