Air pollution and incidence of cardiac arrhythmia.
Air pollution episodes have been associated with increased cardiovascular hospital admissions and mortality in time-series studies. We tested the hypothesis that patients with implanted cardioverter defibrillators experience potentially life-threatening arrhythmias after such air pollution episodes. We compared defibrillator discharge interventions among 100 patients with such devices in eastern Massachusetts, according to variations in concentrations of particulate matter, black carbon, and gaseous air pollutants that were measured daily for the years 1995 through 1997. A 26-ppb increase in nitrogen dioxide was associated with increased defibrillator interventions 2 days later (odds ratio = 1.8; 95% confidence interval = 1.1-2.9). Patients with ten or more interventions experienced increased arrhythmias in association with nitrogen dioxide, carbon monoxide, black carbon, and fine particle mass. These results suggest that elevated levels air pollutants are associated with potentially life-threatening arrhythmia leading to therapeutic interventions by an implanted cardioverter defibrillator.
Peters
A
A
Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
Liu
E
E
Verrier
R L
RL
Schwartz
J
J
Gold
D R
DR
Mittleman
M
M
Baliff
J
J
Oh
J A
JA
Allen
G
G
Monahan
K
K
Dockery
D W
DW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D002244:Carbon / Q000009:adverse effects / Q000032:analysis; D002248:Carbon Monoxide / Q000009:adverse effects / Q000032:analysis; D017147:Defibrillators, Implantable; D018450:Disease Progression; D004554:Electric Countershock; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000009:adverse effects / Q000032:analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D013458:Sulfur Dioxide / Q000009:adverse effects / Q000032:analysis; D015996:Survival Rate
D000393:Air Pollutants; D013458:Sulfur Dioxide; D002244:Carbon; D002248:Carbon Monoxide; D009585:Nitrogen Dioxide