title: Association of air pollution with increased incidence of ventricular tachyarrhythmias recorded by implantable cardioverter defibrillators: Vulnerable patients to air pollution.
abstract: BACKGROUND
  This study investigated the acute effects of exposure to air pollution on ventricular tachyarrhythmias (VTAs) in an East Asian population. The association between air pollution and VTA has not yet been studied in an East Asian country affected by the Asian dust phenomenon, which worsens air quality.
  
  
  METHODS
  The study cohort consisted of 160patients with implantable cardioverter defibrillator (ICD) devices in the Seoul metropolitan area who were followed for 5.5±3.8years. We used ICD records of VTAs and matched these with hourly measurements of air pollutant concentrations and meteorological data. Fine particle mass and gaseous air pollution plus temperature and relative humidity were measured hourly during the study period.
  
  
  RESULTS
  During the study period, 1064 VTA events including 204 instances of ventricular fibrillation (VF) were observed. We found a statistically significant association between overall VTA events and SO2(lag 24h; OR 1.49, 95%CI 1.16-1.92, p=0.002), PM10(lag 2h; OR 2.56, 95%CI 2.03-3.23, p<0.001), NO2(lag 24h; OR 1.25, 95%CI 1.19-1.31, p<0.001) and CO (lag 24h; OR 1.05, 95%CI 1.02-1.08, p=0.003). Sustained ventricular tachycardia or VF was also independently associated with SO2, PM10, NO2and CO (all p<0.01). Exposures to SO2, PM10, NO2, and CO (all p<0.01) were significantly related to overall VTAs, especially in patients with structural heart disease (SHD).
  
  
  CONCLUSIONS
  Associations between air pollution and VTA were observed in a metropolitan area of an East Asian country. Exposures to SO2, PM10, NO2, and CO were significantly associated with VTAs in ICD patients with SHD.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: In-Soo
authors.initials: IS
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jungwoo
authors.initials: J
authors.lastname: Sohn
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung-Jun
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Republic of Korea.
authors.forename: Jin-Kyu
authors.initials: JK
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Sun
authors.initials: JS
authors.lastname: Uhm
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Changsoo
authors.initials: C
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: cby6908@yuhs.ac.
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis*; D015331:Cohort Studies; D017147:Defibrillators, Implantable; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D004784:Environmental Monitoring / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000453:epidemiology*; D014505:Urban Population / Q000639:trends*
chemical_list: D000393:Air Pollutants
keywords: Air pollution; Implantable cardioverter defibrillator; Particulate matter; Ventricular tachyarrhythmia