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Air pollution linked to fatal heart rhythm disorder: Study

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According to a study, exposure to high levels of air pollution makes the heart condition dangerous.

The research, presented last week at the European Society of Cardiology (ESC) scientific conference in Madrid, Spain, was conducted in patients with an implantable cardioverter defibrillator (ICD), which enabled them to track the occurrence of arrhythmias.

“Our study suggests that people at high risk of ventricular arrhythmias, such as those with ICDs, should have daily pollution levels checked,” said study author Alessia Zani, who works at Maggiore Hospital, Bologna and previously Piacenza was in the hospital in Italy. “When particulate matter (PM) 2.5 and PM10 concentrations are high – 35 micrograms per cubic meter (μg/m3) and above 50 μg/m3, – it would be prudent to stay indoors as much as possible and wear an N95 mask. Outdoors, especially in areas with heavy traffic. An air purifier can be used at home,” Zani said in a statement.

PM 2.5 refers to the tiny pollution particles present in the air that are 2.5 microns or less in width, while the pollution particles with a diameter of 10 microns or less are called PM10.

According to the World Health Organization, outdoor air pollution causes an estimated 4.2 million premature deaths each year.

Nearly one in five heart disease deaths are due to dirty air, which was the fourth biggest risk factor for mortality after high blood pressure, tobacco use and poor diet, the researchers said. The study examined the relationship between air pollution and ventricular arrhythmias in Piacenza, northern Italy.

The European Environment Agency has ranked 307 out of 323 cities as the worst with a figure of 20.8 μg/m3 for annual average PM2.5 concentrations in 2019 and 2020.

“We observed that emergency room visits for arrhythmias in patients with ICD were particularly high on days with high air pollution,” Zani said.

“We therefore decided to compare the concentrations of air pollutants on days when patients had arrhythmias versus pollution levels on days without arrhythmias,” he said.

The study included 146 consecutive patients who received an ICD between January 2013 and December 2017. Of them, 93 received ICDs due to heart failure following a heart attack, while 53 had genetic or inflammatory heart conditions.

More than half (79 patients) had never experienced ventricular arrhythmias, and 67 patients had previously had this condition.

Data on ventricular arrhythmias (ventricular tachycardia and ventricular fibrillation) were collected remotely from the ICD until the study was completed at the end of 2017.

The researchers also recorded the therapy delivered by the device. This included antitachycardia pacing to ventricular tachycardia (rapid heartbeat), which delivers electrical impulses to the heart muscle to restore normal heart rate and rhythm.

The second therapy was an electric shock to reset the heartbeat during ventricular fibrillation.

Daily levels of PM10, PM2.5, carbon monoxide (CO), nitrogen dioxide (NO2) and ozone (O3) were obtained from regional Environmental Protection Agency (ARPA) monitoring stations.

Patients were assigned exposures based on their home addresses.

The researchers analyzed the relationship between pollutant concentrations and the occurrence of ventricular arrhythmias.

A total of 440 ventricular arrhythmias were recorded during the study period, of which 322 were treated with antitachycardia pacing and 118 were treated with a stroke.

The researchers found a significant association between PM2.5 levels and ventricular arrhythmias treated with shock, with a 1.5 percent increased risk for every 1 μg/m3 increase in PM2.5.

They also found that the likelihood of ventricular arrhythmias, regardless of temperature, was 2.4 percent higher when PM2.5 concentrations increased by 1 μg/m3 for the entire week, compared to the average level.

According to the researchers, when PM10 was 1 μg/m3 higher than the average for one week, the risk of arrhythmias increased by 2.1 percent. “Particulate matter can cause acute inflammation of the heart muscle that can act as a trigger for cardiac arrhythmias,” Zani said.

“Since these toxic particles are emitted from power plants, industries and cars, there is a need for green projects to protect health, the steps individuals at the top can take to protect themselves,” she said.

The researchers noted that these data confirm that environmental pollution is not only a climate emergency, but also a public health problem.

Studies show that the survival of heart disease patients is affected not only by pharmacological therapies and advances in cardiology, but also by the air they breathe.

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