Association of short-term exposure to air pollution particulate matter with atrial fibrillation in high risk patients

摘要

Background: Several epidemiological studies have found an association between short-term exposure to fine particulate matter of less than 2.5 um and 10 urn in aerodynamic diameter (PM2.5 and PM10) and cardiovascular mortality, cardiovascular diseases and ventricular fibrillation incidence. Effects of air pollution on atrial fibrillation (AF) beyond the first few hours of exposure are still controversial. Methods: Patients with implantable cardioverter-defibrillators (ICDs), cardiac resynchronization therapy defibrillators (ICD-CRT) or pacemakers were prospectively enrolled in this multicenter study. Median daily levels of PM2.5, PM10, temperature, pressure and humidity were collected from monitoring stations within 20 km from the patient's residence. A bias-reduces logistic regression model was implemented to evaluate the association between AF and daily exposure to PM2.5 and PM10. Results: Of one-hundred-forty-five patients enrolled, thirteen of them developed AF. Exposure levels to PM2.5 and PM10 were above the World Health Organization (WHO) thresholds of 25 ug/m3 and 50 ug/m3 respectively in 26% and 18% of the follow-up days. An association was found between daily levels of both PM2.5 and PM10 and AF (95% confidence interval (CI) respectively 1.34 - 2.40 and 1.44 - 4.28). Conclusion: Daily exposure to moderate PM2.5 and PM10 levels seems to be associated with AF.