Air pollution is responsible for life-threatening arrhythmias

Air pollution is responsible for life-threatening arrhythmias

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  • Ventricular fibrillation (VF) is a heart rhythm disorder that corresponds to the rapid, disorganized and inefficient contraction of the cardiac ventricles.
  • In VF, loss of consciousness is usually immediate. It is a cause, if not the leading cause, of cardiac arrest and sudden death.
  • Without specialized medical intervention, death occurs within minutes if no treatment is provided.

According to the World Health Organization (WHO), outdoor air pollution is responsible for 4.2 million deaths each year. Nearly one in five deaths from cardiovascular disease is due to air pollution, which has been ranked as the fourth leading risk factor for death after high blood pressure, smoking and poor diet.

Among the cardiovascular risks linked to air pollution are ventricular arrhythmias (ventricular tachycardia and ventricular fibrillation), linked to the irregular contraction of the heart’s ventricles. Ventricular fibrillation is the most dangerous form of arrhythmia because eventually the heart’s ventricles lose their ability to contract, interrupting blood flow to the body and brain.

A new study presented at Heart Failure, a scientific congress of the European Society of Cardiology (ESC) highlights the link between air pollution and the risk of developing this type of life-threatening arrhythmia. It was performed in patients with an implantable cardioverter defibrillator (ICD), which allowed the authors to monitor the appearance of arrhythmias and the administration of treatment.

“Our study suggests that people at high risk of ventricular arrhythmia, such as those with an ICD, should monitor daily pollution levels.” said study author Dr. Alessia Zanni, who currently works at Bologna Maggiore Hospital.

A significant link between fine particles and ventricular arrhythmias

This study investigated the relationship between air pollution and ventricular arrhythmias in Plaisance. This city in northern Italy ranked 307 out of 323 by the European Environment Agency in terms of average annual concentrations of fine particles PM2.5 in 2019 and 2020, with a figure of 20.8 μg/m34.

The study looked at 146 consecutive patients who received an ICD between January 2013 and December 2017.”We had observed that emergency room visits for arrhythmias in ICD patients tended to cluster on days when air pollution was particularly high, notes Dr. Zanni. Therefore, we decided to compare the concentration of air pollutants on days when patients had arrhythmia with the pollution levels on days without arrhythmia.”

A total of 440 ventricular arrhythmias were recorded during the study period, of which 322 were treated with antitachycardia pacemakers and 118 with shock. The results obtained show a significant association between the levels of PM2.5 fine particles and shock-treated ventricular arrhythmias. For every 1 μg/m3 increase in PM2.5, the risk of ventricular arrhythmia increases by 1.5%.

The researchers also found that when PM2.5 concentrations rose by 1 μg/m3 for an entire week, compared to average levels, the probability of ventricular arrhythmia was 2.4% higher, regardless of temperature. When PM10 was 1 μg/m3 above average for one week, there was a 2.1% increased risk of arrhythmias.

Acute inflammation of the heartbeat

“The particles can cause acute inflammation of the heart muscle that could act as a trigger for cardiac arrhythmias, believes Dr. Zanni. Since these toxic particles are emitted by power plants, industries and automobiles, green projects are needed to protect health, in addition to measures that people can take to protect themselves.”

According to the doctor, “These data confirm that environmental pollution is not only a climate emergency but also a public health problem”. “This battle can be won by an alliance between scientific societies and politicians to protect not only the environment but also the health of the human population”concludes.

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