According to a study, exposure to high levels of air pollution is associated with a fatal heart disease.
The study, presented last week at the Scientific Congress of the European Society of Cardiology (ESC) in Madrid, Spain, was conducted among implantable cardioverter defibrillators (ICD) patients, enabling them to track the incidence of arrhythmias.
“Our study suggests that people at high risk for ventricular arrhythmias, such as those with ICD, should have their daily levels of contamination checked,” said study author Alessia Jenny, who works at Maggiore Hospital in Bologna and previously at Piasenza Hospital in Italy. “When particulate matter (PM) is 2.5 and PM 10 is high – above 35 micrograms (μg / m3) and 50 μg / m3 per cubic meter, respectively – it would be wise to stay indoors and wear one as much as possible. Outside the N95 mask, especially in heavy vehicle areas. An air purifier can be used at home, “Jenny said in a statement.
PM 2.5 refers to particulate matter particles with a width of 2.5 microns or less in the air, whereas particles with a diameter of 10 microns or less are called PM10.
According to the World Health Organization, outdoor air pollution leads to an estimated 4.2 million premature deaths each year.
One in five deaths from heart disease is due to dirty air, which ranks it as the fourth highest risk cause for death after high blood pressure, tobacco use and poor diet, the researchers said. The study explored the relationship between air pollution and ventricular arrhythmias in Piasenza, northern Italy.
The European Environment Agency ranked the 307th city out of 323 cities for the annual average PM2.5 concentration in 2019 and 2020, with a figure of 20.8 μg / m3.
“We noticed that emergency room visits for arrhythmias in ICD patients tend to cluster, especially on days of high air pollution,” Jenny noted.
“We therefore decided to compare the concentration of air pollutants in the days when patients had arrhythmias versus pollution levels without arrhythmias,” he added.
The study included 146 continuous patients who received an ICD between January 2013 and December 2017. 93 of them received an ICD due to heart failure after a heart attack whereas 53 had a genetic or inflammatory heart condition.
Only more than half (79 patients) had never experienced ventricular arrhythmia and 67 patients had this condition before.
Data on ventricular arrhythmias (ventricular tachycardia and ventricular fibrillation) were collected remotely from the ICD until the end of the study in late 2017.
The researchers also recorded the therapy delivered by the device. These include antitocardial pacing for ventricular tachycardia (rapid heartbeat), which provides electrical impulses to the heart muscle to restore a normal heartbeat 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 the Regional Environmental Protection Agency (ARPA) monitoring station.
Patients were assigned exposure based on their home address.
Researchers have analyzed the relationship between contaminant concentration and the occurrence of ventricular arrhythmias.
A total of 440 ventricular arrhythmias were recorded during the study period, of which 322 were treated with antithycardia pacing and 118 were treated with shock.
Researchers have found a significant relationship between PM2.5 levels and shock-treated ventricular arrhythmias, with a 1.5 percent increase in risk for every 1 μg / m3 increase in PM2.5.
They also found that when PM2.5 concentrations were increased by 1 μg / m3 for the entire week, there was a 2.4 percent greater chance of ventricular arrhythmias, regardless of temperature, than on average.
According to the researchers, when PM10 averaged 1 μg / m3 for a week, the risk of arrhythmia increased by 2.1 percent. “Particles can cause acute inflammation of the heart muscle which can act as a trigger for cardiac arrhythmias,” Jenny said.
“Since these toxic particles are emitted from power plants, industry and cars, green projects are needed to protect health, on top of the steps that individuals can take to protect themselves,” he added.
The researchers noted that these data confirm that environmental pollution is not only a climate emergency but also a public health problem.
Studies have suggested that the survival of heart disease patients is affected not only by advances in pharmacological therapy and cardiology but also by the air they breathe, they added.