Arrhythmias & electrophysiology
Association of air pollution with ventricular arrhythmias and physical activity: A natural experiment from US wildfires
Authors' conclusion
In a large cohort of patients with CIEDs, AQI and PM2.5 had significant associations with premature ventricular contraction burden, physical activity, and heart rate. These data also demonstrate the feasibility of linking environmental data with patient sensor data to evaluate exposure-outcome relationships.
Study context
- Population
- Patients with cardiac implantable electronic devices (CIEDs) in the CERTITUDE database9,062 [32%] female, mean age 72.8±11.9 years · pacemakers 17,448 · defibrillators 9,079 · Western US Fire States 8,687
- Participants
- 28,349 patients
- Exposure
- Day-level air pollution and CIED parameters
- Outcome
- Physical activity, heart rate, and thoracic impedance
Methodological detailscase-crossover analysis using a conditional logistic regression, time-varying exposure analysis with the Andersen-Gill model
- Case-crossover analysis using a conditional logistic regression
- Time-varying exposure analysis with the Andersen-Gill model
Main finding
As reported in the abstract
- Air Quality Index (AQI) and PM2.5 were associated with significant changes in physical activity, heart rate, and thoracic impedance
Observational data: associations, not effects.
Further findings
Premature ventricular contraction burden (Western US Fire States)
| Odds ratio (95% CI) | P value | ||
|---|---|---|---|
| PM2.5 ≥ 13.78687 patients living in Western US Fire States | 7.72 (7.48–7.96) | P < 0.0001 | |
| 0.10.31310Odds ratio (log scale) |
Sensitivity analyses
- Multiple sensitivity analyses demonstrated the stability of our findings
Original publication
Association of air pollution with ventricular arrhythmias and physical activity: A natural experiment from US wildfires. Heart Rhythm. Published 17 March 2025. doi:10.
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