Abstract
BackgroundAlthough air pollutants have been associated with cardiopulmonary mortality, their effects on the occurrence of atrial fibrillation (Afib) remain unclear. This study examined the association between ambient air pollutants and Afib occurrence.MethodsUsing a representative sample from the National Health Insurance Database of Taiwan, we applied a case–crossover study design to explore the associations between air pollutants and patients hospitalized with Afib from 2006 to 2011. The event day was when a patient was hospitalized with Afib, and the control days were the same days of the following weeks of the same month. The association between Afib occurrence and levels of ambient air pollutants (including particulate matter [PM] 2.5 PM10, NO2, SO2, and O3) was examined after adjusting for temperature and relative humidity. A two-pollutant model was used to examine the effect of the second pollutant when the first pollutant was determined to be significantly related to Afib.ResultsDuring 2006–2011, 670 patients hospitalized with the first onset of Afib were identified. The occurrence of Afib was associated with PM2.5, in which a 22% (95% confidence interval = 3–44%) increase was related to an interquartile range increase (26.2 μg/m3) on the same day and a 19% (95% confidence interval = 0–40%) increase on the second day. A two-pollutant model was applied, and the results indicated that the effect of PM2.5 was significantly associated with the occurrence of Afib. Patients aged over 65 years with DM and with hyperlipidemia were more susceptible to the effect of PM2.5.ConclusionsIn conclusion, the occurrence of Afib was associated with short-term exposure to fine particulate air pollutants in the general population.
Highlights
Atrial fibrillation (Afib) is the most commonly sustained cardiac arrhythmia, and it occurs in approximately 2% of the general population [1, 2]
The occurrence of atrial fibrillation (Afib) was associated with PM2.5, in which a 22% increase was related to an interquartile range (IQR) increase in PM2.5 (26.2 μg/m3) on the same day and a 19% increase on the second day
A two-pollutant model was applied, and the results indicated that the effect of PM2.5 remained significantly associated with Afib occurrence, with the addition of any of the climate factors or air pollutants (Table 5)
Summary
Atrial fibrillation (Afib) is the most commonly sustained cardiac arrhythmia, and it occurs in approximately 2% of the general population [1, 2]. Lee et al Environmental Health (2019) 18:117 increase in the risk of cardiovascular mortality [10]. Stroke was associated with PM2.5, with increased risks of 1.1% (95% CI = 1.1–1.2%) per 10 μg/m3 increase in PM2.5 [11]. Whether air pollution induces Afib in the general population is uncertain. We determined whether exposure to ambient air pollutants is associated with an increased risk of Afib hospitalization. Air pollutants have been associated with cardiopulmonary mortality, their effects on the occurrence of atrial fibrillation (Afib) remain unclear. This study examined the association between ambient air pollutants and Afib occurrence
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