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• W4377014548 abstract "Particulate matter (PM) air pollution is associated with atherosclerotic cardiovascular disease. While the biological processes that link PM exposure to atherosclerotic disease may also trigger arrhythmias, there are limited data on the association of PM with ventricular arrhythmias. The high levels of PM pollution as a consequence of the 2020 U.S. wildfires provide a unique opportunity to explore the effects of air pollution on cardiac arrhythmias, physical activity, and heart failure markers using device remote monitoring data. To evaluate the association of PM exposure to ventricular arrhythmias, physical activity, and markers of heart failure. We performed a retrospective cohort study using the CERTITUDE database of patients with Biotronik CIEDs. We included patients with at least one remote data transmission on or after 1/1/2020. The primary predictors were Air Quality Index (AQI), PM < 10 μm in diameter (PM10), and PM < 2.5 μm in diameter (PM2.5). We evaluated the predictors as continuous and binary variables for values ≧ the 90th percentile for the 2020 calendar year. We determined day-level air pollutant levels using US EPA data cross-linked to patients’ Zip codes as a proxy for patient location, and we examined the outcomes of interest listed in the Table. We evaluated the association of air pollution to the outcomes of interest with (1) a case-crossover analysis using a conditional logistic regression model followed by (2) a time-varying exposure analysis using an Andersen-Gill model and day level air-pollutant levels as a time-varying exposure. The study cohort included 28349 patients (32% female, age 72.8±11.9), of whom 1822 (6.4%) had loop recorders, 17448 (61.6%) had pacemakers, and 9079 (32%) had defibrillators. In the case-crossover analysis, AQI and PM2.5 demonstrated non-significant trends toward higher ATP and shocks (Table). AQI and PM2.5 had significant but non-meaningful associations with change in heart rate, and PM2.5 with physical activity and thoracic impedance. The time-varying exposure analysis demonstrated significant but non-meaningful associations (ORs 0.99-1). In contrast to prior literature on ambient air pollution, these natural experiment analyses did not demonstrate acute or sub-acute association between AQI, PM2.5, or PM10 with ventricular arrhythmias, physical activity, or heart failure markers in CIED patients. Mediators of these findings merit further investigation to clarify causal and non-causal mechanisms." @default.
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• W4377014548 date "2023-05-01" @default.
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• W4377014548 title "PO-05-186 LEVERAGING A NATURAL EXPERIMENT TO DETERMINE THE EFFECT OF AIR POLLUTION ON VENTRICULAR ARRHYTHMIAS AND PHYSICAL ACTIVITY: THE 2020 U.S. WILDFIRES" @default.
• W4377014548 doi "https://doi.org/10.1016/j.hrthm.2023.03.1389" @default.
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