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Exposure to air pollution has been linked to deaths, including sudden death (arrhythmic mortality). A new study from the January 11, 2011, issue of the Journal of the American College of Cardiology (JACC) suggests the effects of air pollution on the heart and the rhythm of the heartbeat may be under-recognized. That’s because research finds that even healthy people with no known heart disease have detectable changes in important electrical properties of the heart when breathing in air pollution like the smog commonly encountered in cities worldwide.
Authors say these findings suggest that pollutants may impair the ability of the heart to reset its electrical properties in an orderly manner, especially during periods of acute or prolonged smog exposure, creating the conditions needed for arrhythmias, which can lead to sudden cardiac death in some cases.
Such data raises concerns that pollution-induced changes may pose an even greater risk to the increasing number of people who are surviving with structural heart disease. According to the authors, more research concerning the proarrhythmic role of pollutants is urgently needed, with concurrent physician awareness and participation in global efforts to increase education (e.g., smog alerts) and to reduce pollutant emissions.
The present study enrolled 25 healthy individuals (18 to 50 years if age) and, unlike observational and epidemiological studies, allowed for carefully controlled exposure to air pollution in the form of concentrated ambient fine particles (CAPs, which result from the combustion of fossil fuels from industry, traffic and power generators), ozone or both. Exposure-induced changes were captured by continuous electrocardiographic recordings, and pollutant levels and environmental conditions during exposures were controlled. Exposure-induced changes were most pronounced when breathing in both CAP and ozone.
Rachel Lambert, MD, Yale School of Medicine gives further credence to these findings. “This study adds significantly to our understanding of the pathophysiological links between air pollution and ventricular arrhythmias and sudden death,” she writes in her accompanying editorial. “Future studies can focus further on populations at risk as well as other indices of repolarization heterogeneity to confirm these mechanistic pathways.”
The American College of Cardiology is transforming cardiovascular care and improving heart health through continuous quality improvement, patient-centered care, payment innovation and professionalism. The College is a 39,000-member nonprofit medical society comprised of physicians, surgeons, nurses, physician assistants, pharmacists and practice managers, and bestows credentials upon cardiovascular specialists who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at http://www.cardiosource.org/ACC.