Fine Particulate air Pollution is Associated with Higher Vulnerability to Atrial Fibrillation—The APACR Study

The acute effects and the time course of fine particulate pollution (PM(2.5)) on atrial fibrillation/flutter (AF) predictors, including P-wave duration, PR interval duration, and P-wave complexity, were investigated in a community-dwelling sample of 106 nonsmokers. Individual-level 24-h beat-to-beat electrocardiogram (ECG) data were visually examined. After identifying and removing artifacts and arrhythmic beats, the 30-min averages of the AF predictors were calculated. A personal PM(2.5) monitor was used to measure individual-level, real-time PM(2.5) exposures during the same 24-h period, and corresponding 30-min average PM(2.5) concentration were calculated. Under a linear mixed-effects modeling framework, distributed lag models were used to estimate regression coefficients (βs) associating PM(2.5) with AF predictors. Most of the adverse effects on AF predictors occurred within 1.5–2 h after PM(2.5) exposure. The multivariable adjusted βs per 10-µg/m(3) rise in PM(2.5) at lag 1 and lag 2 were significantly associated with P-wave complexity. PM(2.5) exposure was also significantly associated with prolonged PR duration at lag 3 and lag 4. Higher PM(2.5) was found to be associated with increases in P-wave complexity and PR duration. Maximal effects were observed within 2 h. These findings suggest that PM(2.5) adversely affects AF predictors; thus, PM(2.5) may be indicative of greater susceptibility to AF.