Daily Exposure to Air Pollution Particulate Matter Is Associated with Atrial Fibrillation in High-Risk Patients

Several epidemiological studies found an association between acute exposure to fine particulate matter of less than 2.5 μm and 10 μm in aerodynamic diameter (PM(2.5) and PM(10)) and cardiovascular diseases, ventricular fibrillation incidence and mortality. The effects of pollution on atrial fibrillation (AF) beyond the first several hours of exposure remain controversial. A total of 145 patients with implantable cardioverter-defibrillators (ICDs), cardiac resynchronization therapy defibrillators (ICD-CRT), or pacemakers were enrolled in this multicentric prospective study. Daily levels of PM(2.5) and PM(10) were collected from monitoring stations within 20 km of the patient’s residence. A Firth Logistic Regression model was used to evaluate the association between AF and daily exposure to PM(2.5) and PM(10). Exposure levels to PM(2.5) and PM(10) were moderate, being above the World Health Organization (WHO) PM(2.5) and PM(10) thresholds of 25 μg/m(3) and 50 μg/m(3), respectively, on 26% and 18% of the follow-up days. An association was found between daily levels of PM(2.5) and PM(10) and AF (95% confidence intervals (CIs) of 1.34–2.40 and 1.44–4.28, respectively) for an increase of 50 µg/m(3) above the WHO threshold. Daily exposure to moderate PM(2.5) and PM(10) levels is associated with AF in patients who are not prone to AF.