Academic journal article Environmental Health Perspectives

Case Report: Supraventricular Arrhythmia after Exposure to Concentrated Ambient Air Pollution Particles

Academic journal article Environmental Health Perspectives

Case Report: Supraventricular Arrhythmia after Exposure to Concentrated Ambient Air Pollution Particles

Article excerpt

CONTEXT: Exposure to air pollution can result in the onset of arrhythmias.

CASE PRESENTATION: We present a case of a 58-year-old woman who volunteered to participate in a controlled exposure to concentrated ambient particles. Twenty minutes into the exposure, telemetry revealed new onset of atrial fibrillation. The exposure was discontinued, and she reverted to normal sinus rhythm approximately 2 hr later. No abnormality was evident on the volunteer's Laboratory examination or echocardiography that could explain an increased risk for supraventricular arrhythmia.

DIscussioN: Epidemiologic evidence strongly supports a relationship between exposure to air pollutants and cardiovascular disease, but population-level data are not directly relevant to the clinical presentation of individual cases. To our knowledge this is the only case report of an individual suffering an episode of atrial fibrillation after exposure to an air pollutant. The resolution of the arrhythmia with termination of the particle exposure further supports a causal relationship between the two.

RELEVANCE TO CLINICAL PRACTICE: Exposure to air pollution, including particulate matter, may cause supraventricular arrhythmias.

KEY WORDS: air pollution, arrhythmias, atrial fibrillation, atrial flutter, heart diseases, particulate matter. Environ Health Perspect 120: 275-277 (2012). http://dx.doi.org/10.1289/ehp.1l03877 [Online 6 September 2011]

Epidemiologic investigation supports a positive relationship between exposure to air pollution and cardiovascular disease (Rich et al. 2006), with the number of deaths from such illness estimated to exceed that for respiratory disease after exposures to elevated levels of pollutants (Dockery 2001). Air pollutants have been associated with acute cardiac events, including myocardial infarctions and cardiac arrests (Forastiere et al, 2005; Rosenthal et al. 2008; Zanobetti and Schwartz 2005). In addition) air pollution has been associated with the incidence of cardiac arrhythmias (Link and Dockery 2010; Peters et al. 2000; Routledge and Ayres 2005). Studies have demonstrated that discharges by implantable cardioverter defibrillators (ICDs) For ventricular arrhythmias increase with higher levels of black carbon, fine particles, coarse particles, nitric oxide, ozone, nitrogen dioxide, nitric oxide, carbon monoxide, and sulfur dioxide (Metzgcr er al. 2007; Peters et al. 2000; Rich et al. 2005, 2006; Santos et al. 2008). Evidence also supports an association between measures of air pollution and the incidence of supraventricular arrhythmias. In an ICD study, Rich et aI. (2005) Found a statistically significant relationship between the incidence of supraventricular arrhythmias and increased ozone concentrations in the hour preceding the arrhythmia. Holter examinations revealed an increased risk of supraventricular arrhythmias in association with 5-day moving averages of fine particles ozone, and sulfate in nonsmoking adults (Sarnat et al. 2006). In yet another Holter study, Berger et al. (2006) found that both supraventricular and ventricular arrhythmias increased in association with PM and nitrogen dioxide exposures (in the previous 24-72 hr and with 5-day moving averages) among men with coronary artery disease. These arrhythmias developed within a few hours of increased levels of air pollution (Ljungman et al. 2008).

Although epidemiologic data strongly support a relationship between exposure to air pollutants and cardiovascular disease, this methodology does not permit a description of the clinical presentation in an individual case. To our knowledge, this is the first case report of cardiovascular disease after exposure to elevated concentrations of any air pollutant.

Case Presentation

A 58-year-old Caucasian female visited the U.S. Environmental Protection Agency's Human Studies Facility in Chapel Hill, North Carolina, to participate in a study requiring sequential exposures to filtered air and concentrated ambient particles (LAPs). …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.