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Weather and triggering of ventricular arrhythmias in patients with implantable cardioverter-defibrillators

Journal of Exposure Science & Environmental Epidemiology volume 25, pages 175–181 (2015)Cite this article

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Abstract

Outdoor ambient weather has been hypothesized to be responsible for the seasonal distribution of cardiac arrhythmias. Because people spend most of their time indoors, we hypothesized that weather-related arrhythmia risk would be better estimated using an indoor measure or an outdoor measure that correlates well with indoor conditions, such as absolute humidity. The clinical records of 203 patients in eastern Massachusetts, USA, with an implantable cardioverter-defibrillator were abstracted for arrhythmias between 1995 and 2002. We used case-crossover methods to examine the association between weather and ventricular arrhythmia (VA). Among 84 patients who experienced 787 VAs, lower estimated indoor temperature (odds ratio (OR)=1.16, 95% confidence interval (CI) 1.05–1.27 for a 1 °C decrease in the 24-h average) and lower absolute humidity (OR=1.06, 95% CI 1.03–1.08 for a 0.5 g/m3 decrease in the 96-h average) were associated with increased risk. Lower outdoor temperature increased risk only in warmer months, likely attributable to the poor correlation between outdoor and indoor temperature during cooler months. These results suggest that lower temperature and drier air are associated with increased risk of VA onset among implantable cardioverter-defibrillator patients.

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Abbreviations

AH:

absolute humidity

CAD:

coronary artery disease

d.f.:

degree of freedom

ECG:

electrocardiogram

ICD:

implantable cardioverter-defibrillator

PM2.5:

particulate matter <2.5 μm in aerodynamic diameter

SCD:

sudden cardiac death

VA:

ventricular arrhythmia

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Acknowledgements

This study was funded in part by grants from the Health Effects Institute (grant 98-14), the National Institute of Environmental Health Sciences (NIEHS) (grants ES09825 and R21ES020194), and the Harvard-NIEHS Center for Environmental Health (NIEHS ES00002). Particulate air pollution measurements at the Harvard School of Public Health were funded in part by the Environmental Protection Agency (EPA)-Harvard Center on Ambient Particle Health Effects (EPA grants R827353 and RD83479801), and measurements in South Boston were funded by contracts with the Boston Edison and Gillette companies (Boston, MA, USA). JLN received support from the Benjamin Greely Ferris, Jr. Fellowship Fund, and NIEHS grant T32ES007069. JS received support from NIEHS R21ES020695 and NIA R21AG040027. We thank the fellows and researchers who abstracted the ICD data. We especially thank David Q. Rich, who organized the abstraction of data and processed these data.

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Authors and Affiliations

  1. Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA

    Jennifer L Nguyen, Francine Laden, Joel Schwartz, Heike Luttmann-Gibson & Douglas W Dockery

  2. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA

    Francine Laden, Joel Schwartz & Douglas W Dockery

  3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Francine Laden, Joel Schwartz & Douglas W Dockery

  4. Division of Cardiology, Cardiac Arrhythmia Service, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA

    Mark S Link

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  1. Jennifer L Nguyen
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Correspondence to Jennifer L Nguyen.

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Nguyen, J., Laden, F., Link, M. et al. Weather and triggering of ventricular arrhythmias in patients with implantable cardioverter-defibrillators. J Expo Sci Environ Epidemiol 25, 175–181 (2015). https://doi.org/10.1038/jes.2013.72

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