| BACKGROUND:Cardiac arrhythmias,an important public health problem,are associated with many cardiovascular complications,sudden cardiac death,consequently leading to decreased quality of life and work,increased disability and mortality,and high public healthcare expenditure.In recent years,the influence of fine particulate matters on air quality in China has been widely concerned at home and abroad.However,there are still controversies about the association of ambient fine particulate matter and the attacks of cardiac arrhythmias.OBJECTIVE:To investigate the association between short-term exposure to fine particulate matter(PM2.5)and the incidence of various cardiac arrhythmias in general population in Shanghai communities.Then,according to different gender and age stratification,to evaluate the effect of fine particulate matter on the incidence of cardiac arrhythmias in different populations.METHODS:Daily 12-lead ECG diagnosis results of outpatient visits from June 24,2014 to June 23,2016 were collected from the ECG remote diagnosis system of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,which includes 282 community hospitals in Shanghai.Air pollution data were obtained from China National Environment Monitoring Center including 9 air quality control monitoring stations located in Shanghai.Through the method of time-series analysis,a generalized additive quasi-Poisson model was used to examine the associations between PM2.5 and cardiac arrhythmias in different lag days after controlling for time trends,seasonality,meteorological factors(temperature,relative humidity),day of the week(DOW),public holidays.RESULTS:In total,there were 202661 cardiac arrhythmias visits in the study period.The daily mean PM2.5 concentration was 51.8?g/m~3,and ranging from 6?g/m~3 to 219?g/m~3.Per 10?g/m~3increase in PM2.5 concentration was associated with 0.584%(95%CI:0.346-0.689)increase in outpatient visits of cardiac arrhythmias at lag0-2 and with 0.366%(95%CI:0.200%-0.531%)and increase in outpatient visits at lag0.In different types of cardiac arrhythmias,the estimates of percentage change in daily outpatient visits with per 10?g/m~3 increase in PM2.5 concentration were0.709%(95%CI:0.176%-1.245%)increase for atrial fibrillation(AF)group at lag0-2,0.621%(95%CI:0.212%-1.032%)increase for premature atrial contractions and atrial tachycardia(PAC/AT)group at lag0-2,0.815%(95%CI:0.045%-1.592%)increase for supraventricular tachycardia(SVT)group at lag0 and 1.276%(95%CI:0.468%-2.091%)increase for atrioventricular block(AV-block)group at lag0-5.However,no significant association was found between PM2.5 and atrial flutter(AFL)group or premature ventricular contractions and ventricular tachycardia(PVC/VT)group.Moreover,the effect of PM2.5 on visits of cardiac arrhythmias in women was significantly higher than that in men at lag3 and lag0-4(p<0.05).The effect of PM2.5on visits of cardiac arrhythmias among people aged<65 years was significantly higher than the effect among people aged?65 years(p<0.05).CONCLUSION:Short-term exposure to PM2.5 could increase the risk of cardiac arrhythmias attacks in population in Shanghai communities,which also has a lag effect.The lag effect varies due to different types of cardiac arrhythmias.For AF,PAC and AT,the best lag day is lag0-2.For SVT,the best lag day is lag0 and for AV-block,the best lag day is lag0-5.Meanwhile,the effect of PM2.5 on cardiac arrhythmias is higher among women and people aged<65 years. |
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