Study Reveals Air Pollution Could Potentially Heighten Risk of Arrhythmia

An extensive investigation encompassing 322 Chinese cities demonstrates that short-term exposure to air pollution significantly elevates the risk of arrhythmia, particularly atrial flutter and supraventricular tachycardia. The study highlights an immediate and lasting link, emphasizing the urgency of implementing effective safeguard measures for susceptible individuals during intense pollution periods.

The impact of air pollution on heart health is the focus of the recent research. The study, conducted in 322 cities across China and published in the Canadian Medical Association Journal (CMAJ), suggests that a brief encounter with air pollution might heighten the risk of arrhythmia, an irregular heartbeat.

Globally, arrhythmia, such as atrial fibrillation and atrial flutter, affects approximately 59.7 million people. These common arrhythmia types can potentially progress into more severe heart conditions. Despite air pollution being a known manageable risk factor for heart disease, its relationship with arrhythmia has so far produced inconsistent results.

To establish a correlation, Chinese scientists analyzed hourly exposure to air pollution and the sudden onset of arrhythmia symptoms using data from 2025 hospitals in 322 Chinese cities. Given that air pollution in China significantly exceeds the World Health Organization’s air quality guidelines, the researchers utilized air pollutant concentration data from monitoring stations closest to the hospitals involved in the study.

“Our study discovered that acute exposure to environmental air pollution was linked to an increased risk of symptomatic arrhythmia,” says Dr. Renjie Chen, School of Public Health, Fudan University, Shanghai, China, and his co-authors. “The risks emerged in the first few hours post-exposure and could persist for up to 24 hours. The exposure–response relationships between six pollutants and four arrhythmia subtypes were roughly linear, with no noticeable concentration thresholds.”

The research involved 190,115 patients exhibiting acute symptomatic arrhythmia onset, including atrial fibrillation, atrial flutter, premature beats (originating either from the heart’s atria or ventricles), and supraventricular tachycardia.

Ambient air pollution exposure showed the strongest correlation with atrial flutter and supraventricular tachycardia, followed by atrial fibrillation and premature beats. Among the six pollutants, nitrogen dioxide (NO2) displayed the strongest link with all four arrhythmia types, and the association intensified with greater exposure.

“Although we don’t fully understand the exact mechanisms yet, the association we observed between air pollution and acute arrhythmia onset is biologically plausible,” the authors note. “Existing evidence suggests that air pollution modifies cardiac electrophysiological activities by inducing oxidative stress and systemic inflammation, influencing multiple membrane channels, and compromising autonomic nervous function.”

The authors reiterate the immediacy of the association and the critical need to shield vulnerable populations during heavy pollution episodes.

“Our research contributes further to the growing body of evidence relating adverse cardiovascular effects to air pollution, underscoring the necessity to continue efforts to reduce exposure to air pollution and protect vulnerable populations worldwide promptly,” they conclude.

Reference: “Hourly air pollution exposure and the onset of symptomatic arrhythmia: an individual-level case–crossover study in 322 Chinese cities” by Xiaowei Xue, Jialu Hu, Dingcheng Xiang, Huichu Li, Yixuan Jiang, Weiyi Fang, Hongbing Yan, Jiyan Chen, Weimin Wang, Xi Su, Bo Yu, Yan Wang, Yawei Xu, Lefeng Wang, Chunjie Li, Yundai Chen, Dong Zhao, Haidong Kan, Junbo Ge, Yong Huo and Renjie Chen, 1 May 2023, Canadian Medical Association Journal. DOI: 10.1503/cmaj.220929

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More about Air Pollution and Arrhythmia Risk

• The original study in the Canadian Medical Association Journal
• World Health Organization’s guidelines for air quality
• Understanding Arrhythmia
• Air pollution and heart disease
• The health effects of nitrogen dioxide