Main air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis

Objective: Previous studies of ambient air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillator (ICD) have yielded mixed results, and the association between air pollution and ventricular arrhythmias in these patients remains unclear. This study aimed to ass...

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Autores principales: Hong-Jie Yang, Xin Liu, Chuan Qu, Shao-Bo Shi, Jin-Jun Liang, Bo Yang
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Publicado: KeAi Communications Co., Ltd. 2017
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spelling oai:doaj.org-article:3a1001c2f1ba48d5a3dcdb475ff4a3c12021-12-02T14:15:53ZMain air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis2095-882X10.1016/j.cdtm.2017.09.001https://doaj.org/article/3a1001c2f1ba48d5a3dcdb475ff4a3c12017-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095882X17300634https://doaj.org/toc/2095-882XObjective: Previous studies of ambient air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillator (ICD) have yielded mixed results, and the association between air pollution and ventricular arrhythmias in these patients remains unclear. This study aimed to assess and quantify the association between exposure to major air pollutants [CO, inhalable particles (PM10), SO2, fine particulate matter (PM2.5), O3, and NO2] and the presence of ventricular arrhythmia in patients with ICD. Methods: The Medline, PubMed, Web of Science, Global Health Library, Virtual Health Library, Population Information Online (POPLINE), and New York Academy of Medicine Grey Literature Report databases were searched to identify studies analyzing the association between ventricular arrhythmias in patients with ICD and the abovementioned main air pollutants. Pooled estimates were generated using a random-effects model or fixed-effects model, according to the value of heterogeneity. Heterogeneity within studies was assessed using Cochran's Q and I2 statistics. Funnel plots, Egger's regression test, and Begg's rank correlation method were used to evaluate publication bias. Sensitivity analyses were also conducted to evaluate the potential sources of heterogeneity. Results: After a detailed screening of 167 studies, seven separate studies were identified. Ventricular arrhythmias in patients with ICD were found to be positively, but not significantly, associated with CO, PM10, SO2, PM2.5, and NO2, with a pooled estimate [odds ratio (OR) associated with each 10 μg/m3 increase in pollutant concentration, except for CO, which was associated with each 1 mg/m3 increase in concentration] of 1.03 [95% confidence interval (CI): 0.92–1.17, P = 0.59] for CO, 1.01 (95%CI: 0.97–1.05, P = 0.55) for PM10, 1.09 (95%CI: 0.95–1.24, P = 0.22) for SO2, 1.07 (95%CI: 0.95–1.21, P = 0.25) for PM2.5, and 1.06 (95%CI: 0.98–1.14, P = 0.16) for NO2. No increased risk of ventricular arrhythmias in patients with ICD was found to be associated with O3 (OR = 1.00; 95%CI: 0.98–1.01, P = 0.56). Conclusions: The results of this study provide little evidence that ambient air pollutants affect the risk of ICD discharges for treating ventricular arrhythmias.Hong-Jie YangXin LiuChuan QuShao-Bo ShiJin-Jun LiangBo YangKeAi Communications Co., Ltd.articleAir pollutantsVentricular arrhythmiaImplantable cardioverter-defibrillatorSystematic reviewMedicine (General)R5-920ENChronic Diseases and Translational Medicine, Vol 3, Iss 4, Pp 242-251 (2017)
institution DOAJ
collection DOAJ
language EN
topic Air pollutants
Ventricular arrhythmia
Implantable cardioverter-defibrillator
Systematic review
Medicine (General)
R5-920
spellingShingle Air pollutants
Ventricular arrhythmia
Implantable cardioverter-defibrillator
Systematic review
Medicine (General)
R5-920
Hong-Jie Yang
Xin Liu
Chuan Qu
Shao-Bo Shi
Jin-Jun Liang
Bo Yang
Main air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis
description Objective: Previous studies of ambient air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillator (ICD) have yielded mixed results, and the association between air pollution and ventricular arrhythmias in these patients remains unclear. This study aimed to assess and quantify the association between exposure to major air pollutants [CO, inhalable particles (PM10), SO2, fine particulate matter (PM2.5), O3, and NO2] and the presence of ventricular arrhythmia in patients with ICD. Methods: The Medline, PubMed, Web of Science, Global Health Library, Virtual Health Library, Population Information Online (POPLINE), and New York Academy of Medicine Grey Literature Report databases were searched to identify studies analyzing the association between ventricular arrhythmias in patients with ICD and the abovementioned main air pollutants. Pooled estimates were generated using a random-effects model or fixed-effects model, according to the value of heterogeneity. Heterogeneity within studies was assessed using Cochran's Q and I2 statistics. Funnel plots, Egger's regression test, and Begg's rank correlation method were used to evaluate publication bias. Sensitivity analyses were also conducted to evaluate the potential sources of heterogeneity. Results: After a detailed screening of 167 studies, seven separate studies were identified. Ventricular arrhythmias in patients with ICD were found to be positively, but not significantly, associated with CO, PM10, SO2, PM2.5, and NO2, with a pooled estimate [odds ratio (OR) associated with each 10 μg/m3 increase in pollutant concentration, except for CO, which was associated with each 1 mg/m3 increase in concentration] of 1.03 [95% confidence interval (CI): 0.92–1.17, P = 0.59] for CO, 1.01 (95%CI: 0.97–1.05, P = 0.55) for PM10, 1.09 (95%CI: 0.95–1.24, P = 0.22) for SO2, 1.07 (95%CI: 0.95–1.21, P = 0.25) for PM2.5, and 1.06 (95%CI: 0.98–1.14, P = 0.16) for NO2. No increased risk of ventricular arrhythmias in patients with ICD was found to be associated with O3 (OR = 1.00; 95%CI: 0.98–1.01, P = 0.56). Conclusions: The results of this study provide little evidence that ambient air pollutants affect the risk of ICD discharges for treating ventricular arrhythmias.
format article
author Hong-Jie Yang
Xin Liu
Chuan Qu
Shao-Bo Shi
Jin-Jun Liang
Bo Yang
author_facet Hong-Jie Yang
Xin Liu
Chuan Qu
Shao-Bo Shi
Jin-Jun Liang
Bo Yang
author_sort Hong-Jie Yang
title Main air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis
title_short Main air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis
title_full Main air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis
title_fullStr Main air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis
title_full_unstemmed Main air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis
title_sort main air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: a systematic review and meta-analysis
publisher KeAi Communications Co., Ltd.
publishDate 2017
url https://doaj.org/article/3a1001c2f1ba48d5a3dcdb475ff4a3c1
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