Association between air pollution and development of atrial fibrillation: A meta-analysis of observational studies.

BACKGROUND: Current evidence suggests that gaseous or particulate pollutants may increase the risk of atrial fibrillation (AF), although this association is still uncertain.

METHODS: We conducted a systematic review of literature using PubMed, Ovid, Embase and Web of Science to identify studies reporting on the association between gaseous (ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide) or particulate matter 2.5 (PM2.5) and AF risk published until March 2015. The overall effect estimate was presented as the population-attributable risks with 95% CI. We used both fix-effects and random effects models to calculate the overall effect estimate.

RESULTS: We retrieved 4 studies, involving 461,441 participants. There was a statistically significant association between AF development and all gaseous pollutant as well as PM2.5 [NO: 1.19% (0.70-1.67%), CO: 0.60 (0.20-1.09), SO2 : 0.90 (0.60-1.28), O3 : 1.09 (0.20-1.86), PM2.5 : 0.89 (0.20-1.57)].

CONCLUSIONS: Our comprehensive meta-analysis suggests that gaseous or particulate pollutants are associated with the increased risk of AF.