Case Report: Supraventricular Arrhythmia after Exposure to Concentrated Ambient Air Pollution Particles

CONTEXT Exposure to air pollution can result in the onset of arrhythmias. CASE PRESENTATION We present a case of a 58-year-old woman who volunteered to participate in a controlled exposure to concentrated ambient particles. Twenty minutes into the exposure, telemetry revealed new onset of atrial fibrillation. The exposure was discontinued, and she reverted to normal sinus rhythm approximately 2 hr later. No abnormality was evident on the volunteer's laboratory examination or echocardiography that could explain an increased risk for supraventricular arrhythmia. DISCUSSION Epidemiologic evidence strongly supports a relationship between exposure to air pollutants and cardiovascular disease, but population-level data are not directly relevant to the clinical presentation of individual cases. To our knowledge, this is the only case report of an individual suffering an episode of atrial fibrillation after exposure to an air pollutant. The resolution of the arrhythmia with termination of the particle exposure further supports a causal relationship between the two. RELEVANCE TO CLINICAL PRACTICE Exposure to air pollution, including particulate matter, may cause supraventricular arrhythmias.