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The Impact of Temperature and Relative Humidity on Ventricular Arrhythmias in Patients with Implanted Cardiac Devices: A Case Time Series Analysis in North Carolina, 2010-2021
Citation:
Hill, K., S. Cleland, L. Rosman, A. Mazzella, A. Rappold, L. Neas, AND C. Ward-Caviness. The Impact of Temperature and Relative Humidity on Ventricular Arrhythmias in Patients with Implanted Cardiac Devices: A Case Time Series Analysis in North Carolina, 2010-2021. ISES 2023 Annual Meeting, Chicago, IL, August 27 - 31, 2023.
Impact/Purpose:
We examined the effect of warm season weather conditions on the risk of ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with implanted cardiac devices. We used remote monitoring data on daily VT/VF occurrence in 526 patients enrolled in the University of North Carolina Cardiovascular Device Surveillance Registry between 2010-2021. Local average temperature and relative humidity (RH) exposure during mid-April to mid-October was estimated using weather station data. Associations between meteorology and VT/VF occurrence were estimated using a case time series design with distributed lag non-linear models. Models were adjusted for temporal trends and physical activity. VT/VF events occurred on 1,404 of the 96,144 person-days. Temperature was not associated with VT/VF, nor did it confound the association with RH. Instead, high RH increased VT/VF risk in 1-2 days following exposure. When RH increased from the median (73.8%) to the 95th percentile (90.0%), odds of VT/VF occurring the next day increased 11.7% (95% CI: 3.4%, 20.7%). Patients in neighborhoods with low urbanicity and high deprivation, as well as male, older, and white patients, had an elevated risk of VT/VF when exposed to high RH. Exposure to humid conditions during the warm season increased risk of VT/VF in patients with implanted cardiac devices, with key differences by individual- and area-level characteristics. Additional research in larger populations is needed to determine generalizability of these findings. Remote monitoring data may provide opportunities to increase resilience and reduce inequalities in patient outcomes.
Description:
Medical professionals are interested in using remote monitoring to identify at-risk populations, reduce outcome disparities, and provide timely interventions to vulnerable patients. We examined the effect of warm season weather conditions on the risk of ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with implanted cardiac devices. We used remote monitoring data on daily VT/VF occurrence in 526 patients enrolled in the University of North Carolina Cardiovascular Device Surveillance Registry between 2010-2021. Local average temperature and relative humidity (RH) exposure during mid-April to mid-October was estimated using weather station data. Associations between meteorology and VT/VF occurrence were estimated using a case time series design with distributed lag non-linear models. Models were adjusted for temporal trends and physical activity. VT/VF events occurred on 1,404 of the 96,144 person-days. Temperature was not associated with VT/VF, nor did it confound the association with RH. Instead, high RH increased VT/VF risk in 1-2 days following exposure. When RH increased from the median (73.8%) to the 95th percentile (90.0%), odds of VT/VF occurring the next day increased 11.7% (95% CI: 3.4%, 20.7%). Patients in neighborhoods with low urbanicity and high deprivation, as well as male, older, and white patients, had an elevated risk of VT/VF when exposed to high RH. Exposure to humid conditions during the warm season increased risk of VT/VF in patients with implanted cardiac devices, with key differences by individual- and area-level characteristics. Additional research in larger populations is needed to determine generalizability of these findings. Remote monitoring data may provide opportunities to increase resilience and reduce inequalities in patient outcomes.