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
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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.