About This Project
Ongoing global climate change and air pollution emissions pose a major threat to cardiovascular health. Atrial fibrillation (AFib) is one of the most common cardiac arrhythmias and is associated with an increased risk of stroke, heart failure, and mortality. However, environmental risk factors that trigger AFib remain unclear. Our goal is to address this knowledge gap. We aim to identify the environmental triggers of AFib and the most vulnerable population to such triggers.
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What is the context of this research?
Climate change and air pollution are major public health challenges of the 21st century. Together, they pose a major threat to cardiovascular health. Moreover, such environmental factors often disproportionately impact vulnerable populations, including those who are older, socially disadvantaged, and have underlying health conditions. Understanding this is crucial for mitigating the harmful effects of climate change and air pollution.
Atrial fibrillation (AFib) is one of the most common cardiac arrhythmias. AFib is projected to increase from 5.2 million cases in 2010 to 12.1 million in 2030. AFib is associated with an increased risk of stroke, heart failure, and mortality. Therefore, understanding the risk factors for AFib is important for reducing its future public health burden.
What is the significance of this project?
Most epidemiologic evidence on AFib risk factors is derived from hospital admissions for AFib. However, because AFib episodes are often transient and asymptomatic, hospital admissions data underestimate the incidence of AFib. Also, it is unable to capture the exact moment and duration of AFib episodes using this data. The true incidence and clinical characteristics of AFib episodes can only be identified using continuous cardiac monitoring.
We will examine a cohort of ~550,000 patients across the US with implantable cardiac devices which continuously record heart rhythm/rate. This will allow us to precisely detect the date, time, and duration of AFib episodes. This study is one of the first and largest studies with accurate information on AFib episodes of a diverse population.
What are the goals of the project?
The goal of this project is to better understand the association between climate change, air pollution, and AFib. To achieve this goal, we will examine a cohort of ~550,000 patients to identify where (using the patient’s ZIP code) and when (using cardiac monitoring data) AFib episodes occurred. We will then link the AFib episodes to the nationwide climate data and air quality data.
Using this dataset, we will compare the exposure levels between days with vs. without AFib episodes to examine the association between environmental triggers and AFib. We further aim to identify those who are the most vulnerable to such environmental triggers. Our findings will be published in peer-reviewed journals and presented at academic conferences.
The funding will be used to cover essential costs for this project. This includes purchasing a US ZIP code database to geocode the location of the study participant's residential ZIP code ($2,500). We will link this to the nationwide meteorological data and air pollution data. The funding will also be used to purchase a workstation with high computing power that is necessary for statistical analyses ($1,940).
The timeline is based on four 3-month periods to complete this project.
January–March: Link the geographic location of the study participants to the environmental exposure data. Finalize statistical analysis plan.
April–June: Clean linked data. Conduct statistical analyses.
July–September: Prepare manuscripts. Share preliminary findings.
October–December: Finalize manuscript. Publish project results in peer-reviewed journals.
Nov 29, 2022
Mar 31, 2023
Link data and finalize statistical analysis plan
Jun 30, 2023
Clean linked data and conduct statistical analyses
Sep 30, 2023
Prepare manuscript and share preliminary findings
Dec 31, 2023
Meet the Team
Jihwan Park is a PhD student in the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health. His research interests include environmental exposure mixtures (i.e. heavy metals, air pollutants), health impact of climate change, and epidemiological methods.
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