Drier air, lower temperatures, and triggering of paroxysmal atrial fibrillation

Abstract

Background: The few previous studies on the onset of paroxysmal atrial fibrillation and meteorologic conditions have focused on outdoor temperature and hospital admissions, but hospital admissions are a crude indicator of atrial fibrillation incidence, and studies have found other weather measures in addition to temperature to be associated with cardiovascular outcomes.

Methods: Two hundred patients with dual chamber implantable cardioverter-defibrillators were enrolled and followed prospectively from 2006 to 2010 for new onset episodes of atrial fibrillation. The date and time of arrhythmia episodes documented by the implanted cardioverter-defibrillators were linked to meteorologic data and examined using a case-crossover analysis. We evaluated associations with outdoor temperature, apparent temperature, air pressure, and three measures of humidity (relative humidity, dew point, and absolute humidity).

Results: Of the 200 enrolled patients, 49 patients experienced 328 atrial fibrillation episodes lasting ≥30 seconds. Lower temperatures in the prior 48 hours were positively associated with atrial fibrillation. Lower absolute humidity (ie, drier air) had the strongest and most consistent association: each 0.5 g/m decrease in the prior 24 hours increased the odds of atrial fibrillation by 4% (95% confidence interval [CI]: 0%, 7%) and by 5% (95% CI: 2%, 8%) for exposure in the prior 2 hours. Results were similar for dew point but slightly weaker.

Conclusions: Recent exposure to drier air and lower temperatures were associated with the onset of atrial fibrillation among patients with known cardiac disease, supporting the hypothesis that meteorologic conditions trigger acute cardiovascular episodes.

FIGURE

Percent change in the odds of atrial fibrillation associated with lower outdoor temperatures, air pressure, and humidity as a function of moving and lagged averages in the prior 72 hours. Lower temperature and apparent temperature in the prior 48 hours were positively associated with atrial fibrillation. Absolute humidity in the prior 2 hours had the strongest association; fibrillation the odds of atrial increased by 5% (95% confidence interval: 2%, 8%) for each decrease of 0.5 g/m³. Dew point and absolute humidity displayed a temporal pattern of weaker effects with increasing time since the atrial fibrillation event.