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/m3 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.

Fine-scale spatial and temporal variation in temperature and arrhythmia episodes in the VA Normative Aging Study

“…In Boston, patients with implantable cardioverter-defibrillators exposed to drier air and lower temperatures were associated with the onset of atrial fibrillation (Nguyen et al, 2015). In the same cohort the authors found a nonlinear association between outdoor temperature and ventricular arrhythmias, with lower temperature and drier air were associated with increased risk of ventricular arrhythmia onset (Nguyen et al, 2013).…”

“…Increased mortality has been linked not only to heat wave episodes (Kaiser et al, 2007; Le Tertre et al, 2006; Ostro et al, 2009), but also to exposure to colder weather conditions (Analitis et al, 2008; Lee et al, 2014). These studies focused on hospital admissions or mortality, while fewer studies have investigated patient’s specific onset of arrhythmia (Nguyen et al, 2013; Nguyen et al, 2015; McGuinn et al, 2013). Some studies showed that chronic disease including cardiovascular disease, diabetes mellitus, mental illness, but also sociodemographic characteristics, and social isolation may heighten susceptibility to temperature-related mortality (Basu, 2009; O’Neill et al, 2003; Zanobetti et al, 2013), and that even without known chronic medical conditions, aging may increase susceptibility to the cardiovascular effects of temperature extremes and changes in temperature.…”

Winter season mortality: will climate warming bring benefits?

“…It has been shown that dry air increases the risk of influenza infection and probably other respiratory viruses (Shaman and Kohn, 2009). Dry air exposure has been associated with cardiac arrhythmias in an adult cohort (Nguyen et al, in press). Another recent study showed that indoor and outdoor absolute humidity was highly correlated in winter in Boston (Nguyen et al, 2013).…”

Correlation between Concentration of Air Pollutants and Occurrence of Cardiac Arrhythmias in a Region with Humid Continental Climate

“…It should be noted that daily concentrations of air pollutants were below the permissible exposure limits during the study period. Nguyen et al found negative association between air temperature and occurrence of Afi b 14 . Gluszak et al report no association between air temperature, pressure, or relative humidity, and occurrence of Afi b 15 .…”