Meteorological factors and air pollutants contributing to seasonal variation of acute exacerbation of atrial fibrillation: A population-based study

Objective: We investigated seasonal variation of acute exacerbation of atrial fibrillation (AAF) and contributing environmental factors. Methods: AAF events, meteorological elements, and air pollutants in Seoul between 2013 and 2015 were obtained from the nationwide database. AAF was defined if a patient visited the emergency room due to any AF-relevant symptoms or signs. Results: AAF occurred less frequently in summer than in other seasons (6.71 vs 7.25 events/d, P ¼ 0.005). AAF tended to decrease with an increase of air temperature (r ¼ –0.058). Among air pollutants, NO₂ was significantly lower in summer and positively correlated with AAF after adjusting for other variables (b ¼ 3.197). Conclusions: The rate of AAF events was the lowest in summer; air temperature and NO₂ were contributing factors. The weather and environmental conditions should be considered as risk factors of AAF.