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J Occup Environ Med. 2018 Dec;60(12):1082-1086. doi: 10.1097/JOM.0000000000001449.

Meteorological Factors and Air Pollutants Contributing to Seasonal Variation of Acute Exacerbation of Atrial Fibrillation: A Population-Based Study.

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Division of Cardiology, Department of Internal Medicine (Drs Ahn, Choe, Shin, Park, Lee, Oh, Choi, Lee, Cha, Hong); Biomedical Research Institute (Dr Ahn), Pusan National University Hospital; Department of Statistics, Pukyong National University (Dr Uhm); Department of Atmospheric Sciences, Pusan National University (Dr Won), Busan; Department of Statistics and Institute of Statistics, Hallym University, Chuncheon (Dr Han); and Division of Cardiology, Department of Internal Medicine, Korea University Medical Center, Seoul (Dr Kim), Republic of Korea.



We investigated seasonal variation of acute exacerbation of atrial fibrillation (AAF) and contributing environmental factors.


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.


AAF occurred less frequently in summer than in other seasons (6.71 vs 7.25 events/d, P = 0.005). AAF tended to decrease with an increase of air temperature (r = -0.058). Among air pollutants, NO2 was significantly lower in summer and positively correlated with AAF after adjusting for other variables (β = 3.197).


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.

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