Rapid weather changes are associated with daily hospital visitors for atrial fibrillation accompanied by abnormal ECG repolarization: A case-crossover study

Background: Atrial fibrillation (AF) is highly prevalent in the population, yet the factors contributing to AF events in susceptible individuals remain partially understood. The potential relationship between meteorological factors and AF, particularly with abnormal electrocardiograph (ECG) repolarization, has not been adequately studied. This case-crossover study aims to investigate the association between meteorological factors and daily hospital visits for AFwith abnormal ECG repolarization in Shanghai, China. Methods: : The study cohort comprised 10,325 patients with ECG-confirmed AF who sought treatment at Shanghai Sixth People's Hospital between 2015 and 2018. Meteorological and air pollutant concentration data were matched with the patient records. Using a case-crossover design, we analyzed the association between meteorological factors and the daily count of hospital visitors for AF with abnormal ECG repolarization at our AF center. Lag analysis models were applied to examine the temporal relationship between meteorological factors and AF events. Results: : The analysis revealed statistically significant associations between AF occurrence and specific meteorological factors. AF events were significantly associated with average atmospheric pressure (lag0d,OR0.9901,95%CI0.9825~0.9977,P<0.05), average temperature (lag1d,OR0.9890,95%CI0.9789~0.9992,P<0.05), daily pressure range (lag7d,OR1.0195,95%CI1.0079~1.0312,P<0.01), and daily temperature range (lag5d,OR1.0208,95%CI1.0087~1.0331,P<0.01). Moreover, a significant correlation was observed between daily pressure range and daily temperature range with AF patients, particularly those with abnormal ECG repolarization, as evident in the case-crossover analysis. Conclusion: This study highlights a significant correlation between meteorological factors and daily hospital visits for AF in Shanghai, China. Additionally, AF patients with abnormal ECG repolarization were found to be more vulnerable to rapid daily changes in pressure and temperature compared to AF patients without such repolarization abnormalities.