Watanabe Eiichi, Kuno Yukiko, Takasuga Hirohisa, Tong MaoQing, Sobue Yoshihiro, Uchiyama Tatsushi, Kodama Itsuo, Hishida Hitoshi
Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
Heart Rhythm. 2007 Jan;4(1):27-31. doi: 10.1016/j.hrthm.2006.09.030. Epub 2006 Sep 28.
The incidence of various cardiovascular diseases is known to exhibit seasonal variations, but seasonal patterns of paroxysmal atrial fibrillation (AF) have not been well characterized.
The objective of this study was to determine whether seasonal variation affects the incidence of paroxysmal AF and whether this pattern is affected by patient age.
We identified 258 paroxysmal AF episodes in 237 patients (age 65 +/- 14 years, mean +/- standard deviation; age range 16-95 years) among 12,390 consecutive 24-hour Holter electrocardiogram recordings obtained from 2001 to 2005 at our institute. Seasonal variations were analyzed by both month and by season. The relative risk (RR) of AF for each period was determined as being high or low in relation to the overall mean incidence. The association among clinical covariates and risk of paroxysmal AF was tested by logistic regression analysis.
The incidence of paroxysmal AF was highest in September (RR = 1.40, 95% confidence interval [CI] 1.36-1.44) and lowest in June (RR = 0.52, 95% CI 0.50-0.54), with an RR difference of 63% (P < .001) among all patients. Patients aged > or =65 years demonstrated a peak incidence in September (RR = 1.46, 95% CI 1.41-1.51) and a minimum in June (RR = 0.55, 95% CI 0.52-0.58), while those aged <65 years showed a peak incidence in December (RR = 1.33, 95% CI 1.27-1.39) and a minimum in June (RR = 0.49, 95% CI 0.45-0.53). The incidence of paroxysmal AF also showed an autumn peak (RR = 1.21, 95% CI 1.16-1.27) and a summer minimum (RR = 0.66, 95% CI 0.62-0.70), with an RR difference of 53% (P < .001) among all patients. This seasonal variation in paroxysmal AF did not differ between patients of different age ranges. Clinical covariates including underlying disease or medications did not influence the monthly or seasonal variation in paroxysmal AF. There was a significant inverse relationship between the incidence of paroxysmal AF and the length of daylight in patients aged <65 years (r = -0.57, P < .05).
There was a significant seasonal variation in paroxysmal AF, with maximum and minimum incidences in autumn and summer, respectively, and this pattern was not age dependent.
已知各种心血管疾病的发病率呈现季节性变化，但阵发性心房颤动（AF）的季节模式尚未得到充分描述。
本研究的目的是确定季节变化是否影响阵发性AF的发病率，以及这种模式是否受患者年龄的影响。
我们在2001年至2005年于我院连续进行的12390份24小时动态心电图记录中，识别出237例患者（年龄65±14岁，平均±标准差；年龄范围16 - 95岁）中的258次阵发性AF发作。通过月份和季节分析季节性变化。将每个时期AF的相对风险（RR）确定为相对于总体平均发病率的高或低。通过逻辑回归分析测试临床协变量与阵发性AF风险之间的关联。
阵发性AF的发病率在9月最高（RR = 1.40，95%置信区间[CI] 1.36 - 1.44），在6月最低（RR = 0.52，95% CI 0.50 - 0.54），所有患者的RR差异为63%（P <.001）。年龄≥65岁的患者在9月发病率最高（RR = 1.46，95% CI 1.41 - 1.51），在6月最低（RR = 0.55，95% CI 0.52 - 0.58），而年龄<65岁的患者在12月发病率最高（RR = 1.33，95% CI 1.27 - 1.39），在6月最低（RR = 0.49，95% CI 0.45 - 0.53）。阵发性AF的发病率在秋季也出现高峰（RR = 1.21，95% CI 1.16 - 1.27），在夏季出现最低值（RR = 0.66，95% CI 0.62 - 0.70），所有患者的RR差异为53%（P <.001）。不同年龄范围的患者阵发性AF的这种季节性变化没有差异。包括基础疾病或药物在内的临床协变量不影响阵发性AF的月度或季节性变化。年龄<65岁的患者中，阵发性AF的发病率与日照时长之间存在显著的负相关（r = -0.57，P <.05）。
阵发性AF存在显著的季节性变化，分别在秋季和夏季发病率最高和最低，且这种模式与年龄无关。
