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Seasonal Variation in AF-related Admissions to a Coronary Care Unit in a “Hot” Climate: Fact or Fiction?

Kiu, Andrew Medical Student; Horowitz, John D. PhD, FRACP; Stewart, Simon PhD, RN, FAHA

Section Editor(s): Wood, Kathryn PhD, RN

The Journal of Cardiovascular Nursing: March-April 2004 - Volume 19 - Issue 2 - p 138–141

Background Seasonal variations in atrial fibrillation (AF)-related morbidity and mortality have been demonstrated in “cold” northern European climates, but there are few data describing such a phenomenon in a “hot” climate.

Research objective To examine the pattern of AF-related admissions to a coronary care unit (CCU) in South Australia operating within a Mediterranean climate, and to determine potential differences according to mean daily temperatures.

Patient cohort and methods A total of 144 admissions to the CCU during the 30 hottest and coldest days (60 days in total) during the calendar year 2001 were analyzed in respect to the absolute number of admissions and the profile of those admitted during “hot” and “cold” days.

Results Overall, there were significantly more admissions to the CCU on “cold” as opposed to “hot” days (90 vs 54 patients in 30 days, P ≤ .001). Of the 24 patients found to be in AF on presentation to hospital, 18 (75%) were admitted on cold days (P < .05). Alternatively, during “hot” days, patients were more likely to be diagnosed with unstable angina rather than acute myocardial infarction (46% vs 30%, P = .07) with proportionately fewer patients in AF at the time (11% vs 20%, P = NS).

Conclusions These preliminary data suggest that the phenomenon of seasonal variations in AF-related morbidity extend beyond colder climates to hotter climates with sufficiently large relative (as opposed to absolute) changes in ambient temperatures during the year.

Andrew Kiu, Medical Student, Cardiology Unit, University of Adelaide, North Terrace, Adelaide, Australia.

John D. Horowitz, PhD, FRACP, Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia.

Simon Stewart, PhD, RN, FAHA, NHF of Australia, Chair of Cardiovascular Nursing, School of Nursing and Midwifery, University of South Australia, Adelaide, Australia.

Corresponding author: Simon Stewart, PhD, RN, FAHA, School of Nursing and Midwifery, University of South Australia, City East Campus, North TCE, Adelaide, Australia (e-mail:

Professor Stewart in supported by the NHF of Australia and the NH&MRC of Australia.

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